Examining the management of muscle-invasive bladder cancer by medical oncologists in the United States Journal Article


Authors: Apolo, A. B.; Kim, J. W.; Bochner, B. H.; Steinberg, S. M.; Bajorin, D. F.; Kevin Kelly, W.; Agarwal, P. K.; Koppie, T. M.; Kaag, M. G.; Quinn, D. I.; Vogelzang, N. J.; Sridhar, S. S.
Article Title: Examining the management of muscle-invasive bladder cancer by medical oncologists in the United States
Abstract: Background: Neoadjuvant chemotherapy (NACT) for the treatment of muscle-invasive bladder cancer (MIBC) remains underutilized in the United States despite evidence supporting its use. Objectives: To examine the perioperative chemotherapy management of patients with MIBC by medical oncologists (MedOncs) to move toward standardization of practice. Participants and methods: A 26-question survey was emailed to 92 MedOncs belonging to the Bladder Cancer Advocacy Network or the American Society of Clinical Oncology for completion from May to October 2011. Results: A total of 83 MedOncs completed the survey: 52% were based in academic centers. Most referrals were from urologists (79%). NACT for treatment of MIBC and high-grade upper-tract urothelial carcinoma is offered by 80% and 46% of respondents, respectively. Adjuvant chemotherapy for treatment of MIBC and upper-tract urothelial carcinoma is offered by 46% and 42% of respondents, respectively. NACT was not offered by 49%, 29%, and 35% of respondents if Eastern Cooperative Oncology Group performance status was 3 or greater, if patients had T2 lesions without lymphovascular invasion, and if the glomerular filtration rate was<50. ml/min, respectively. Chemotherapy regimens included gemcitabine/cisplatin (90%), methotrexate/vinblastine/adriamycin/cisplatin (30%), dose-dense methotrexate, vinblastine, adriamycin, and cisplatin (20%), and gemcitabine/carboplatin (37%). Conclusions: Most MedOncs (79%) in this survey offer perioperative chemotherapy to all patients with MIBC. This increased use of NACT is higher than previously reported, suggesting an increase in the adoption of recommendations that follow best evidence. © 2014.
Keywords: medical oncologist; adjuvant chemotherapy; neoadjuvant chemotherapy; survey; muscle-invasive bladder cancer
Journal Title: Urologic Oncology: Seminars and Original Investigations
Volume: 32
Issue: 5
ISSN: 1078-1439
Publisher: Elsevier Inc.  
Date Published: 2014-07-01
Start Page: 637
End Page: 644
Language: English
DOI: 10.1016/j.urolonc.2013.12.012
PROVIDER: scopus
PUBMED: 24840869
PMCID: PMC6771274
DOI/URL:
Notes: Urol. Oncol. Semin. Orig. Invest. -- Export Date: 8 July 2014 -- CODEN: UOSOA -- Source: Scopus
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  1. Dean Bajorin
    658 Bajorin
  2. Bernard Bochner
    468 Bochner