학술논문
EAU–ESMO consensus statements on the management of advanced and variant bladder cancer - an international collaborative multi-stakeholder effort: under the auspices of the EAU and ESMO Guidelines Committees
Document Type
Author
Horwich, A; Babjuk, M; Bellmunt, J; Bruins, H M; Reijke, T M De; Santis, M De; Gillessen, S; James, N; Maclennan, S; Palou, J; Powles, T; Ribal, M J; Shariat, S F; Kwast, T Van Der; Xylinas, E; Agarwal, N; Arends, T; Bamias, A; Birtle, A; Black, P C; Bochner, B H; Bolla, M; Boormans, J L; Bossi, A; Briganti, A; Brummelhuis, I; Burger, M; Castellano, D; Cathomas, R; Chiti, A; Choudhury, A; Compérat, E; Crabb, S; Culine, S; Bari, B De; Blok, W De; De Visschere, P J L; Decaestecker, K; Dimitropoulos, K; Dominguez-Escrig, J L; Fanti, S; Fonteyne, V; Frydenberg, M; Futterer, J J; Gakis, G; Geavlete, B; Gontero, P; Grubmüller, B; Hafeez, S; Hansel, D E; Hartmann, A; Hayne, D; Henry, A M; Hernandez, V; Herr, H; Herrmann, K; Hoskin, P; Huguet, J; Jereczek-Fossa, B A; Jones, R; Kamat, A M; Khoo, V; Kiltie, A E; Krege, S; Ladoire, S; Lara, P C; Leliveld, A; Linares-Espinós, E; Løgager, V; Lorch, A; Loriot, Y; Meijer, R; Mir, M Carmen; Moschini, M; Mostafid, H; Müller, A-C; Müller, C R; N'Dow, J; Necchi, A; Neuzillet, Y; Oddens, J R; Oldenburg, J; Osanto, S; Oyen, W J G; Pacheco-Figueiredo, L; Pappot, H; Patel, M I; Pieters, B R; Plass, K; Remzi, M; Retz, M; Richenberg, J; Rink, M; Roghmann, F; Rosenberg, J E; Rouprêt, M; Rouvière, O; Salembier, C; Salminen, A; Sargos, P; Sengupta, S; Sherif, Amir; Smeenk, R J; Smits, A; Stenzl, A; Thalmann, G N; Tombal, B; Turkbey, B; Lauridsen, S Vahr; Valdagni, R; Van Der Heijden, A G; Van Poppel, H; Vartolomei, M D; Veskimäe, E; Vilaseca, A; Rivera, F A Vives; Wiegel, T; Wiklund, P; Williams, A; Zigeuner, R; Witjes, J A
Source
Annals of Oncology. 30(11):1697-1727
Subject
Language
English
ISSN
0923-7534
1569-8041
1569-8041
Abstract
BACKGROUND: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial.OBJECTIVE: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management.DESIGN: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts before voting during a consensus conference.SETTING: Online Delphi survey and consensus conference.PARTICIPANTS: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus).RESULTS AND LIMITATIONS: Overall, 116 statements were included in the Delphi survey. Of these, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease and the evolving role of checkpoint inhibitor therapy in metastatic disease.CONCLUSIONS: These consensus statements provide further guidance on controversial topics in advanced and variant bladder cancer management until a time where further evidence is available to guide our approach.