EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer—An International Collaborative Multistakeholder Effort†[Formula presented]: Under the Auspices of the EAU-ESMO Guidelines Committees
Por:
Witjes J.A., Babjuk M., Bellmunt J., Maxim Bruins H., De Reijke T.M., De Santis M., Gillessen S., James N., Maclennan S., Palou J., Powles T., Ribal M.J., Shariat S.F., Van Der Kwast T., 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., De Bari B., De Blok W., 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., Carmen Mir M., 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 A., Smeenk R.J., Smits A., Stenzl A., Thalmann G.N., Tombal B., Turkbey B., Lauridsen S.V., Valdagni R., Van Der Heijden A.G., Van Poppel H., Vartolomei M.D., Veskimäe E., Vilaseca A., Vives Rivera F.A., Wiegel T., Wiklund P., Williams A., Zigeuner R., Horwich A.
Publicada:
1 ene 2020
Resumen:
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 prior to 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), and 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 statements, 33 (28%) achieved level 1 consensus and 49 (42%) 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 when further evidence is available to guide our approach. Patient summary: This report summarises findings from an international, multistakeholder project organised by the EAU and ESMO. In this project, a steering committee identified areas of bladder cancer management where there is currently no good-quality evidence to guide treatment decisions. From this, they developed a series of proposed statements, 71 of which achieved consensus by a large group of experts in the field of bladder cancer. It is anticipated that these statements will provide further guidance to health care professionals and could help improve patient outcomes until a time when good-quality evidence is available. © 2019 European Society of Medical Oncology and European Association of Urology
Filiaciones:
Witjes J.A.:
Department of Urology, Radboud University Medical Center, Nijmegen, Netherlands
Babjuk M.:
Depatment of Urology, 2nd Faculty of Medicine, Hospital Motol, Charles University, Prague, Czech Republic
Department of Urology, Medical University of Vienna, Vienna, Austria
Bellmunt J.:
IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
Harvard Medical School, Boston, MA, United States
Maxim Bruins H.:
Department of Urology, Radboud University Medical Center, Nijmegen, Netherlands
De Reijke T.M.:
Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Netherlands
De Santis M.:
Department of Urology, Medical University of Vienna, Vienna, Austria
Department of Urology, Charité University Hospital, Berlin, Germany
Gillessen S.:
Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
The Christie NHS Foundation Trust, Manchester, United Kingdom
Division of Oncology and Haematology, Kantonsspital St Gallen, St Gallen, Switzerland
University of Bern, Bern, Switzerland
James N.:
University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom
Maclennan S.:
Academic Urology Unit, University of Aberdeen, Aberdeen, United Kingdom
Palou J.:
Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
Powles T.:
The Royal Free NHS Trust, London, United Kingdom
Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
Ribal M.J.:
Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Spain
Shariat S.F.:
Depatment of Urology, 2nd Faculty of Medicine, Hospital Motol, Charles University, Prague, Czech Republic
Department of Urology, Medical University of Vienna, Vienna, Austria
Department of Urology, Weill Cornell Medical College, New York, NY, United States
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, United States
Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
Weill Cornell Medical College, New York, NY, United States
Van Der Kwast T.:
Department of Pathology, Erasmus Medical Center, Rotterdam, Netherlands
Xylinas E.:
Department of Urology, Bichat-Claude Bernard Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
Paris Descartes University, Paris, France
Agarwal N.:
Huntsman Cancer Institute, University of Utah (NCI-CCC), Salt Lake City, UT, United States
Arends T.:
Urology Department, Canisius-Wilhelmina Ziekenhuis Nijmegen, Netherlands
Bamias A.:
2nd Propaedeutic Dept of Internal Medicine, Medical School, National & Kapodistrian University of Athens, Athens, Greece
Birtle A.:
Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
Rosemere Cancer Centre, Lancashire Teaching Hospitals, Preston, United Kingdom
Black P.C.:
Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, British Colombia, Canada
Bochner B.H.:
Department of Urology, Weill Cornell Medical College, New York, NY, United States
Urology Service, Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
Weill Cornell Medical College, New York, NY, United States
Bolla M.:
Emeritus Professor of Radiation Oncology, Grenoble-Alpes University, Grenoble, France
Boormans J.L.:
Department of Urology, Erasmus University Medical Center, Rotterdam, Netherlands
Bossi A.:
Department of Radiation Oncology, Gustave Roussy Institute, Villejuif, France
Briganti A.:
