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

{"article_title":"Updated 2016 EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer.","author":"Alfred Witjes J, Lebret T, Comp\u00e9rat EM, Cowan NC, De Santis M, Bruins HM, Hern\u00e1ndez V, Espin\u00f3s EL, Dunn J, Rouanne M, Neuzillet Y, Veskim\u00e4e E, van der Heijden AG, Gakis G, Ribal MJ","journal_title":"European urology","issn":"1873-7560","isbn":"","publication_date":"2017-03-01","volume":"71","issue":"3","first_page":"462","page_count":"","accession_number":"27375033","doi":"10.1016\/j.eururo.2016.06.020","publisher":"Elsevier Science","doctype":"Journal Article","subjects":"Adjuvants, Immunologic therapeutic use; Antineoplastic Combined Chemotherapy Protocols therapeutic use; BCG Vaccine therapeutic use; Carcinoma, Transitional Cell therapy; Cystectomy; Cystoscopy; Radiotherapy; Urinary Bladder Neoplasms therapy; Carcinoma, Transitional Cell pathology; Carcinoma, Transitional Cell secondary; Europe; Humans; Muscle, Smooth pathology; Neoplasm Invasiveness; Neoplasm Metastasis; Societies, Medical; Urinary Bladder pathology; Urinary Bladder Neoplasms pathology; Urology","interest_area":["Urology & Nephrology"," Oncology"],"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. Copyright \u00a9 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=27375033","isPdfLink":false,"isSAML":true,"an":"27375033","number_other":"","type_pub":"","issn_electronic":"1873-7560","languages":"English","language":"eng","date_entry":"Date Created: 20160705 Date Completed: 20180212 Latest Revision: 20221109","date_update":"20240104","titleSource":"European urology [Eur Urol] 2017 Mar; Vol. 71 (3), pp. 462-475. Date of Electronic Publication: 2016 Jun 30.","date_pub_cy":"","type_document":"","contract_publisher":"","authored_on":"2017-03-01","description":"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.<br \/>Objective: To provide a summary of the EAU guidelines for physicians and patients confronted with muscle-invasive and metastatic bladder cancer.<br \/>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.<br \/>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.<br \/>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.<br \/>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.<br \/> (Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.)","upload_link":"https:\/\/dx.doi.org\/doi:10.1016\/j.eururo.2016.06.020","no_of_pages":"","authored_by":"Alfred Witjes J, Lebret T, Comp\u00e9rat EM, Cowan NC, De Santis M, Bruins HM, Hern\u00e1ndez V, Espin\u00f3s EL, Dunn J, Rouanne M, Neuzillet Y, Veskim\u00e4e E, van der Heijden AG, Gakis G, Ribal MJ","additionalInfo":{"Authored_By":"Alfred Witjes J, Lebret T, Comp\u00e9rat EM, Cowan NC, De Santis M, Bruins HM, Hern\u00e1ndez V, Espin\u00f3s EL, Dunn J, Rouanne M, Neuzillet Y, Veskim\u00e4e E, van der Heijden AG, Gakis G, Ribal MJ","Journal_Info":"Publisher: Elsevier Science Country of Publication: Switzerland NLM ID: 7512719 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-7560 (Electronic) Linking ISSN: 03022838 NLM ISO Abbreviation: Eur Urol Subsets: MEDLINE","Publication_Type":"Journal Article; Practice Guideline","Published_Date":"2017-03-01","Source":"European urology [Eur Urol] 2017 Mar; Vol. 71 (3), pp. 462-475. Date of Electronic Publication: 2016 Jun 30.","Languages":"English","Electronic_ISSN":"1873-7560","MeSH_Terms":"Cystectomy* , Cystoscopy* , Radiotherapy*, Adjuvants, Immunologic\/*therapeutic use , Antineoplastic Combined Chemotherapy Protocols\/*therapeutic use , BCG Vaccine\/*therapeutic use , Carcinoma, Transitional Cell\/*therapy , Urinary Bladder Neoplasms\/*therapy, Carcinoma, Transitional Cell\/pathology ; Carcinoma, Transitional Cell\/secondary ; Europe ; Humans ; Muscle, Smooth\/pathology ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Societies, Medical ; Urinary Bladder\/pathology ; Urinary Bladder Neoplasms\/pathology ; Urology","Subjects":"Carcinoma, Transitional Cell pathology, Carcinoma, Transitional Cell secondary, Europe, Humans, Muscle, Smooth pathology, Neoplasm Invasiveness, Neoplasm Metastasis, Societies, Medical, Urinary Bladder pathology, Urinary Bladder Neoplasms pathology, Urology, Adjuvants, Immunologic therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, BCG Vaccine therapeutic use, Carcinoma, Transitional Cell therapy, Cystectomy, Cystoscopy, Radiotherapy, Urinary Bladder Neoplasms therapy","Title_Abbreviations":"European urology","Volume":"71"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"27375033","RelevancyScore":"736","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"736.443115234375"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=27375033&authtype=shib&custid=ns346513&group=main&profile=eds"}