Evidence map›Paper›PMID 41922791›Full record

ArticleNature reviews. Urology2026

Active surveillance in low-grade NMIBC - results of an international two-round modified Delphi consensus.

Roberto Contieri, Paolo Gontero, Rodolfo Hurle, Luca Afferi, Simone Albisinni, Marek Babjuk, Alison Birtle, Peter Black, Maurizio Brausi, Max Bruins and 48 more

Abstract readConsensus Statement
PubMed Publisher
In one paragraph

Article in Nature reviews. Urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

58 authors.

Roberto ContieriDepartment of Urology, Istituto Nazionale Tumori di Napoli, IRCCS 'G. Pascale', Naples, Italy.ORCID http://orcid.org/0000-0001-7011-0537
Paolo GonteroDivision of Urology, Department of Surgical Sciences, AOU Città della Salute e della Scienza at Molinette Hospital and University of Turin, Turin, Italy.
Rodolfo HurleDepartment of Urology, Humanitas Clinical and Research Institute IRCCS, Milan, Italy.
Luca AfferiDepartment of Urology, Kantonsspital Aarau, Aarau, Switzerland.
Simone AlbisinniUrology Unit, Department of Surgical Sciences, Tor Vergata University Hospital, University of Rome Tor Vergata, Rome, Italy.
Marek BabjukDepartment of Urology, Teaching Hospital Motol, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic.
Alison BirtleUniversity of Manchester, Manchester, UK.
Peter BlackDepartment of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada.ORCID http://orcid.org/0000-0002-2919-7068
Maurizio BrausiDepartment of Urology, Hesperia Hospital, Modena, Italy.
Max BruinsDepartment of Urology, Zuyderland Medisch Centrum, Sittard/Heerlen, The Netherlands.
Otakar ČapounDepartment of Urology, General University Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czechia.
Albert CarrionDepartment of Urology, Vall Hebron Hospital, Autonomous University of Barcelona, Barcelona, Spain.
James CattoDivision of Clinical Medicine, School of Medicine & Population Health, University of Sheffield, Sheffield, UK.
Ananya ChoudhuryClinical Oncology, The Christie NHS Foundation Trust, Manchester, UK.
Alessia CimadamoreInstitute of Pathological Anatomy, Department of Medicine, University of Udine, Udine, Italy.
Eva ComperatDepartment of Pathology, Medical University Vienna, Vienna, Austria.
Siamak DaneshmandDepartment of Urology, USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
David D'andreaDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.ORCID http://orcid.org/0000-0003-1625-1077
Francesco Del GiudiceDepartment of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy.ORCID http://orcid.org/0000-0003-3865-5988
Jose Luis Domínguez EscrigDepartment of Urology, Instituto Valenciano de Oncologia, Valencia, Spain.
Patrick HensleyDepartment of Urology, University of Kentucky College of Medicine, Lexington, KY, USA.
Wojciech KrajewskiUniversity Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, Wroclaw, Poland.
Ekaterina LaukhtinaDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.ORCID http://orcid.org/0000-0002-8953-0272
Roger LiDepartment of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.ORCID http://orcid.org/0000-0003-1274-7200
Fredrik LiedbergDivision of Urological Research, Department of Translational Medicine, Lund University, Skåne University Hospital, Malmö, Sweden.
Yair LotanUniversity of Texas Southwestern, Dallas, TX, USA.ORCID http://orcid.org/0000-0001-5692-2723
Gautier MarcqDepartment of Urology, CHU Lille, Lille UniversityUniversity, Lille, France.ORCID http://orcid.org/0000-0002-1806-1448
Paramananthan MariappanEdinburgh Bladder Cancer Surgery (EBCS), Department of Urology, Western General Hospital, Edinburgh, UK.ORCID http://orcid.org/0000-0001-8221-4640
Andrea MariUnit of Oncologic Minimally-Invasive Urology and Andrology, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, Florence, Italy.
Alberto MartiniDepartment of Urology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.ORCID http://orcid.org/0000-0003-1272-7154
Alexandra Masson LecomteDepartment of Urology, Hôpital Saint-Louis AP-HP, Université Paris Cité, Paris, France.
Richard MeijerDepartment of Oncological Urology, University Medical Center Utrecht, Utrecht, The Netherlands.
