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EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer-An International Collaborative Multistakeholder Effort†: Under the Auspices of the EAU-ESMO Guidelines Committees
JA. Witjes, M. Babjuk, J. Bellmunt, HM. Bruins, TM. De Reijke, M. De Santis, S. Gillessen, N. James, S. Maclennan, J. Palou, T. Powles, MJ. Ribal, SF. Shariat, TV. Der Kwast, E. Xylinas, N. Agarwal, T. Arends, A. Bamias, A. Birtle, PC. Black, BH....
Language English Country Switzerland
Document type Consensus Development Conference, Journal Article, Practice Guideline
- MeSH
- Humans MeSH
- International Cooperation MeSH
- Urinary Bladder Neoplasms pathology therapy MeSH
- Neoplasm Staging MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Consensus Development Conference MeSH
- Practice Guideline MeSH
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.
Academic Urology Unit University of Aberdeen Aberdeen UK
Barts Cancer Institute Queen Mary University of London London UK
Brighton and Sussex Medical School Brighton UK
Cancer Sciences Unit University of Southampton Southampton UK
Cancer Treatment Centre Sorlandet Hospital Kristiansand Norway
CRUK MRC Oxford Institute for Radiation Oncology University of Oxford Oxford UK
Department of Biomedical Sciences Humanitas University Milan Italy
Department of Cancer Medicine Hôpital Saint Louis Paris France
Department of Clinical Oncology Leiden University Medical Center Leiden The Netherlands
Department of Clinical Oncology The Royal Marsden NHS Foundation Trust London UK
Department of Imaging and Nuclear Medicine Royal Sussex County Hospital Brighton UK
Department of Medical Oncology and Hematology University Hospital Zürich Zürich Switzerland
Department of Medical Oncology Centre Georges François Leclerc Dijon France
Department of Medical Oncology Istituto Nazionale Tumori of Milan Milan Italy
Department of Medicine Memorial Sloan Kettering Cancer Center New York New York USA
Department of Medicine University of Melbourne
Department of Nuclear Medicine Policlinico S Orsola University of Bologna Italy
Department of Nuclear Medicine Universitätsklinikum Essen Essen Germany
Department of Oncology Akershus University Hospital Lørenskog Norway
Department of Oncology and Hemato oncology University of Milan Milan
Department of Oncology Hospital Universitario San Roque
Department of Oncology Rigshospitalet University Hospital of Copenhagen Copenhagen Denmark
Department of Pathology Erasmus Medical Center Rotterdam The Netherlands
Department of Pathology Tenon hospital HUEP Paris France
Department of Radiation Oncology Eberhard Karls University Tübingen Germany
Department of Radiation Oncology Europe Hospitals Brussels Belgium
Department of Radiation Oncology Gustave Roussy Institute Villejuif France
Department of Radiation Oncology Radboud University Medical Center Nijmegen The Netherlands
Department of Radiation Oncology University Hospital Ulm Ulm Germany
Department of Radiology and Nuclear Medicine Rijnstate Hospital Arnhem The Netherlands
Department of Radiology Copenhagen University Hospital Herlev and Gentofte Herlev Denmark
Department of Radiotherapy Institut Bergonié Bordeaux France
Department of Radiotherapy Oncology Ghent University Hospital Ghent Belgium
Department of Surgery Austin Health University of Melbourne Melbourne Australia
Department of Surgical and Perioperative Sciences Urology and Andrology Umeå university Umeå Sweden
Department of Urology Aberdeen Royal Infirmary Aberdeen UK
Department of Urology Amsterdam University Medical Centers University of Amsterdam The Netherlands
Department of Urology Auckland City Hospital Auckland New Zealand
Department of Urology Caritas St Josef Medical Center University of Regensburg Regensburg Germany
Department of Urology Centro Hospitalar São João Porto Portugal
Department of Urology Charité University Hospital Berlin Germany
Department of Urology Eberhard Karls University Tübingen Tübingen Germany
Department of Urology Erasmus University Medical Center Rotterdam The Netherlands
Department of Urology Fundació Puigvert Universitat Autònoma de Barcelona Barcelona Spain
Department of Urology Ghent University Hospital Ghent Belgium
Department of Urology Hospital Universitario Fundación de Alcorcón Madrid Spain
Department of Urology Inselspital Bern University Hospital Bern Switzerland
Department of Urology Karolinska Institutet Stockholm Sweden
Department of Urology Luzerner Kantonsspital Luzern Switzerland
Department of Urology Medical University of Vienna Vienna Austria
Department of Urology Medizinische Universität Graz Graz Austria
Department of Urology Pediatric Urology and Urologic Oncology Kliniken Essen Mitte Essen Germany
Department of Urology Radboud University Medical Center Nijmegen The Netherlands
Department of Urology Rechts der Isar Medical Center Technical University of Munich Munich Germany
Department of Urology Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
Department of Urology Royal Surrey County Hospital Guildford UK
