EAU-ESMO consensus statements on the management of advanced and variant bladder cancer-an international collaborative multi-stakeholder effort

TY - JOUR

T1 - EAU-ESMO consensus statements on the management of advanced and variant bladder cancer-an international collaborative multi-stakeholder effort

T2 - under the auspices of the EAU and ESMO Guidelines Committees†

AU - Horwich, A

AU - Babjuk, M

AU - Bellmunt, J

AU - Bruins, H M

AU - De Reijke, T M

AU - De Santis, M

AU - Gillessen, S

AU - James, N

AU - Maclennan, S

AU - Palou, J

AU - Powles, T

AU - Ribal, M J

AU - Shariat, S F

AU - Van Der Kwast, T

AU - Xylinas, E

AU - Agarwal, N

AU - Arends, T

AU - Bamias, A

AU - Birtle, A

AU - Black, P C

AU - Bochner, B H

AU - Bolla, M

AU - Boormans, J L

AU - Bossi, A

AU - Briganti, A

AU - Brummelhuis, I

AU - Burger, M

AU - Castellano, D

AU - Cathomas, R

AU - Chiti, A

AU - Choudhury, A

AU - Compérat, E

AU - Crabb, S

AU - Culine, S

AU - De Bari, B

AU - DeBlok, W

AU - De Visschere, P J L

AU - Decaestecker, K

AU - Dimitropoulos, K

AU - Dominguez-Escrig, J L

AU - Fanti, S

AU - Fonteyne, V

AU - Frydenberg, M

AU - Futterer, J J

AU - Gakis, G

AU - Geavlete, B

AU - Gontero, P

AU - Grubmüller, B

AU - Hafeez, S

AU - Hansel, D E

AU - Hayne, D

AU - Henry, A M

AU - Hernandez, V

AU - Herr, H

AU - Herrmann, K

AU - Hoskin, P

AU - Huguet, J

AU - Jereczek-Fossa, B A

AU - Jones, R

AU - Kamat, A M

AU - Khoo, V

AU - Kiltie, A E

AU - Krege, S

AU - Ladoire, S

AU - Lara, P C

AU - Leliveld, A

AU - Linares-Espinós, E

AU - Løgager, V

AU - Lorch, A

AU - Loriot, Y

AU - Meijer, R

AU - Carmen Mir, M

AU - Moschini, M

AU - Mostafid, H

AU - N'Dow, J

AU - Necchi, A

AU - Neuzillet, Y

AU - Oddens, J R

AU - Oldenburg, J

AU - Osanto, S

AU - Oyen, W J G

AU - Pacheco-Figueiredo, L

AU - Pappot, H

AU - Patel, M I

AU - Pieters, B R

AU - Plass, K

AU - Remzi, M

AU - Retz, M

AU - Richenberg, J

AU - Rink, M

AU - Roghmann, F

AU - Rouprêt, M

AU - Rouvière, O

AU - Salembier, C

AU - Salminen, A

AU - Sargos, P

AU - Sengupta, S

AU - Sherif, A

AU - Smeenk, R J

AU - Smits, A

AU - Stenzl, A

AU - Thalmann, G N

AU - Tombal, B

AU - Turkbey, B

AU - Vahr Lauridsen, S

AU - Valdagni, R

AU - Van Der Heijden, A G

AU - Van Poppel, H

AU - Vartolomei, M D

AU - Veskimäe, E

AU - Vilaseca, A

AU - Vives Rivera, F A

AU - Wiegel, T

AU - Wiklund, P

AU - Williams, A

AU - Zigeuner, R

AU - Witjes, J A

N1 - © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

PY - 2019/11/1

Y1 - 2019/11/1

N2 - 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 before 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), 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, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements 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 where further evidence is available to guide our approach.

AB - 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 before 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), 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, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements 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 where further evidence is available to guide our approach.

KW - Consensus

KW - Delphi Technique

KW - Europe

KW - Humans

KW - International Cooperation

KW - Medical Oncology/methods

KW - Neoplasm Staging

KW - Practice Guidelines as Topic

KW - Societies, Medical/standards

KW - Stakeholder Participation

KW - Surveys and Questionnaires

KW - Urinary Bladder/pathology

KW - Urinary Bladder Neoplasms/pathology

KW - Urology/methods

U2 - 10.1093/annonc/mdz296

DO - 10.1093/annonc/mdz296

M3 - SCORING: Journal article

C2 - 31740927

VL - 30

SP - 1697

EP - 1727

JO - ANN ONCOL

JF - ANN ONCOL

SN - 0923-7534

IS - 11

ER -