title: Are referral centers for non-muscle-invasive bladder cancer compliant to EAU guidelines? A report from the vesical antiblastic therapy Italian study.
abstract: BACKGROUND
  Adherence to international guidelines is viewed as a prerequisite for optimal medical care delivery. Previously reported surveys for non-muscle-invasive bladder cancer (NMIBC) employed mailed questionnaires to urologists or patients resulting in conflicting degrees of agreement with existing guidelines. In the current study, contemporary information on the management of NMIBC was generated from a sample of italian centers.
  
  
  METHODS
  Eight Italian referral centers for the treatment of NMIBC were asked to collect information relative to all consecutive patients with a histology-proven NMIBC undergoing a transurethral resection from January 1 to March 31, 2009. The primary study objective was to verify the level of adherence of disease management with European guidelines.
  
  
  RESULTS
  344 patients resulted in being evaluable. 49.2% of high-risk patients underwent a repeat transurethral resection. Bacillus Calmette-Guérin was employed in 35% of cases, while chemotherapy was in 22%. An early single regimen was adopted in 136 patients and only in 1 out of 3 low-risk patients. High-risk NMIBC received bacillus Calmette-Guérin and chemotherapy as first-line therapy in 66 and 12.5% respectively. After 3 months, cystoscopy had been reported for 82.5% of patients with a recurrence rate of 13%.
  
  
  CONCLUSIONS
  Adherence of Italian Institutions to EAU guidelines was optimal when reporting baseline variables. Significant degrees of discrepancy emerged in treatment choices.
authors.affiliation: Urologia 1, Università degli Studi di Torino, Torino, Italy. paolo.gontero@unito.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Gontero
authors.forename: Marco
authors.initials: M
authors.lastname: Oderda
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Altieri
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bartoletti
authors.forename: Tommaso
authors.initials: T
authors.lastname: Cai
authors.forename: Renzo
authors.initials: R
authors.lastname: Colombo
authors.forename: Antonio
authors.initials: A
authors.lastname: Curotto
authors.forename: Savino
authors.initials: S
authors.lastname: Di Stasi
authors.forename: Massimo
authors.initials: M
authors.lastname: Maffezzini
authors.forename: Stefania
authors.initials: S
authors.lastname: Tamagno
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Serretta
authors.forename: Filippo
authors.initials: F
authors.lastname: Sogni
authors.forename: Carlo
authors.initials: C
authors.lastname: Terrone
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tizzani
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morgia
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Mirone
authors.forename: Giorgio
authors.initials: G
authors.lastname: Carmignani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000628:therapy*