Department of Urology, Urological Research Institute, Milan, Italy
Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
Brummelhuis I.:
Department of Urology, Radboud University Medical Center, Nijmegen, Netherlands
Burger M.:
Department of Urology, Caritas-St. Josef Medical Center, University of Regensburg, Regensburg, Germany
Castellano D.:
Medical Oncology Department, 12 de Octubre University Hospital, CIBERONC, Madrid, Spain
Cathomas R.:
Departement Innere Medizin, Abteilung Onkologie und Hämatologie, Kantonsspital Graubünden, Chur, Switzerland
Chiti A.:
Department of Biomedical Sciences, Humanitas University, Milan, Italy
Humanitas Research Hospital, Milan, Italy
Choudhury A.:
Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
The Christie NHS Foundation Trust, Manchester, United Kingdom
Compérat E.:
Department of Pathology, Tenon hospital, HUEP, Paris, France
Sorbonne University, Paris, France
Crabb S.:
Cancer Sciences Unit, University of Southampton, Southampton, United Kingdom
Culine S.:
Department of Cancer Medicine, Hôpital Saint Louis, Paris, France
De Bari B.:
Radiation Oncology Department, Centre Hospitalier Régional Universitaire "Jean Minjoz" of Besançon, INSERM UMR 1098, Besançon, France
Radiation Oncology Department, centre Hospitalier Universitaire Vaudois, Université de Lausanne, Lausanne, Switzerland
De Blok W.:
Department of Urology, University Medical Center Utrecht, Utrecht, Netherlands
De Visschere P.J.L.:
Department of Radiology and Nuclear Medicine, Division of Genitourinary Radiology and Mammography, Ghent University Hospital, Ghent, Belgium
Decaestecker K.:
Department of Urology, Ghent University Hospital, Ghent, Belgium
Dimitropoulos K.:
Department of Urology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
Dominguez-Escrig J.L.:
Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
Fanti S.:
Department of Nuclear Medicine, Policlinico S Orsola, University of Bologna, Italy
Fonteyne V.:
Department of Radiotherapy Oncology, Ghent University Hospital, Ghent, Belgium
Frydenberg M.:
Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
Futterer J.J.:
Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, Netherlands
Gakis G.:
Department of Urology and Paediatric Urology, University Hospital of Würzburg, Julius-Maximillians University, Würzburg, Germany
Geavlete B.:
Department of Urology, Saint John Emergency Clinical Hospital, Bucharest, Romania
Gontero P.:
Division of Urology, Molinette Hospital, University of Studies of Torino, Torino, Italy
Grubmüller B.:
Department of Urology, Medical University of Vienna, Vienna, Austria
Hafeez S.:
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
Department of Clinical Oncology, The Royal Marsden NHS Foundation Trust, London, United Kingdom
The Institute of Cancer Research, London, United Kingdom
Hansel D.E.:
Department of Urology, University of California, San Diego Pathology, La Jolla, CA, United States
Hartmann A.:
Institute of Pathology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
Hayne D.:
Department of Urology, UWA Medical School, University of Western Australia, Perth, Australia
Henry A.M.:
Leeds Institute of Medical Research, University of Leeds, Leeds, United Kingdom
Hernandez V.:
Department of Urology, Hospital Universitario Fundación de Alcorcón, Madrid, Spain
Herr H.:
Urology Service, Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
Herrmann K.:
Department of Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany
Hoskin P.:
Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
The Christie NHS Foundation Trust, Manchester, United Kingdom
Mount Vernon Centre for Cancer Treatment, London, United Kingdom
Huguet J.:
Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
Jereczek-Fossa B.A.:
Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy
Jones R.:
Institute of Cancer Sciences, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
Kamat A.M.:
Department of Urology-Division of Surgery, The University of Texas, MD Anderson Cancer Center, Houston, TX, United States
Khoo V.:
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
Department of Clinical Oncology, The Royal Marsden NHS Foundation Trust, London, United Kingdom
Department of Medicine, University of Melbourne
Monash University, Melbourne, Australia
The Institute of Cancer Research, London, United Kingdom
Kiltie A.E.:
CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
Krege S.:
Department of Urology, Pediatric Urology and Urologic Oncology, Kliniken Essen-Mitte, Essen, Germany
Ladoire S.:
Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
Lara P.C.:
Department of Oncology, Hospital Universitario San Roque, Spain
Universidad Fernando Pessoa, Canarias, Spain
Leliveld A.:
Department of Urology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
Linares-Espinós E.:
Department of Urology, University Hospital La Paz, Madrid, Spain
Løgager V.:
Department of Radiology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
Lorch A.:
Department of Medical Oncology and Hematology, University Hospital Zürich, Zürich, Switzerland
Loriot Y.:
Département de Médecine Oncologique, Gustave Roussy, INSERM U981, université Paris-Sud, Université Paris-Saclay, Villejuif, France
