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Low compliance to guidelines in nonmuscle-invasive bladder carcinoma: A systematic review

K. Mori, N. Miura, M. Babjuk, PI. Karakiewicz, H. Mostafaei, E. Laukhtina, F. Quhal, RS. Motlagh, B. Pradere, S. Kimura, S. Egawa, SF. Shariat

. 2020 ; 38 (10) : 774-782. [pub] 20200710

Language English Country United States

Document type Journal Article, Systematic Review

Persistent link   https://www.medvik.cz/link/bmc21020094

PURPOSE: This systematic review assessed compliance to guidelines for the management of nonmuscle-invasive bladder carcinoma (NMIBC). METHODS: The PUBMED, Web of Science, Cochrane Library, and Scopus databases were searched in November 2019 in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis statement. RESULTS: Fifteen studies incorporating a collective total of 10,575 NMIBC patients were eligible for inclusion in this systematic review. We found that the rates of compliance were 53.0% with a single immediate intravesical instillation in patients with presumed low or intermediate risk, 37.1% with intravesical bacillus Calmette-Guerin or chemotherapy in those with intermediate risk, 43.4% with performance of a second transurethral resection in high-risk patients, 32.5% with administration of adjuvant intravesical bacillus Calmette-Guerin in high-risk patients, 36.1% with radical cystectomy in highest-risk patients, and 82.2% with cystoscopy for follow-up. CONCLUSIONS: Compliance with NMIBC guidelines remains low. Better guideline education and understanding holds the key to achieving high compliance. Strategies to improve guideline compliance at the physician level are urgently required.

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$a Mori, Keiichiro $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
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$a Low compliance to guidelines in nonmuscle-invasive bladder carcinoma: A systematic review / $c K. Mori, N. Miura, M. Babjuk, PI. Karakiewicz, H. Mostafaei, E. Laukhtina, F. Quhal, RS. Motlagh, B. Pradere, S. Kimura, S. Egawa, SF. Shariat
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$a PURPOSE: This systematic review assessed compliance to guidelines for the management of nonmuscle-invasive bladder carcinoma (NMIBC). METHODS: The PUBMED, Web of Science, Cochrane Library, and Scopus databases were searched in November 2019 in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis statement. RESULTS: Fifteen studies incorporating a collective total of 10,575 NMIBC patients were eligible for inclusion in this systematic review. We found that the rates of compliance were 53.0% with a single immediate intravesical instillation in patients with presumed low or intermediate risk, 37.1% with intravesical bacillus Calmette-Guerin or chemotherapy in those with intermediate risk, 43.4% with performance of a second transurethral resection in high-risk patients, 32.5% with administration of adjuvant intravesical bacillus Calmette-Guerin in high-risk patients, 36.1% with radical cystectomy in highest-risk patients, and 82.2% with cystoscopy for follow-up. CONCLUSIONS: Compliance with NMIBC guidelines remains low. Better guideline education and understanding holds the key to achieving high compliance. Strategies to improve guideline compliance at the physician level are urgently required.
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$a Miura, Noriyoshi $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Ehime University Graduate School of Medicine, Ehime, Japan
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$a Babjuk, Marek $u Department of Urology, Hospital Motol, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
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$a Karakiewicz, Pierre I $u Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada
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$a Mostafaei, Hadi $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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$a Laukhtina, Ekaterina $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
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$a Quhal, Fahad $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
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$a Motlagh, Reza Sari $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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$a Pradere, Benjamin $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, CHRU Tours, Francois Rabelais University, France
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$a Kimura, Shoji $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
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$a Egawa, Shin $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
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$a Shariat, Shahrokh F $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Hospital Motol, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia; Department of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern, Dallas, TX; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, University of Jordan, Amman, Jordan; European Association of Urology Research Foundation, Arnhem, the Netherlands. Electronic address: shahrokh.shariat@meduriwien.ac.at
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