Format

Send to

Choose Destination
Urol Oncol. 2014 Jul;32(5):637-44. doi: 10.1016/j.urolonc.2013.12.012. Epub 2014 May 16.

Examining the management of muscle-invasive bladder cancer by medical oncologists in the United States.

Author information

1
Medical Oncology Branch, National Cancer Institute, NIH, Bethesda, MD. Electronic address: andrea.apolo@nih.gov.
2
Department of Medicine, Yale School of Medicine, Yale Cancer Center, New Haven, CT.
3
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY.
4
Biostatistics and Data Management Section, National Cancer Institute, NIH, Bethesda, MD.
5
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY.
6
Department of Medical Oncology, Thomas Jefferson University, Kimmel Cancer Center, Philadelphia, PA.
7
Urologic Oncology Branch, National Cancer Institute, NIH, Bethesda, MD.
8
Department of Urology, Oregon Health and Science University, Portland, OR.
9
Division of Urology, Penn State Hershey Medical Center, Hershey, PA.
10
Developmental Therapeutics and Genitourinary Cancer Programs, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA.
11
US Oncology Research, Houston, TX; Comprehensive Cancer Centers of Nevada, Las Vegas, NV.
12
Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Canada.

Abstract

BACKGROUND:

Neoadjuvant chemotherapy (NACT) for the treatment of muscle-invasive bladder cancer (MIBC) remains underutilized in the United States despite evidence supporting its use.

OBJECTIVES:

To examine the perioperative chemotherapy management of patients with MIBC by medical oncologists (MedOncs) to move toward standardization of practice

PARTICIPANTS AND METHODS:

A 26-question survey was emailed to 92 MedOncs belonging to the Bladder Cancer Advocacy Network or the American Society of Clinical Oncology for completion from May to October 2011 RESULTS: A total of 83 MedOncs completed the survey: 52% were based in academic centers. Most referrals were from urologists (79%). NACT for treatment of MIBC and high-grade upper-tract urothelial carcinoma is offered by 80% and 46% of respondents, respectively. Adjuvant chemotherapy for treatment of MIBC and upper-tract urothelial carcinoma is offered by 46% and 42% of respondents, respectively. NACT was not offered by 49%, 29%, and 35% of respondents if Eastern Cooperative Oncology Group performance status was 3 or greater, if patients had T2 lesions without lymphovascular invasion, and if the glomerular filtration rate was<50ml/min, respectively. Chemotherapy regimens included gemcitabine/cisplatin (90%), methotrexate/vinblastine/adriamycin/cisplatin (30%), dose-dense methotrexate, vinblastine, adriamycin, and cisplatin (20%), and gemcitabine/carboplatin (37%).

CONCLUSIONS:

Most MedOncs (79%) in this survey offer perioperative chemotherapy to all patients with MIBC. This increased use of NACT is higher than previously reported, suggesting an increase in the adoption of recommendations that follow best evidence.

KEYWORDS:

Adjuvant chemotherapy; Medical oncologist; Muscle-invasive bladder cancer; Neoadjuvant chemotherapy; Survey

PMID:
24840869
DOI:
10.1016/j.urolonc.2013.12.012
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center