Abstract
Purpose Although associated with an overall favorable survival rate, the heterogeneity of non-muscle invasive bladder cancer (NMIBC) affects patients’ rates of recurrence and progression. Risk stratification should influence evaluation, treatment and surveillance. This guideline attempts to provide a clinical framework for the management of NMIBC. Materials and Methods A systematic review utilized research from the Agency for Healthcare Research and Quality (AHRQ) and additional supplementation by the authors and consultant methodologists. Evidence-based statements were based on body of evidence strength Grade A, B, or C and were designated as Strong, Moderate, and Conditional Recommendations with additional statements presented in the form of Clinical Principles or Expert Opinions.1 Results A risk-stratified approach categorizes patients into broad groups of low-, intermediate-, and high-risk. Importantly, the evaluation and treatment algorithm takes into account tumor characteristics and uniquely considers a patient's response to therapy. The 38 statements vary in level of evidence, but none include Grade A evidence, and many were Grade C. Conclusion The intensity and scope of care for NMIBC should focus on patient, disease, and treatment response characteristics. This guideline attempts to improve a clinician's ability to evaluate and treat each patient, but higher quality evidence in future trials will be essential to improve level of care for these patients.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1021-1029 |
| Number of pages | 9 |
| Journal | Journal of Urology |
| Volume | 196 |
| Issue number | 4 |
| DOIs | |
| State | Published - Oct 1 2016 |
| Externally published | Yes |
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Keywords
- cystectomy
- drug therapy
- immunotherapy
- urinary bladder neoplasms
ASJC Scopus subject areas
- Urology
Cite this
Diagnosis and Treatment of Non-Muscle Invasive Bladder Cancer : AUA/SUO Guideline. / Chang, Sam S.; Boorjian, Stephen A.; Chou, Roger; Clark, Peter E.; Daneshmand, Siamak; Konety, Badrinath R.; Pruthi, Raj; Quale, Diane Z.; Ritch, Chad; Seigne, John D.; Skinner, Eila Curlee; Smith, Norm D.; McKiernan, James M.
In: Journal of Urology, Vol. 196, No. 4, 01.10.2016, p. 1021-1029.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Diagnosis and Treatment of Non-Muscle Invasive Bladder Cancer
T2 - AUA/SUO Guideline
AU - Chang, Sam S.
AU - Boorjian, Stephen A.
AU - Chou, Roger
AU - Clark, Peter E.
AU - Daneshmand, Siamak
AU - Konety, Badrinath R.
AU - Pruthi, Raj
AU - Quale, Diane Z.
AU - Ritch, Chad
AU - Seigne, John D.
AU - Skinner, Eila Curlee
AU - Smith, Norm D.
AU - McKiernan, James M.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Purpose Although associated with an overall favorable survival rate, the heterogeneity of non-muscle invasive bladder cancer (NMIBC) affects patients’ rates of recurrence and progression. Risk stratification should influence evaluation, treatment and surveillance. This guideline attempts to provide a clinical framework for the management of NMIBC. Materials and Methods A systematic review utilized research from the Agency for Healthcare Research and Quality (AHRQ) and additional supplementation by the authors and consultant methodologists. Evidence-based statements were based on body of evidence strength Grade A, B, or C and were designated as Strong, Moderate, and Conditional Recommendations with additional statements presented in the form of Clinical Principles or Expert Opinions.1 Results A risk-stratified approach categorizes patients into broad groups of low-, intermediate-, and high-risk. Importantly, the evaluation and treatment algorithm takes into account tumor characteristics and uniquely considers a patient's response to therapy. The 38 statements vary in level of evidence, but none include Grade A evidence, and many were Grade C. Conclusion The intensity and scope of care for NMIBC should focus on patient, disease, and treatment response characteristics. This guideline attempts to improve a clinician's ability to evaluate and treat each patient, but higher quality evidence in future trials will be essential to improve level of care for these patients.
AB - Purpose Although associated with an overall favorable survival rate, the heterogeneity of non-muscle invasive bladder cancer (NMIBC) affects patients’ rates of recurrence and progression. Risk stratification should influence evaluation, treatment and surveillance. This guideline attempts to provide a clinical framework for the management of NMIBC. Materials and Methods A systematic review utilized research from the Agency for Healthcare Research and Quality (AHRQ) and additional supplementation by the authors and consultant methodologists. Evidence-based statements were based on body of evidence strength Grade A, B, or C and were designated as Strong, Moderate, and Conditional Recommendations with additional statements presented in the form of Clinical Principles or Expert Opinions.1 Results A risk-stratified approach categorizes patients into broad groups of low-, intermediate-, and high-risk. Importantly, the evaluation and treatment algorithm takes into account tumor characteristics and uniquely considers a patient's response to therapy. The 38 statements vary in level of evidence, but none include Grade A evidence, and many were Grade C. Conclusion The intensity and scope of care for NMIBC should focus on patient, disease, and treatment response characteristics. This guideline attempts to improve a clinician's ability to evaluate and treat each patient, but higher quality evidence in future trials will be essential to improve level of care for these patients.
KW - cystectomy
KW - drug therapy
KW - immunotherapy
KW - urinary bladder neoplasms
UR - http://www.scopus.com/inward/record.url?scp=84995939797&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84995939797&partnerID=8YFLogxK
U2 - 10.1016/j.juro.2016.06.049
DO - 10.1016/j.juro.2016.06.049
M3 - Article
C2 - 27317986
AN - SCOPUS:84995939797
VL - 196
SP - 1021
EP - 1029
JO - Journal of Urology
JF - Journal of Urology
SN - 0022-5347
IS - 4
ER -