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The Use of Neoadjuvant Chemotherapy in Patients With Urothelial Carcinoma of the Bladder: Current Practice Among Clinicians

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The Use of Neoadjuvant Chemotherapy in Patients With Urothelial Carcinoma of the Bladder: Current Practice Among Clinicians. / Martini, Thomas; Gilfrich, Christian; Mayr, Roman; Burger, Maximilian; Pycha, Armin; Aziz, Atiqullah; Gierth, Michael; Stief, Christian G; Müller, Stefan C; Wagenlehner, Florian; Roigas, Jan; Hakenberg, Oliver W; Roghmann, Florian; Nuhn, Philipp; Wirth, Manfred; Novotny, Vladimir; Hadaschik, Boris; Grimm, Marc-Oliver; Schramek, Paul; Haferkamp, Axel; Colleselli, Daniela; Kloss, Birgit; Herrmann, Edwin; Fisch, Margit; May, Matthias; Bolenz, Christian.

In: CLIN GENITOURIN CANC, Vol. 15, No. 3, 06.2017, p. 356-362.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Martini, T, Gilfrich, C, Mayr, R, Burger, M, Pycha, A, Aziz, A, Gierth, M, Stief, CG, Müller, SC, Wagenlehner, F, Roigas, J, Hakenberg, OW, Roghmann, F, Nuhn, P, Wirth, M, Novotny, V, Hadaschik, B, Grimm, M-O, Schramek, P, Haferkamp, A, Colleselli, D, Kloss, B, Herrmann, E, Fisch, M, May, M & Bolenz, C 2017, 'The Use of Neoadjuvant Chemotherapy in Patients With Urothelial Carcinoma of the Bladder: Current Practice Among Clinicians', CLIN GENITOURIN CANC, vol. 15, no. 3, pp. 356-362. https://doi.org/10.1016/j.clgc.2016.09.003

APA

Martini, T., Gilfrich, C., Mayr, R., Burger, M., Pycha, A., Aziz, A., Gierth, M., Stief, C. G., Müller, S. C., Wagenlehner, F., Roigas, J., Hakenberg, O. W., Roghmann, F., Nuhn, P., Wirth, M., Novotny, V., Hadaschik, B., Grimm, M-O., Schramek, P., ... Bolenz, C. (2017). The Use of Neoadjuvant Chemotherapy in Patients With Urothelial Carcinoma of the Bladder: Current Practice Among Clinicians. CLIN GENITOURIN CANC, 15(3), 356-362. https://doi.org/10.1016/j.clgc.2016.09.003

Vancouver

Martini T, Gilfrich C, Mayr R, Burger M, Pycha A, Aziz A et al. The Use of Neoadjuvant Chemotherapy in Patients With Urothelial Carcinoma of the Bladder: Current Practice Among Clinicians. CLIN GENITOURIN CANC. 2017 Jun;15(3):356-362. https://doi.org/10.1016/j.clgc.2016.09.003

Bibtex

@article{eb8713c85805426d9de2ccb53666df27,
title = "The Use of Neoadjuvant Chemotherapy in Patients With Urothelial Carcinoma of the Bladder: Current Practice Among Clinicians",
abstract = "INTRODUCTION: Guidelines recommend neoadjuvant chemotherapy (NAC) before radical cystectomy (RC) in patients with urothelial carcinoma of the bladder in clinical stages T2-T4a, cN0M0. We examined the frequency and current practice of NAC and sought to identify predictors for the use of NAC in a prospective contemporary cohort.MATERIALS AND METHODS: We analyzed prospective data from 679 patients in the PROMETRICS (PROspective MulticEnTer RadIcal Cystectomy Series 2011) database. All patients underwent RC in 2011. Uni- and multivariable regression analyses identified predictors of NAC application. Furthermore, a questionnaire was used to evaluate the practice patterns of NAC at the PROMETRICS centers.RESULTS: A total of 235 patients (35%) were included in the analysis. Only 15 patients (2.2%) received NAC before RC. Younger age (< 70 years; P = .035), lower case volume of the center (< 30 RC/year; P < .001), and advanced tumor stage (≥ cT3; P = .038) were identified as predictors for NAC. Of the 200 urologists who replied to the questionnaire, 69% (n = 125) declared tumor stage cT3-4 a/o N1M0 to be the best indication for NAC application, although 45% of the urologists stated that they would not perform NAC despite recommendations. The decision for NAC was made by the individual urologist in 69% of cases, and only 29% reported that all cases were discussed in an interdisciplinary tumor board.CONCLUSION: NAC was rarely applied in the present cohort. We observed a discrepancy between guideline recommendations and practice patterns, despite medical indication and pre-therapeutic interdisciplinary discussion. The potential benefit of NAC within a multimodal approach seems to be neglected by many urologists.",
author = "Thomas Martini and Christian Gilfrich and Roman Mayr and Maximilian Burger and Armin Pycha and Atiqullah Aziz and Michael Gierth and Stief, {Christian G} and M{\"u}ller, {Stefan C} and Florian Wagenlehner and Jan Roigas and Hakenberg, {Oliver W} and Florian Roghmann and Philipp Nuhn and Manfred Wirth and Vladimir Novotny and Boris Hadaschik and Marc-Oliver Grimm and Paul Schramek and Axel Haferkamp and Daniela Colleselli and Birgit Kloss and Edwin Herrmann and Margit Fisch and Matthias May and Christian Bolenz",
note = "Copyright {\textcopyright} 2016 Elsevier Inc. All rights reserved.",
year = "2017",
month = jun,
doi = "10.1016/j.clgc.2016.09.003",
language = "English",
volume = "15",
pages = "356--362",
journal = "CLIN GENITOURIN CANC",
issn = "1558-7673",
publisher = "Elsevier",
number = "3",