Maria Carmen MirDepartment of Urology, Mount Sinai Icahn School of Medicine, Elmhurst/Queens Hospitals, New York, NY, USA.ORCID http://orcid.org/0000-0002-1391-1378
Keiichiro MoriDepartment of Urology, Jikei University School of Medicine, Tokyo, Japan.ORCID http://orcid.org/0000-0002-6147-6569
Marco MoschiniDivision of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.
Hugh MostafidDepartment of Urology, Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK.
Micheal O'DonnellDepartment of Urology, University of Iowa, Iowa City, IA, USA; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA.ORCID http://orcid.org/0000-0001-7202-6427
Joan PalouDepartment of Urology, Fundació Puigvert, Barcelona, Spain.
Valeria PanebiancoDepartment of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.ORCID http://orcid.org/0000-0001-8466-918X
Sisto PerdonàDepartment of Urology, Istituto Nazionale Tumori di Napoli, IRCCS 'G. Pascale', Naples, Italy.
Sima PortenDepartment of Urology, University of California San Francisco, San Francisco, CA, USA.
Sarah PsutkaDepartment of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
Michael RinkDepartment of Urology, Marienkrankenhaus Hamburg, Hamburg, Germany.
Morgan RoupretGRC n°5, Predictive Onco-Urology, Ap-Hp, Hôpital Pitié-Salpêtrière Urology, Sorbonne Université, Paris, France.
Thomas SeisenGRC n°5, Predictive Onco-Urology, Ap-Hp, Hôpital Pitié-Salpêtrière Urology, Sorbonne Université, Paris, France.ORCID http://orcid.org/0000-0003-4602-8351
Mark SolowayUrologic Oncology, Memorial Physician Group, Division of Urology, Memorial Healthcare System, Aventura, FL, USA.ORCID http://orcid.org/0000-0002-8198-0922
Viktor SoukupDepartment of Urology, General University Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czechia.
Gary SteinbergDepartment of Urology, Rush University Medical Center, Chicago, IL, USA.
Arnulf StenzlDepartment of Urology, Eberhard-Karls-University, Tübingen, Germany.
Jeremy Yc TeohDepartment of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.ORCID http://orcid.org/0000-0002-9361-2342
Karl TullyDepartment of Urology and Neurourology, Marien Hospital Herne, Ruhr-University Bochum, Herne, Germany.
Toine van der HeijdenDepartment of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0002-8839-8601
Bas W G van RhijnDepartment of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Alfred WitjesDepartment of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Evanguelos XylinasDepartment of Urology, Bichat Claude Bernard Hospital, Paris University, Paris, France.
Ashish M KamatDepartment of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.ORCID http://orcid.org/0000-0003-3546-9928
Benjamin PradereDepartment of Urology, La Croix Du Sud Hospital, Quint-Fonsegrives, France.ORCID http://orcid.org/0000-0002-7768-8558
Laura S MertensDepartment of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. l.mertens@nki.nl.ORCID http://orcid.org/0000-0003-3317-6427

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Standard management for recurrent low-grade non-muscle-invasive bladder cancer (LG-NMIBC) often involves a substantial treatment burden, which is not justified by the relatively indolent course of the disease, prompting a need for de-intensification strategies. Active surveillance (AS) is an alternative approach aimed at reducing overtreatment in selected patients. However, the broader adoption of AS is hindered by a lack of standardized protocols for patient selection, monitoring and intervention. To address this gap, we conducted an international, two-round Delphi consensus among 51 bladder cancer experts to establish foundational statements for the use of AS. Consensus was achieved on 20 statements, providing clear recommendations for terminology; inclusion and exclusion criteria; follow-up monitoring; and exit criteria. This Delphi consensus provides the first expert-driven framework to standardize the clinical application of AS for LG-NMIBC. These statements could guide current clinical practice and unify the design of future trials.

Indexed as

Delphi TechniqueNon-Muscle Invasive Bladder NeoplasmsUrinary Bladder NeoplasmsWatchful WaitingConsensusHumansNeoplasm Grading

Identifiers

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.