%0 Journal Article
%T Low compliance to guidelines in nonmuscle-invasive bladder carcinoma: A systematic review.
%A Mori K
%A Miura N
%A Babjuk M
%A Karakiewicz PI
%A Mostafaei H
%A Laukhtina E
%A Quhal F
%A Motlagh RS
%A Pradere B
%A Kimura S
%A Egawa S
%A Shariat SF
%J Urol Oncol
%V 38
%N 10
%D 10 2020
%M 32654948
%F 2.954
%R 10.1016/j.urolonc.2020.06.013
%X This systematic review assessed compliance to guidelines for the management of nonmuscle-invasive bladder carcinoma (NMIBC).<BR>The PUBMED, Web of Science, Cochrane Library, and Scopus databases were searched in November 2019 in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis statement.<BR>Fifteen studies incorporating a collective total of 10,575 NMIBC patients were eligible for inclusion in this systematic review. We found that the rates of compliance were 53.0% with a single immediate intravesical instillation in patients with presumed low or intermediate risk, 37.1% with intravesical bacillus Calmette-Guerin or chemotherapy in those with intermediate risk, 43.4% with performance of a second transurethral resection in high-risk patients, 32.5% with administration of adjuvant intravesical bacillus Calmette-Guerin in high-risk patients, 36.1% with radical cystectomy in highest-risk patients, and 82.2% with cystoscopy for follow-up.<BR>Compliance with NMIBC guidelines remains low. Better guideline education and understanding holds the key to achieving high compliance. Strategies to improve guideline compliance at the physician level are urgently required.