}

RIS

TY - JOUR

T1 - The Use of Neoadjuvant Chemotherapy in Patients With Urothelial Carcinoma of the Bladder: Current Practice Among Clinicians

AU - Martini, Thomas

AU - Gilfrich, Christian

AU - Mayr, Roman

AU - Burger, Maximilian

AU - Pycha, Armin

AU - Aziz, Atiqullah

AU - Gierth, Michael

AU - Stief, Christian G

AU - Müller, Stefan C

AU - Wagenlehner, Florian

AU - Roigas, Jan

AU - Hakenberg, Oliver W

AU - Roghmann, Florian

AU - Nuhn, Philipp

AU - Wirth, Manfred

AU - Novotny, Vladimir

AU - Hadaschik, Boris

AU - Grimm, Marc-Oliver

AU - Schramek, Paul

AU - Haferkamp, Axel

AU - Colleselli, Daniela

AU - Kloss, Birgit

AU - Herrmann, Edwin

AU - Fisch, Margit

AU - May, Matthias

AU - Bolenz, Christian

N1 - Copyright © 2016 Elsevier Inc. All rights reserved.

PY - 2017/6

Y1 - 2017/6

N2 - INTRODUCTION: Guidelines recommend neoadjuvant chemotherapy (NAC) before radical cystectomy (RC) in patients with urothelial carcinoma of the bladder in clinical stages T2-T4a, cN0M0. We examined the frequency and current practice of NAC and sought to identify predictors for the use of NAC in a prospective contemporary cohort.MATERIALS AND METHODS: We analyzed prospective data from 679 patients in the PROMETRICS (PROspective MulticEnTer RadIcal Cystectomy Series 2011) database. All patients underwent RC in 2011. Uni- and multivariable regression analyses identified predictors of NAC application. Furthermore, a questionnaire was used to evaluate the practice patterns of NAC at the PROMETRICS centers.RESULTS: A total of 235 patients (35%) were included in the analysis. Only 15 patients (2.2%) received NAC before RC. Younger age (< 70 years; P = .035), lower case volume of the center (< 30 RC/year; P < .001), and advanced tumor stage (≥ cT3; P = .038) were identified as predictors for NAC. Of the 200 urologists who replied to the questionnaire, 69% (n = 125) declared tumor stage cT3-4 a/o N1M0 to be the best indication for NAC application, although 45% of the urologists stated that they would not perform NAC despite recommendations. The decision for NAC was made by the individual urologist in 69% of cases, and only 29% reported that all cases were discussed in an interdisciplinary tumor board.CONCLUSION: NAC was rarely applied in the present cohort. We observed a discrepancy between guideline recommendations and practice patterns, despite medical indication and pre-therapeutic interdisciplinary discussion. The potential benefit of NAC within a multimodal approach seems to be neglected by many urologists.

AB - INTRODUCTION: Guidelines recommend neoadjuvant chemotherapy (NAC) before radical cystectomy (RC) in patients with urothelial carcinoma of the bladder in clinical stages T2-T4a, cN0M0. We examined the frequency and current practice of NAC and sought to identify predictors for the use of NAC in a prospective contemporary cohort.MATERIALS AND METHODS: We analyzed prospective data from 679 patients in the PROMETRICS (PROspective MulticEnTer RadIcal Cystectomy Series 2011) database. All patients underwent RC in 2011. Uni- and multivariable regression analyses identified predictors of NAC application. Furthermore, a questionnaire was used to evaluate the practice patterns of NAC at the PROMETRICS centers.RESULTS: A total of 235 patients (35%) were included in the analysis. Only 15 patients (2.2%) received NAC before RC. Younger age (< 70 years; P = .035), lower case volume of the center (< 30 RC/year; P < .001), and advanced tumor stage (≥ cT3; P = .038) were identified as predictors for NAC. Of the 200 urologists who replied to the questionnaire, 69% (n = 125) declared tumor stage cT3-4 a/o N1M0 to be the best indication for NAC application, although 45% of the urologists stated that they would not perform NAC despite recommendations. The decision for NAC was made by the individual urologist in 69% of cases, and only 29% reported that all cases were discussed in an interdisciplinary tumor board.CONCLUSION: NAC was rarely applied in the present cohort. We observed a discrepancy between guideline recommendations and practice patterns, despite medical indication and pre-therapeutic interdisciplinary discussion. The potential benefit of NAC within a multimodal approach seems to be neglected by many urologists.

U2 - 10.1016/j.clgc.2016.09.003

DO - 10.1016/j.clgc.2016.09.003

M3 - SCORING: Journal article

C2 - 27765613

VL - 15

SP - 356

EP - 362

JO - CLIN GENITOURIN CANC

JF - CLIN GENITOURIN CANC

SN - 1558-7673

IS - 3

ER -