Department of Urology Ruhr University Bochum Marien Hospital Herne Germany
Department of Urology Saint John Emergency Clinical Hospital Bucharest Romania
Department of Urology Tampere University Hospital Tampere Finland
Department of Urology University Hospital La Paz Madrid Spain
Department of Urology University Hospital of Turku Finland
Department of Urology University Hospitals Leuven Belgium
Department of Urology University Medical Center Hamburg Eppendorf Hamburg Germany
Department of Urology University Medical Center Utrecht Utrecht The Netherlands
Department of Urology University of California San Diego Pathology La Jolla California USA
Department of Urology University of Texas Southwestern Medical Center Dallas Texas USA
Department of Urology Urological Research Institute Milan
Department of Urology UWA Medical School University of Western Australia Perth Australia
Department of Urology Weill Cornell Medical College New York New York USA
Department of Urology Westmead Hospital University of Sydney Sydney Australia
Depatment of Urology 2nd Faculty of Medicine Hospital Motol Charles University Prague Czech Republic
Division of Cancer Sciences University of Manchester Manchester UK
Division of Oncology and Haematology Kantonsspital St Gallen St Gallen Switzerland
Division of Radiotherapy and Imaging The Institute of Cancer Research London UK
Division of Radiotherapy IEO European Institute of Oncology IRCCS Milan Italy
Division of Urology IREC Cliniques Universitaires Saint Luc UCL Brussels Belgium
Division of Urology Molinette Hospital University of Studies of Torino Torino Italy
Eastern Health Clinical School Monash University Melbourne Australia
EAU Guidelines Office Arnhem The Netherlands
Emeritus Professor of Radiation Oncology Grenoble Alpes University Grenoble France
Emeritus Professor The Institute of Cancer Research London UK
Faculty of Medicine University of Oslo Oslo Norway
Harvard Medical School Boston Massachusetts USA
Humanitas Research Hospital Milan Italy
Huntsman Cancer Institute University of Utah Salt Lake City Utah USA
Icahn School of Medicine Mount Sinai Health System New York City New York USA
IMIM Hospital del Mar Medical Research Institute Barcelona Spain
Institute of Cancer and Genomic Sciences University of Birmingham Birmingham UK
Institute of Pathology Friedrich Alexander University Erlangen Nürnberg Erlangen Germany
Leeds Institute of Medical Research University of Leeds Leeds UK
Life and Health Sciences Research Institute School of Medicine University of Minho Braga Portugal
Medical Oncology Department 12 de Octubre University Hospital Madrid Spain
Molecular Imaging Program National Cancer Institute Bethesda Maryland USA
Monash University Melbourne Australia
Mount Vernon Centre for Cancer Treatment London UK
Paris Descartes University Paris France
Rosemere Cancer Centre Lancashire Teaching Hospitals Preston UK
Servicio de Urología Fundación Instituto Valenciano de Oncología Valencia Spain
Sorbonne University Paris France
The Christie NHS Foundation Trust Manchester UK
The Royal Free NHS Trust London UK
UMC Utrecht Cancer Center MS Oncologic Urology Utrecht The Netherlands
Universidad Fernando Pessoa Canarias Spain
Université de Lyon Université Lyon 1 faculté de médecine Lyon Est Lyon France
University Hospitals Birmingham NHS Foundation Trust Birmingham UK
University of Bern Bern Switzerland
Uro Oncology Unit Hospital Clinic University of Barcelona Spain
Urology Department Canisius Wilhelmina Ziekenhuis Nijmegen The Netherlands
Urology Service Department of Urology Memorial Sloan Kettering Cancer Center New York New York USA
Vita Salute University San Raffaele Scientific Institute Milan Italy
References provided by Crossref.org
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- $a Witjes, J Alfred $u Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: Fred.Witjes@radboudumc.nl
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- $a EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer-An International Collaborative Multistakeholder Effort†: Under the Auspices of the EAU-ESMO Guidelines Committees / $c JA. Witjes, M. Babjuk, J. Bellmunt, HM. Bruins, TM. De Reijke, M. De Santis, S. Gillessen, N. James, S. Maclennan, J. Palou, T. Powles, MJ. Ribal, SF. Shariat, TV. Der Kwast, E. Xylinas, N. Agarwal, T. Arends, A. Bamias, A. Birtle, PC. Black, BH. Bochner, M. Bolla, JL. Boormans, A. Bossi, A. Briganti, I. Brummelhuis, M. Burger, D. Castellano, R. Cathomas, A. Chiti, A. Choudhury, E. Compérat, S. Crabb, S. Culine, B. De Bari, W. De Blok, P. J L De Visschere, K. Decaestecker, K. Dimitropoulos, JL. Dominguez-Escrig, S. Fanti, V. Fonteyne, M. Frydenberg, JJ. Futterer, G. Gakis, B. Geavlete, P. Gontero, B. Grubmüller, S. Hafeez, DE. Hansel, A. Hartmann, D. Hayne, AM. Henry, V. Hernandez, H. Herr, K. Herrmann, P. Hoskin, J. Huguet, BA. Jereczek-Fossa, R. Jones, AM. Kamat, V. Khoo, AE. Kiltie, S. Krege, S. Ladoire, PC. Lara, A. Leliveld, E. Linares-Espinós, V. Løgager, A. Lorch, Y. Loriot, R. Meijer, MC. Mir, M. Moschini, H. Mostafid, AC. Müller, CR. Müller, J. N'Dow, A. Necchi, Y. Neuzillet, JR. Oddens, J. Oldenburg, S. Osanto, W. J G Oyen, L. Pacheco-Figueiredo, H. Pappot, MI. Patel, BR. Pieters, K. Plass, M. Remzi, M. Retz, J. Richenberg, M. Rink, F. Roghmann, JE. Rosenberg, M. Rouprêt, O. Rouvière, C. Salembier, A. Salminen, P. Sargos, S. Sengupta, A. Sherif, RJ. Smeenk, A. Smits, A. Stenzl, GN. Thalmann, B. Tombal, B. Turkbey, SV. Lauridsen, R. Valdagni, AG. Van Der Heijden, H. Van Poppel, MD. Vartolomei, E. Veskimäe, A. Vilaseca, FAV. Rivera, T. Wiegel, P. Wiklund, A. Williams, R. Zigeuner, A. Horwich
