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Abstract：
OBJECTIVE: To assess whether the initial treatment of non-muscle invasive bladder cancer (NMIBC) was performed according to the guidelines, and to determine the reasons why initial treatment was not provided in nonadherence cases.
METHODS: We retrospectively reviewed all patients with NMIBC who underwent their first transurethral resection of bladder tumor (TURBT) at a peripheral hospital, between 2007 and 2016. The treatment offered to the patient was compared to the European Association of Urology guidelines according to risk stratification. For each patient who did not receive the treatment according to the guidelines, one of the following reasons was identified: poor patient compliance, poor patient general health status, urologist\'s decision, lack of resources.
RESULTS: One hundred fifty-nine patients were included with a mean age of 72.2 years at the time of NMIBC diagnosis. The low-risk patients were strictly treated according to the guidelines. Among the intermediate-risk patients, 14% received mitomycin C. Among the high-risk patients, 39% received intravesical Bacillus Calmette-Guerin. In the nonadherence cases (61%), the reasons were related to the patient in 44% of cases (poor compliance, 21%; poor patient general health status, 23%), urologist\'s decision in 54% of cases, and lack of resources in 2% of cases. Thirty-seven percent of the high-risk patients underwent re-resection.
CONCLUSIONS: Overall, adherence to NMIBC guidelines was low in all treatment types (intravesical therapy, re-resection, or cystectomy for very high-risk patients), but this finding was similar to that in previous studies. Reasons were mainly related to the urologist\'s decision or to the patient condition (poor compliance or poor general health status).
METHODS: 3.
METHODS: We retrospectively reviewed all patients with NMIBC who underwent their first transurethral resection of bladder tumor (TURBT) at a peripheral hospital, between 2007 and 2016. The treatment offered to the patient was compared to the European Association of Urology guidelines according to risk stratification. For each patient who did not receive the treatment according to the guidelines, one of the following reasons was identified: poor patient compliance, poor patient general health status, urologist\'s decision, lack of resources.
RESULTS: One hundred fifty-nine patients were included with a mean age of 72.2 years at the time of NMIBC diagnosis. The low-risk patients were strictly treated according to the guidelines. Among the intermediate-risk patients, 14% received mitomycin C. Among the high-risk patients, 39% received intravesical Bacillus Calmette-Guerin. In the nonadherence cases (61%), the reasons were related to the patient in 44% of cases (poor compliance, 21%; poor patient general health status, 23%), urologist\'s decision in 54% of cases, and lack of resources in 2% of cases. Thirty-seven percent of the high-risk patients underwent re-resection.
CONCLUSIONS: Overall, adherence to NMIBC guidelines was low in all treatment types (intravesical therapy, re-resection, or cystectomy for very high-risk patients), but this finding was similar to that in previous studies. Reasons were mainly related to the urologist\'s decision or to the patient condition (poor compliance or poor general health status).
METHODS: 3.
摘要：
目的：评估非肌层浸润性膀胱癌（NMIBC）的初始治疗是否按照指南进行，并确定在不依从病例中未提供初始治疗的原因。
方法：我们回顾性分析了所有在外围医院接受首次经尿道膀胱肿瘤电切术（TURBT）的NMIBC患者，2007年至2016年。根据风险分层，将向患者提供的治疗与欧洲泌尿外科协会指南进行比较。对于每位未根据指南接受治疗的患者，确定了以下原因之一：患者依从性差，患者总体健康状况较差，泌尿科医生的决定，缺乏资源。
结果：纳入NMIBC诊断时的59例患者，平均年龄为72.2岁。低危患者严格按照指南进行治疗。在中等风险患者中，14%接受丝裂霉素C。在高危患者中，39%接受膀胱内卡介苗。在不依从的情况下（61%），在44%的病例中，原因与患者有关(依从性差，21%；患者一般健康状况差，23%），泌尿科医生在54%的病例中做出的决定，2％的病例缺乏资源。37％的高危患者接受了再次切除。
结论：总体而言，所有治疗类型对NMIBC指南的依从性均较低(膀胱内治疗，再切除,或针对高危患者的膀胱切除术)，但这一发现与以前的研究相似。原因主要与泌尿科医师的决定或患者病情（依从性差或一般健康状况差）有关。
方法：3.
方法：我们回顾性分析了所有在外围医院接受首次经尿道膀胱肿瘤电切术（TURBT）的NMIBC患者，2007年至2016年。根据风险分层，将向患者提供的治疗与欧洲泌尿外科协会指南进行比较。对于每位未根据指南接受治疗的患者，确定了以下原因之一：患者依从性差，患者总体健康状况较差，泌尿科医生的决定，缺乏资源。
结果：纳入NMIBC诊断时的59例患者，平均年龄为72.2岁。低危患者严格按照指南进行治疗。在中等风险患者中，14%接受丝裂霉素C。在高危患者中，39%接受膀胱内卡介苗。在不依从的情况下（61%），在44%的病例中，原因与患者有关(依从性差，21%；患者一般健康状况差，23%），泌尿科医生在54%的病例中做出的决定，2％的病例缺乏资源。37％的高危患者接受了再次切除。
结论：总体而言，所有治疗类型对NMIBC指南的依从性均较低(膀胱内治疗，再切除,或针对高危患者的膀胱切除术)，但这一发现与以前的研究相似。原因主要与泌尿科医师的决定或患者病情（依从性差或一般健康状况差）有关。
方法：3.
