title: The use of immediate postoperative instillations of intravesical chemotherapy after TURBT of NMIBC among European countries.
abstract: OBJECTIVE
  The aim of this study was to assess the use of immediate postoperative instillation of intravesical chemotherapy (IPOIC) after transurethral resection of bladder tumour (TURBT) of nonmuscle invasive bladder cancer (NMIBC) in Europe.
  
  
  METHODS
  Urologists based in five European Union nations were asked to extract information from the records of patients with NMIBC-urothelial carcinoma who received at least one TURBT. Multivariate logistic regression models were developed to determine the significant predictors of IPOIC usage. Data were weighted to control for country-to-country and other differences.
  
  
  RESULTS
  Overall, 324 urologists (58 France, 72 Germany, 62 Italy, 65 Spain, 67 United Kingdom) were involved; the participation rate was 55 %. Overall, 771 patients received 954 TURBTs (mean-1.2/patient), of which 413 of the TURBTs (43.3 %) were administered IPOIC . Sixty-six of the 413 IPOICs (16.0 %) were for a recurrent tumour. Five of the tested variables were significantly associated with a patient's likelihood of receiving IPOIC after TURBT. Variables in the order of significance are as follows: (1) country (United Kingdom, patients most likely to receive IPOIC; France, least likely); (2) progression risk (physician assessed) [lower-risk conditions (no CIS, tumour < 3 cm) or intermediate risk-more likely]; (3) whether urologist completed a uro-oncology fellowship (completed-more likely); (4) recurrence risk (physician assessed) [higher-risk conditions (≥T2, ≥3 cm, CIS)-more likely]; and (5) physician's NMIBC patients volume (higher volume-more likely).
  
  
  CONCLUSIONS
  This study revealed wide practice variation and substantial noncompliance with European Association of Urology Guidelines on the use of IPOIC after TURBT for NMIBC.
authors.affiliation: Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Calle Cartagena 340-350, 08025, Barcelona, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Palou-Redorta
authors.forename: Morgan
authors.initials: M
authors.lastname: Rouprêt
authors.forename: Jack R
authors.initials: JR
authors.lastname: Gallagher
authors.forename: Kylee
authors.initials: K
authors.lastname: Heap
authors.forename: Catherine
authors.initials: C
authors.lastname: Corbell
authors.forename: Brent
authors.initials: B
authors.lastname: Schwartz
mesh_terms: D000283:Administration, Intravesical; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D015653:Cystectomy / Q000379:methods; D004522:Educational Status; D005260:Female; D005602:France; D005858:Germany; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009130:Muscle, Smooth / Q000473:pathology; D009361:Neoplasm Invasiveness / Q000473:pathology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013030:Spain; D006113:United Kingdom; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D014572:Urology
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