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Definition and Diagnosis of Oligometastatic Bladder Cancer: A Delphi Consensus Study Endorsed by the European Association of Urology, European Society for Radiotherapy and Oncology, and European Society of Medical Oncology Genitourinary Faculty
A. Bamias, A. Stenzl, SL. Brown, L. Albiges, M. Babjuk, A. Birtle, A. Briganti, M. Burger, A. Choudhury, M. Colecchia, M. De Santis, S. Fanti, V. Fonteyne, M. Gallucci, JG. Rivas, R. Huddart, K. Junker, S. Kroeze, Y. Loriot, A. Merseburger, R....
Jazyk angličtina Země Švýcarsko
Typ dokumentu systematický přehled, časopisecké články, práce podpořená grantem
- MeSH
- akademický sbor MeSH
- delfská metoda MeSH
- lékařská onkologie MeSH
- lidé MeSH
- nádory močového měchýře * terapie MeSH
- urologie * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- systematický přehled MeSH
BACKGROUND: In contrast to other cancers, the concept of oligometastatic disease (OMD) has not been investigated in bladder cancer (BC). OBJECTIVE: To develop an acceptable definition, classification, and staging recommendations for oligometastatic BC (OMBC) spanning the issues of patient selection and the roles of systemic therapy and ablative local therapy. DESIGN, SETTING, AND PARTICIPANTS: A European consensus group of 29 experts, led by the European Association of Urology (EAU), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Medical Oncology (ESMO), and including members from all other relevant European societies, was established. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: A modified Delphi method was used. A systematic review was used to build consensus questions. Consensus statements were extracted from two consecutive surveys. The statements were formulated during two consensus meetings. Agreement levels were measured to determine if consensus was achieved (≥75% agreement). RESULTS AND LIMITATIONS: The first survey included 14 questions and the second survey had 12. Owing to a considerable lack of evidence, which was the major limitation, definition was limited in the context of de novo OMBC, which was further classified as synchronous OMD, oligorecurrence, and oligoprogression. A maximum of three metastatic sites, all resectable or amenable to stereotactic therapy, was proposed as the definition of OMBC. Pelvic lymph nodes represented the only "organ" not included in the definition of OMBC. For staging, no consensus on the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography was reached. A favourable response to systemic treatment was proposed as the criterion for selection of patients for metastasis-directed therapy. CONCLUSIONS: A consensus statement on the definition and staging of OMBC has been formulated. This statement will help to standardise inclusion criteria in future trials, potentiate research on aspects of OMBC for which consensus was not achieved, and hopefully will lead to the development of guidelines on optimal management of OMBC. PATIENT SUMMARY: As an intermediate state between localised cancer and disease with extensive metastasis, oligometastatic bladder cancer (OMBC) might benefit from a combination of systemic treatment and local therapy. We report the first consensus statements on OMBC drawn up by an international expert group. These statements can provide a basis for standardisation of future research, which will lead to high-quality evidence in the field.
2nd Faculty of Medicine Hospital Motol Charles University Praha Czechia
Addenbrookes Hospital Cambridge UK
Akershus University Hospital Ahus Denmark
Department of Human Structure and Repair Ghent University Ghent Belgium
Department of Radiation Oncology Ghent University Hospital Ghent Belgium
Department of Radiation Oncology Iridium Network Wilrijk Belgium
Department of Radiation Oncology MediClin Robert Janker Klinik Bonn Germany
Department of Urology Caritas St Josef Medical Centre University of Regensburg Regensburg Germany
Department of Urology Charité University Hospital Berlin Germany
Department of Urology Hospital Clinico San Carlos Madrid Spain
Department of Urology University Hospital Schleswig Holstein Campus Luebeck Luebeck Germany
Division of Nuclear Medicine IRCCS Azienda Ospedaliero Universitaria di Bologna Bologna Italy
Goustave Roussy Institute Villejuif France
Kantonsspital Aarau AG Aarau Switzerland
Mount Vernon Cancer Centre Northwood UK
National and Kapodistrian University of Athens Attikon University Hospital Chaidari Greece
Rosemere Cancer Centre Lancashire Teaching Hospitals NHS Foundation Trust Preston UK
Royal Marsden Hospital Foundation Trust London UK
Sorbonne University GRC 5 Predictive Onco Uro AP HP Pitie Salpetriere Hospital Paris France
University of Tübingen Medical Center Tübingen Germany
Uro Oncology Unit Hospital Clinic University of Barcelona Barcelona Spain
Vita Salute San Raffaele University IRCCS San Raffaele Hospital and Scientific Institute Milan Italy
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- $a Bamias, Aristotelis $u National & Kapodistrian University of Athens, Attikon University Hospital, Chaidari, Greece. Electronic address: abamias@med.uoa.gr
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