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†.

Horwich, A and Babjuk, M and Bellmunt, J and Bruins, H M and Reijke, T M De and Santis, M De and Gillessen, S and James, N and Maclennan, S and Palou, J and Powles, T and Ribal, M J and Shariat, S F and Kwast, T Van Der and Xylinas, E and Agarwal, N and Arends, T and Bamias, A and Birtle, A and Black, P C and Bochner, B H and Bolla, M and Boormans, J L and Bossi, A and Briganti, A and Brummelhuis, I and Burger, M and Castellano, D and Cathomas, R and Chiti, A and Choudhury, A and Compérat, E and Crabb, S and Culine, S and Bari, B De and Blok, W De and De Visschere, P J L and Decaestecker, K and Dimitropoulos, K and Dominguez-Escrig, J L and Fanti, S and Fonteyne, V and Frydenberg, M and Futterer, J J and Gakis, G and Geavlete, B and Gontero, P and Grubmüller, B and Hafeez, S and Hansel, D E and Hartmann, A and Hayne, D and Henry, A M and Hernandez, V and Herr, H and Herrmann, K and Hoskin, P and Huguet, J and Jereczek-Fossa, B A and Jones, R and Kamat, A M and Khoo, V and Kiltie, A E and Krege, S and Ladoire, S and Lara, P C and Leliveld, A and Linares-Espinós, E and Løgager, V and Lorch, A and Loriot, Y and Meijer, R and Mir, M Carmen and Moschini, M and Mostafid, H and Müller, A-C and Müller, C R and N'Dow, J and Necchi, A and Neuzillet, Y and Oddens, J R and Oldenburg, J and Osanto, S and Oyen, W J G and Pacheco-Figueiredo, L and Pappot, H and Patel, M I and Pieters, B R and Plass, K and Remzi, M and Retz, M and Richenberg, J and Rink, M and Roghmann, F and Rosenberg, J E and Rouprêt, M and Rouvière, O and Salembier, C and Salminen, A and Sargos, P and Sengupta, S and Sherif, A and Smeenk, R J and Smits, A and Stenzl, A and Thalmann, G N and Tombal, B and Turkbey, B and Lauridsen, S Vahr and Valdagni, R and Van Der Heijden, A G and Van Poppel, H and Vartolomei, M D and Veskimäe, E and Vilaseca, A and Rivera, F A Vives and Wiegel, T and Wiklund, P and Williams, A and Zigeuner, R and Witjes, J A (2019) 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†. Annals of oncology : official journal of the European Society for Medical Oncology. ISSN 1569-8041.

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Official URL: https://academic.oup.com/annonc/advance-article/do...

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.

Item Type: Article
Subjects: QZ Pathology. Oncology
Divisions: Planned IP Care > Oncology and Clinical Haematology
Related URLs:
Depositing User: Mr Philip O'Reilly
Date Deposited: 27 Nov 2019 09:41
Last Modified: 27 Nov 2019 09:41
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2624

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