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Eur Urol. 2017 Mar;71(3):462-475. doi: 10.1016/j.eururo.2016.06.020. Epub 2016 Jun 30.

Updated 2016 EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer.

Author information

1
Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Electronic address: Fred.Witjes@radboudumc.nl.
2
Hôpital Foch, Department of Urology, University of Versailles-Saint-Quentin-en-Yvelines, Suresnes, France.
3
Department of Pathology, Hôpital La Pitié Salpetrière, UPMC, Paris, France.
4
Radiology Department, Queen Alexandra Hospital, Portsmouth, UK.
5
University of Warwick, Cancer Research Unit, Coventry, UK; Queen Elizabeth Hospital, Birmingham, UK.
6
Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
7
Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
8
Department of Urology, Hospital Universitario Infanta Sofia, Madrid, Spain.
9
Department of Urology, Derriford Hospital, Plymouth, UK.
10
Department of Urology, Tampere University Hospital, Tampere, Finland.
11
Department of Urology, Eberhard-Karls University, Tübingen, Germany.
12
Department of Urology, Hospital Clinic, University of Barcelona, Barcelona, Spain.

Abstract

CONTEXT:

Invasive bladder cancer is a frequently occurring disease with a high mortality rate despite optimal treatment. The European Association of Urology (EAU) Muscle-invasive and Metastatic Bladder Cancer (MIBC) Guidelines are updated yearly and provides information to optimise diagnosis, treatment, and follow-up of this patient population.

OBJECTIVE:

To provide a summary of the EAU guidelines for physicians and patients confronted with muscle-invasive and metastatic bladder cancer.

EVIDENCE ACQUISITION:

An international multidisciplinary panel of bladder cancer experts reviewed and discussed the results of a comprehensive literature search of several databases covering all sections of the guidelines. The panel defined levels of evidence and grades of recommendation according to an established classification system.

EVIDENCE SYNTHESIS:

Epidemiology and aetiology of bladder cancer are discussed. The proper diagnostic pathway, including demands for pathology and imaging, is outlined. Several treatment options, including bladder-sparing treatments and combinations of treatment modalities (different forms of surgery, radiation therapy, and chemotherapy) are described. Sequencing of these modalities is discussed. Potential indications and contraindications, such as comorbidity, are related to treatment choice. There is a new paragraph on organ-sparing approaches, both in men and in women, and on minimal invasive surgery. Recommendations for chemotherapy in fit and unfit patients are provided including second-line options. Finally, a follow-up schedule is provided.

CONCLUSIONS:

The current summary of the EAU Muscle-invasive and Metastatic Bladder Cancer Guidelines provides an up-to-date overview of the available literature and evidence dealing with diagnosis, treatment, and follow-up of patients with metastatic and muscle-invasive bladder cancer.

PATIENT SUMMARY:

Bladder cancer is an important disease with a high mortality rate. These updated guidelines help clinicians refine the diagnosis and select the appropriate therapy and follow-up for patients with metastatic and muscle-invasive bladder cancer.

KEYWORDS:

Bladder cancer; Cystectomy; Diagnosis; EAU; Follow-up; Guidelines; Metastatic; Multimodality; Muscle invasive; Treatment

PMID:
27375033
DOI:
10.1016/j.eururo.2016.06.020
[Indexed for MEDLINE]

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