Controversies in terminology associated with management of BCG-unresponsive NMIBC in Asia-Pacific

Eiji Kikuchi, Chi Fai Ng, Hiroshi Kitamura, Ja Hyeon Ku, Lui Shiong Lee, Tzu Ping Lin, Junice Yi Siu Ng, Hiroyuki Nishiyama, Darren Ming Chun Poon, Ravindran Kanesvaran, Ho Kyung Seo, Carmel Spiteri, Ee Min Tan, Yuh Shyan Tsai, Ben Tran

研究成果: Article同行評審


Objectives: Examine the understanding of terminologies and management patterns of bacillus Calmette-Guérin (BCG)-unresponsive nonmuscle invasive bladder cancer (NMIBC) in six territories in Asia-Pacific. Methods: This study involved two phases: (1) a survey with 32 urologists and 7 medical oncologists (MOs) and (2) a factorial experiment and in-depth interviews with 23 urologists and 2 MOs. All clinicians had ≥8 years' experience managing NMIBC patients in Australia, Hong Kong, Japan, South Korea, Singapore, and Taiwan. Data from Phase 1 were summarized using descriptive statistics; content and thematic analyses applied in Phase 2. Results: In phase 1, 35% of clinicians defined BCG-unresponsive as BCG-refractory, -relapse and -resistant, 6% defined it as BCG-refractory and -relapse; 22% classified BCG-failure as BCG-refractory, -relapse, -resistant, and when muscle-invasive bladder cancer is detected. If eligible and willing, 50% (interquartile range [IQR], 50%–80%) of BCG-unresponsive patients would undergo radical cystectomy (RC), and 50% (IQR 20%–50%) of RC-eligible patients would receive bladder-sparing treatment or surveillance. In phase 2, we found that 32%, 88%, and 48% of clinicians, respectively, used “BCG-unresponsive,” “BCG-refractory,” and “BCG-relapse” in clinical practice but with no consistent interpretation of the terms. Compared with EAU definitions, 8%–60% of clinicians appropriately classified 9 tumor types that are persistent or recurrent after adequate BCG. Fifty percent of clinicians mentioned a lack of bladder-preserving treatment that outperforms RC in quality of life as a reason to retreat BCG-unresponsive patients with BCG. Conclusions: Our study revealed varied understanding and application of BCG-unresponsive terminologies in practice. There is a need for a uniform and simple definition of BCG-unresponsive disease in Asia-Pacific.

頁(從 - 到)32-38
期刊International Journal of Urology
出版狀態Published - 2024 1月

All Science Journal Classification (ASJC) codes

  • 泌尿科學


深入研究「Controversies in terminology associated with management of BCG-unresponsive NMIBC in Asia-Pacific」主題。共同形成了獨特的指紋。