BACKGROUND AND OBJECTIVE: There is no standardized regimen for follow-up after radical cystectomy (RC) for bladder cancer (BC). To address this gap, we conducted a multicenter study involving urologist members from the European Association of Urology (EAU) bladder cancer guideline panels. Our objective was to identify consistent post-RC follow-up strategies and develop a practice-based framework based on expert opinion. METHODS: We surveyed 27 urologist members of the EAU guideline panels for non-muscle-invasive bladder cancer and muscle-invasive and metastatic bladder cancer using a pre-tested questionnaire with dichotomous responses. The survey inquired about follow-up strategies after RC and the use of risk-adapted strategies. Consistency was defined as >75% affirmative responses for follow-up practices commencing 3 mo after RC. Descriptive statistics were used for analysis. KEY FINDINGS AND LIMITATIONS: We received responses from 96% of the panel members, who provided data from 21 European hospitals. Risk-adapted follow-up is used in 53% of hospitals, with uniform criteria for high-risk (at least ≥pT3 or pN+) and low-risk ([y]pT0/a/1N0) cases. In the absence of agreement for risk-based follow up, a non-risk-adapted framework for follow-up was developed. Higher conformity was observed within the initial 3 yr, followed by a decline in subsequent follow-up. Follow-up was most frequent during the first year, including patient assessments, physical examinations, and laboratory tests. Computed tomography of the chest and abdomen/pelvis was the most common imaging modality, initially at least biannually, and then annually from years 2 to 5. There was a lack of consistency for continuing follow-up beyond 10 yr after RC. CONCLUSIONS AND CLINICAL IMPLICATIONS: This practice-based post-RC follow-up framework developed by EAU bladder cancer experts may serve as a valuable guide for urologists in the absence of prospective randomized studies. PATIENT SUMMARY: We asked urologists from the EAU bladder cancer guideline panels about their patient follow-up after surgical removal of the bladder for bladder cancer. We found that although urologists have varying approaches, there are also common follow-up practices across the panel. We created a practical follow-up framework that could be useful for urologists in their day-to-day practice.

Department of Oncological Urology University Medical Center Utrecht Utrecht The Netherlands

Department of Urology Bichat Claude Bernard Hospital AP HP Université Paris Cité Paris France

Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria; Division of Urology Department of Special Surgery University of Jordan Amman Jordan; Karl Landsteiner Institute of Urology and Andrology Vienna Austria; Department of Urology Weill Cornell Medical College New York NY USA; Department of Urology University of Texas Southwestern Dallas TX USA; Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic

Department of Urology Foch Hospital University of Versailles Saint Quentin en Yvelines Suresnes France

Department of Urology Freeman Hospital The Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK

Department of Urology General Teaching Hospital and 1st Faculty of Medicine Charles University Prague Czech Republic

Department of Urology Hospital Universitari Vall d'Hebron Barcelona Spain

Department of Urology Inselspital University Hospital Bern Bern Switzerland

Department of Urology Instituto Valenciano de Oncologia Valencia Spain

Department of Urology La Croix du Sud Hospital Quint Fonsegrives France

Department of Urology MD Anderson Cancer Center Houston TX USA

Department of Urology Netherlands Cancer Institute Amsterdam The Netherlands

Department of Urology Netherlands Cancer Institute Amsterdam The Netherlands; Department of Urology Caritas St Josef Medical Centre University of Regensburg Regensburg Germany

Department of Urology Radboud University Medical Center Nijmegen The Netherlands

Department of Urology Royal Surrey Hospital Guildford UK

Department of Urology Saint Louis Hospital AP HP Paris Cité University Paris France

Department of Urology Skane University Hospital Malmö Sweden; Institute of Translational Medicine Lund University Malmö Sweden

Department of Urology Teaching Hospital Motol 2nd Faculty of Medicine Charles University Prague Czech Republic

Department of Urology Zuyderland Medical Center Sittard Heerlen The Netherlands

Division of Urology Department of Surgical Sciences AOU Citta della Salute e della Scienca Torina School of Medicine Turin Italy

Edinburgh Bladder Cancer Surgery University of Edinburgh Western General Hospital Edinburgh UK

GRC 5 Predictive Onco Urology Sorbonne University Department of Urology Pitié Salpetriere Hospital Paris France

Patient Representative European Association of Urology Guidelines Office Arnhem The Netherlands

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