{Reference Type}: Journal Article
{Title}: Consistencies in Follow-up After Radical Cystectomy for Bladder Cancer: A Framework Based on Expert Practices Collaboratively Developed by the European Association of Urology Bladder Cancer Guideline Panels.
{Author}: Mertens LS;Bruins HM;Contieri R;Babjuk M;Rai BP;Puig AC;Escrig JLD;Gontero P;van der Heijden AG;Liedberg F;Martini A;Masson-Lecomte A;Meijer RP;Mostafid H;Neuzillet Y;Pradere B;Redlef J;van Rhijn BWG;Rouanne M;Rouprêt M;Sæbjørnsen S;Seisen T;Shariat SF;Soria F;Soukup V;Thalmann G;Xylinas E;Mariappan P;Alfred Witjes J;
{Journal}: Eur Urol Oncol
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jun 20
{Factor}: 8.208
{DOI}: 10.1016/j.euo.2024.05.010
{Abstract}: <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>UNASSIGNED: </B>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.<BR><B>CONCLUSIONS: </B>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.<BR><B>RESULTS: </B>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.