Improving compliance with guidelines may lead to favorable clinical outcomes for patients with non‐muscle‐invasive bladder cancer: A retrospective multicenter study-Reference-Cited by-同舟云学术

Improving compliance with guidelines may lead to favorable clinical outcomes for patients with non‐muscle‐invasive bladder cancer: A retrospective multicenter study

Published:2023-09-04 Issue:12 Volume:30 Page:1155-1163
ISSN:0919-8172
Container-title:International Journal of Urology
language:en
Short-container-title:Int J of Urology

Author:

Sato Takuma¹²^ORCID,Sano Takeshi³^ORCID,Kawamura Sadafumi²⁴,Ikeda Yoshihiro²⁵,Orikasa Kazuhiko²⁶,Tanaka Takaki²⁷,Kyan Atsushi²⁸,Ota Shozo²⁹,Tokuyama Satoru²¹⁰,Saito Hideo²¹¹,Mitsuzuka Koji¹²^ORCID,Yamashita Shinichi¹²^ORCID,Arai Yoichi¹²,Kobayashi Takashi³^ORCID,Ito Akihiro¹²

Affiliation:

1. Department of Urology Tohoku University Graduate School of Medicine Sendai Miyagi Japan

2. Tohoku Urological Evidence‐Based Medicine Study Group Sendai Japan

3. Department of Urology Kyoto University Graduate School of Medicine Kyoto Japan

4. Department of Urology Miyagi Cancer Center Natori Miyagi Japan

5. Department of Urology Osaki Citizen Hospital Ōsaki Miyagi Japan

6. Department of Urology Kesennuma City Hospital Kesennuma Miyagi Japan

7. Department of Urology Hachinohe City Hospital Aomori Japan

8. Department of Urology Shirakawa Kosei General Hospital Fukushima Japan

9. Department of Urology Sendai Red Cross Hospital Sendai Miyagi Japan

10. Department of Urology Iwaki City Medical Center Fukushima Japan

11. Department of Urology National Hospital Organization Sendai Medical Center Miyagi Japan

Abstract

ObjectivesClinical guidelines recommend that patients with non‐muscle‐invasive bladder cancer (NMIBC) should be treated with appropriate adjuvant therapy. However, compliance with guideline recommendations is insufficient, and this may lead to unfavorable outcomes. We aimed to investigate the level of adherence to guideline recommendations in patients with NMIBC and evaluate the outcomes of those who did and did not receive guideline‐recommended therapies.MethodsWe performed a retrospective analysis of patients with histologically diagnosed NMIBC. The percentage of patients with intermediate‐ and high‐risk tumors who received adjuvant intravesical therapy or second transurethral resection (TUR) was calculated. Recurrence‐free survival was assessed in patients who did and did not receive the therapies. We conducted a propensity score‐matched analysis to compare outcomes between patients with intermediate‐risk and T1 NMIBC who did and did not undergo guideline‐recommended therapies.ResultsOverall, 1204 patients from the Tohoku Urological Evidence‐Based Medicine Study Group and Kyoto University Hospital were included. Of patients with intermediate‐ and high‐risk tumors, 91.0% and 74.0% did not receive maintenance bacillus Calmette–Guérin (BCG), respectively. In both groups, significantly better recurrence‐free survival was found for patients treated with maintenance BCG. Among patients with T1 NMIBC, only 16.7% underwent guideline‐recommended therapies, that is, a second TUR and maintenance BCG. Significantly greater recurrence‐free survival was observed in patients who received guideline‐recommended therapies compared with propensity‐matched patients who did not.ConclusionsGuideline‐recommended therapies may contribute to improvements in outcomes for patients with NMIBC, suggesting that improvements in adherence to clinical guidelines may lead to favorable outcomes.

Publisher

Wiley

Subject

Urology

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1111/iju.15294

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1. Editorial Comment to “Improving compliance with guidelines may lead to favorable clinical outcomes for patients with non‐muscle‐invasive bladder cancer: A retrospective multicenter study”;International Journal of Urology;2023-09-27