Meijer R.:
UMC Utrecht Cancer Center, MS Oncologic Urology, Utrecht, Netherlands
Carmen Mir M.:
Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
Moschini M.:
Department of Urology, Luzerner Kantonsspital, Luzern, Switzerland
Mostafid H.:
Department of Urology, Royal Surrey County Hospital, Guildford, United Kingdom
Müller A.-C.:
Department of Radiation Oncology, Eberhard Karls University, Tübingen, Germany
Müller C.R.:
Cancer Treatment Centre, Sorlandet Hospital, Kristiansand, Norway
N’dow J.:
Academic Urology Unit, University of Aberdeen, Aberdeen, United Kingdom
Department of Urology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
Necchi A.:
Department of Medical Oncology, Istituto Nazionale Tumori of Milan, Milan, Italy
Neuzillet Y.:
Department of Urology, Hospital Foch, University of Versailles-Saint-Quentin-en-Yvelines, Suresnes, France
Oddens J.R.:
Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Netherlands
Oldenburg J.:
Department of Oncology, Akershus University Hospital, Lørenskog, Norway
Faculty of Medicine, University of Oslo, Oslo, Norway
Osanto S.:
Department of Clinical Oncology, Leiden University Medical Center, Leiden, Netherlands
Oyen W.J.G.:
Department of Biomedical Sciences, Humanitas University, Milan, Italy
Humanitas Research Hospital, Milan, Italy
Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, Netherlands
Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, Netherlands
Pacheco-Figueiredo L.:
Department of Urology, Centro Hospitalar São João, Porto, Portugal
Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
Pappot H.:
Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
Patel M.I.:
Department of Urology, Westmead Hospital, University of Sydney, Sydney, Australia
Pieters B.R.:
Department Radiation Oncology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
Plass K.:
EAU Guidelines Office, Arnhem, Netherlands
Remzi M.:
Department of Urology, Medical University of Vienna, Vienna, Austria
Retz M.:
Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany
Richenberg J.:
Department of Imaging and Nuclear Medicine, Royal Sussex County Hospital, Brighton, United Kingdom
Brighton and Sussex Medical School, Brighton, United Kingdom
Rink M.:
Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Roghmann F.:
Department of Urology, Ruhr-University Bochum, Marien Hospital, Herne, Germany
Rosenberg J.E.:
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
Weill Cornell Medical College, New York, NY, United States
Rouprêt M.:
Department of Urology, Sorbonne Université, GRC n°5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
Rouvière O.:
Hospices Civils de Lyon, Service d’Imagerie Urinaire et Vasculaire, Hôpital Edouard Herriot, Lyon, France
Université de Lyon, université Lyon 1, faculté de Médecine Lyon Est, Lyon, France
Salembier C.:
Department of Radiation Oncology, Europe Hospitals Brussels, Belgium
Salminen A.:
Department of Urology, University Hospital of Turku, Finland
Sargos P.:
Department of Radiotherapy, Institut Bergonié, Bordeaux, France
Sengupta S.:
Monash University, Melbourne, Australia
Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia
Eastern Health Clinical School, Monash University, Melbourne, Australia
Sherif A.:
Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
Smeenk R.J.:
Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, Netherlands
Smits A.:
Department of Urology, Radboud University Medical Center, Nijmegen, Netherlands
Stenzl A.:
Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany
Thalmann G.N.:
Department of Urology, Inselspital, Bern University Hospital, Bern, Switzerland
Tombal B.:
Division of Urology, IREC, Cliniques Universitaires Saint Luc, UCL, Brussels, Belgium
Turkbey B.:
Molecular Imaging Program, National Cancer Institute, Bethesda, MD, United States
Lauridsen S.V.:
Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Valdagni R.:
Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
Van Der Heijden A.G.:
Department of Urology, Radboud University Medical Center, Nijmegen, Netherlands
Van Poppel H.:
Department of Urology, University Hospitals Leuven, Belgium
Vartolomei M.D.:
Department of Urology, Medical University of Vienna, Vienna, Austria
Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
Veskimäe E.:
Department of Urology, Tampere University Hospital, Tampere, Finland
Vilaseca A.:
Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Spain
Vives Rivera F.A.:
Clinica HematoOncologica Bonadona Prevenir, Universidad Metropolitana, Clinica Club de Leones, Barranquilla, Colombia
Wiegel T.:
Department of Radiation Oncology, University Hospital Ulm, Ulm, Germany
Wiklund P.:
Icahn School of Medicine, Mount Sinai Health System New York City, New York, United States
Department of Urology, Karolinska Institutet, Stockholm, Sweden
Williams A.:
Department of Urology, Auckland City Hospital, Auckland, New Zealand
Zigeuner R.:
Department of Urology, Medizinische Universität Graz, Graz, Austria
Horwich A.:
The Institute of Cancer Research, London, United Kingdom
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