Diagnosis and Treatment of Non-Muscle Invasive Bladder Cancer: AUA/SUO Guideline

作者：Chang, Sam S.^*; Boorjian, Stephen A.; Chou, Roger; Clark, Peter E.; Daneshmand, Siamak; Konety, Badrinath R.; Pruthi, Raj; Quale, Diane Z.; Ritch, Chad R.; Seigne, John D.; Skinner, Eila Curlee; Smith, Norm D.; McKiernan, James M.

来源：Journal of Urology, 2016, 196(4): 1021-1029.

DOI：10.1016/j.juro.2016.06.049

• urinary bladder neoplasms
• cystectomy
• drug therapy
• immunotherapy

Purpose: Although associated with an overall favorable survival rate, the heterogeneity of non-muscle invasive bladder cancer (NMIBC) affects patients' rates of recurrence and progression. Risk stratification should influence evaluation, treatment and surveillance. This guideline attempts to provide a clinical framework for the management of NMIBC. @@@ Materials and Methods: A systematic review utilized research from the Agency for Healthcare Research and Quality (AHRQ) and additional supplementation by the authors and consultant methodologists. Evidence-based statements were based on body of evidence strength Grade A, B, or C and were designated as Strong, Moderate, and Conditional Recommendations with additional statements presented in the form of Clinical Principles or Expert Opinions. 1 @@@ Results: A risk-stratified approach categorizes patients into broad groups of low-, intermediate-, and high-risk. Importantly, the evaluation and treatment algorithm takes into account tumor characteristics and uniquely considers a patient's response to therapy. The 38 statements vary in level of evidence, but none include Grade A evidence, and many were Grade C. @@@ Conclusion: The intensity and scope of care for NMIBC should focus on patient, disease, and treatment response characteristics. This guideline attempts to improve a clinician's ability to evaluate and treat each patient, but higher quality evidence in future trials will be essential to improve level of care for these patients.

• 出版日期2016-10