Abstract：
OBJECTIVE: There is no standardized regimen for follow-up after radical cystectomy (RC) for bladder cancer (BC). To address this gap, we conducted a multicenter study involving urologist members from the European Association of Urology (EAU) bladder cancer guideline panels. Our objective was to identify consistent post-RC follow-up strategies and develop a practice-based framework based on expert opinion.
METHODS: We surveyed 27 urologist members of the EAU guideline panels for non-muscle-invasive bladder cancer and muscle-invasive and metastatic bladder cancer using a pre-tested questionnaire with dichotomous responses. The survey inquired about follow-up strategies after RC and the use of risk-adapted strategies. Consistency was defined as >75% affirmative responses for follow-up practices commencing 3 mo after RC. Descriptive statistics were used for analysis.
UNASSIGNED: We received responses from 96% of the panel members, who provided data from 21 European hospitals. Risk-adapted follow-up is used in 53% of hospitals, with uniform criteria for high-risk (at least ≥pT3 or pN+) and low-risk ([y]pT0/a/1N0) cases. In the absence of agreement for risk-based follow up, a non-risk-adapted framework for follow-up was developed. Higher conformity was observed within the initial 3 yr, followed by a decline in subsequent follow-up. Follow-up was most frequent during the first year, including patient assessments, physical examinations, and laboratory tests. Computed tomography of the chest and abdomen/pelvis was the most common imaging modality, initially at least biannually, and then annually from years 2 to 5. There was a lack of consistency for continuing follow-up beyond 10 yr after RC.
CONCLUSIONS: This practice-based post-RC follow-up framework developed by EAU bladder cancer experts may serve as a valuable guide for urologists in the absence of prospective randomized studies.
RESULTS: We asked urologists from the EAU bladder cancer guideline panels about their patient follow-up after surgical removal of the bladder for bladder cancer. We found that although urologists have varying approaches, there are also common follow-up practices across the panel. We created a practical follow-up framework that could be useful for urologists in their day-to-day practice.
METHODS: We surveyed 27 urologist members of the EAU guideline panels for non-muscle-invasive bladder cancer and muscle-invasive and metastatic bladder cancer using a pre-tested questionnaire with dichotomous responses. The survey inquired about follow-up strategies after RC and the use of risk-adapted strategies. Consistency was defined as >75% affirmative responses for follow-up practices commencing 3 mo after RC. Descriptive statistics were used for analysis.
UNASSIGNED: We received responses from 96% of the panel members, who provided data from 21 European hospitals. Risk-adapted follow-up is used in 53% of hospitals, with uniform criteria for high-risk (at least ≥pT3 or pN+) and low-risk ([y]pT0/a/1N0) cases. In the absence of agreement for risk-based follow up, a non-risk-adapted framework for follow-up was developed. Higher conformity was observed within the initial 3 yr, followed by a decline in subsequent follow-up. Follow-up was most frequent during the first year, including patient assessments, physical examinations, and laboratory tests. Computed tomography of the chest and abdomen/pelvis was the most common imaging modality, initially at least biannually, and then annually from years 2 to 5. There was a lack of consistency for continuing follow-up beyond 10 yr after RC.
CONCLUSIONS: This practice-based post-RC follow-up framework developed by EAU bladder cancer experts may serve as a valuable guide for urologists in the absence of prospective randomized studies.
RESULTS: We asked urologists from the EAU bladder cancer guideline panels about their patient follow-up after surgical removal of the bladder for bladder cancer. We found that although urologists have varying approaches, there are also common follow-up practices across the panel. We created a practical follow-up framework that could be useful for urologists in their day-to-day practice.
摘要：
目的：膀胱癌（BC）根治性膀胱切除术（RC）后随访尚无标准化方案。为了解决这个差距，我们进行了一项多中心研究,纳入了来自欧洲泌尿外科协会(EAU)膀胱癌指南小组的泌尿科医师.我们的目标是确定一致的RC后后续战略，并根据专家意见制定基于实践的框架。
方法：我们调查了EAU指南小组的27位泌尿科医师成员，他们使用带有二分法反应的预先测试问卷，对非肌肉浸润性膀胱癌和肌肉浸润性和转移性膀胱癌进行了调查。调查询问了RC后的后续策略以及风险适应策略的使用。一致性定义为RC后3个月开始的后续实践的肯定回答>75%。描述性统计用于分析。
■我们收到了96％的小组成员的答复，他们提供了来自21家欧洲医院的数据。53%的医院使用风险适应随访，对于高风险（至少≥pT3或pN）和低风险（[y]pT0/a/1N0）病例具有统一标准。在缺乏基于风险的跟进协议的情况下，制定了不适应风险的后续行动框架。在最初的3年内观察到更高的一致性，随后的后续行动有所下降。第一年随访最频繁，包括患者评估，体检,和实验室测试。胸部和腹部/骨盆的计算机断层扫描是最常见的成像方式，最初至少每两年一次，然后每年从2年到5年。RC后10年以上的持续随访缺乏一致性。
结论：由EAU膀胱癌专家开发的基于实践的RC后随访框架可能在没有前瞻性随机研究的情况下为泌尿科医师提供有价值的指导。
结果：我们向来自EAU膀胱癌指南小组的泌尿科医师询问了膀胱癌手术切除膀胱后的患者随访情况。我们发现尽管泌尿科医师有不同的方法，整个小组也有共同的跟进做法。我们创建了一个实用的后续框架，对泌尿科医师的日常实践很有用。
方法：我们调查了EAU指南小组的27位泌尿科医师成员，他们使用带有二分法反应的预先测试问卷，对非肌肉浸润性膀胱癌和肌肉浸润性和转移性膀胱癌进行了调查。调查询问了RC后的后续策略以及风险适应策略的使用。一致性定义为RC后3个月开始的后续实践的肯定回答>75%。描述性统计用于分析。
■我们收到了96％的小组成员的答复，他们提供了来自21家欧洲医院的数据。53%的医院使用风险适应随访，对于高风险（至少≥pT3或pN）和低风险（[y]pT0/a/1N0）病例具有统一标准。在缺乏基于风险的跟进协议的情况下，制定了不适应风险的后续行动框架。在最初的3年内观察到更高的一致性，随后的后续行动有所下降。第一年随访最频繁，包括患者评估，体检,和实验室测试。胸部和腹部/骨盆的计算机断层扫描是最常见的成像方式，最初至少每两年一次，然后每年从2年到5年。RC后10年以上的持续随访缺乏一致性。
结论：由EAU膀胱癌专家开发的基于实践的RC后随访框架可能在没有前瞻性随机研究的情况下为泌尿科医师提供有价值的指导。
结果：我们向来自EAU膀胱癌指南小组的泌尿科医师询问了膀胱癌手术切除膀胱后的患者随访情况。我们发现尽管泌尿科医师有不同的方法，整个小组也有共同的跟进做法。我们创建了一个实用的后续框架，对泌尿科医师的日常实践很有用。
