ArticleBladder cancer (Amsterdam, Netherlands)
Guideline-recommended post-operative intravesical chemotherapy and cystoscopic surveillance among patients with low- and intermediate-risk non-muscle invasive bladder cancer.
Article in Bladder cancer (Amsterdam, Netherlands). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: We sought to characterize concordance of surveillance and treatment patterns in a large community-based healthcare system with the American Urologic Association/Society of Urologic Oncology (AUA/SUO) guideline for low- and intermediate-risk non-muscle invasive bladder cancer (NMIBC). We expect the results of this study to improve the oncologic care of patients with NMIBC. Methods: This was a retrospective cohort study of patients aged 18 years or older diagnosed with low- or intermediate-risk NMIBC between 1/1/2018 and 12/31/2022 and followed until 12/31/2024. The prevalence of single-dose post-operative intravesical chemotherapy instillations, cystoscopy procedures, and urine cytology tests were used to determine at, below, and above guideline-concordance. Results: A total of 631 low-risk and 619 intermediate-risk NMIBC patients were identified. Prevalences of single-dose immediate postoperative intravesical chemotherapy were: 35.2% (low-risk) and 36.8% (intermediate-risk). In the low-risk NMIBC group, average guideline-concordance was 47.5% for cystoscopy and 82.3% for cytology. In the intermediate-risk group, average guideline-concordance was 54.1% for cystoscopy and 27.2% for cytology. Percent of cystoscopy procedures exceeding guideline-concordance was 30.5% and 14.5% in the low- and intermediate-risk NMIBC groups, respectively. Discussion: Although guideline-concordance of single-dose intravesical instillations, cystoscopy procedures, and cytology tests mirrored what is reported in the literature, the prevalence of cystoscopy and cytology tests exceeding guideline-concordance was notably less, which may be a feature of our integrated delivery and finance system. Conclusion: Understanding the current landscape of concordance with the AUA/SUO guideline is necessary for every healthcare delivery system to optimize the oncologic care of patients with NMIBC.
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