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- $a James, Nicholas $u University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
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- $a Shariat, Shahrokh F $u 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, New York, USA; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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- 700 1_
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- 700 1_
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- 700 1_
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- $a Bolla, Michel $u Emeritus Professor of Radiation Oncology, Grenoble - Alpes University, Grenoble, France
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- $a Boormans, Joost L $u Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- $a Remzi, Mesut $u Department of Urology, Medical University of Vienna, Vienna, Austria
- 700 1_
- $a Retz, Margitta $u Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany
- 700 1_
- $a Richenberg, Jonathan $u Department of Imaging and Nuclear Medicine, Royal Sussex County Hospital, Brighton, UK; Brighton and Sussex Medical School, Brighton, UK
- 700 1_
- $a Rink, Michael $u Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- 700 1_
- $a Roghmann, Florian $u Department of Urology, Ruhr-University Bochum, Marien Hospital, Herne, Germany
- 700 1_
- $a Rosenberg, Jonathan E $u Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Weill Cornell Medical College, New York, New York, USA
- 700 1_
- $a Rouprêt, Morgan $u Department of Urology, Sorbonne Université, GRC n°5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
- 700 1_
- $a Rouvière, Olivier $u 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
- 700 1_
- $a Salembier, Carl $u Department of Radiation Oncology, Europe Hospitals Brussels, Belgium
- 700 1_
- $a Salminen, Antti $u Department of Urology, University Hospital of Turku, Finland
- 700 1_
- $a Sargos, Paul $u Department of Radiotherapy, Institut Bergonié, Bordeaux, France
- 700 1_
- $a Sengupta, Shomik $u Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia
- 700 1_
- $a Sherif, Amir $u Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå university, Umeå, Sweden
- 700 1_
- $a Smeenk, Robert J $u Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
- 700 1_
- $a Smits, Anita $u Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
- 700 1_
- $a Stenzl, Arnulf $u Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany
- 700 1_
- $a Thalmann, George N $u Department of Urology, Inselspital, Bern University Hospital, Bern, Switzerland
- 700 1_
- $a Tombal, Bertrand $u Division of Urology, IREC, Cliniques Universitaires Saint Luc, UCL, Brussels, Belgium
- 700 1_
- $a Turkbey, Baris $u Molecular Imaging Program, National Cancer Institute, Bethesda, Maryland, USA
- 700 1_
- $a Lauridsen, Susanne Vahr $u Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- 700 1_
- $a Valdagni, Riccardo $u Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- 700 1_
- $a Van Der Heijden, Antoine G $u Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
- 700 1_
- $a Van Poppel, Hein $u Department of Urology, University Hospitals Leuven, Belgium
- 700 1_
- $a Vartolomei, Mihai D $u 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
- 700 1_
- $a Veskimäe, Erik $u Department of Urology, Tampere University Hospital, Tampere, Finland
- 700 1_
- $a Vilaseca, Antoni $u Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Spain
- 700 1_
- $a Rivera, Franklin A Vives $u Clinica HematoOncologica Bonadona Prevenir, Universidad Metropolitana, Clinica Club de Leones, Barranquilla, Colombia
- 700 1_
- $a Wiegel, Thomas $u Department of Radiation Oncology, University Hospital Ulm, Ulm, Germany
- 700 1_
- $a Wiklund, Peter $u Icahn School of Medicine, Mount Sinai Health System New York City, New York, USA; Department of Urology, Karolinska Institutet, Stockholm, Sweden
- 700 1_
- $a Williams, Andrew $u Department of Urology, Auckland City Hospital, Auckland, New Zealand
- 700 1_
- $a Zigeuner, Richard $u Department of Urology, Medizinische Universität Graz, Graz, Austria
- 700 1_
- $a Horwich, Alan $u Emeritus Professor, The Institute of Cancer Research, London, UK
- 773 0_
- $w MED00001669 $t European urology $x 1873-7560 $g Roč. 77, č. 2 (2020), s. 223-250
- 856 41
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- 990 __
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