Struck, Julian P., Hennig, Martin J. P., Hupe, Marie C., Moharam, Nadim, Paffenholz, Pia, Nestler, Tim, Frank, Tanja, Worst, Thomas S., Grabbert, Markus, Pohlmann, Philippe-Fabian, Dogan, Serkan, Hofbauer, Sebastian L., Kalogirou, Charis, Mattigk, Angelika, Brandt, Maximilian P., Krabbe, Laura-Maria, Reis, Henning ORCID: 0000-0003-1373-5295, Dressler, Franz F., Kramer, Mario W. and Salem, Johannes . Discrepancy between German S3 Guideline Recommendations and Daily Urologic Practice in the Management of Nonmuscle Invasive Bladder Cancer: Results of a Binational Survey. Urol.Int.. BASEL: KARGER. ISSN 1423-0399

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Abstract

Introduction: Guideline recommendations are meant to help minimize morbidity and to improve the care of nonmuscle invasive bladder cancer (NMIBC) patients but studies have suggested an underuse of guideline-recommended care. The aim of this study was to evaluate the level of adherence of German and Austrian urologists to German guideline recommendations. Methods: A survey of 27 items evaluating diagnostic and therapeutic recommendations (15 cases of strong consensus and 6 cases of consensus) for NMIBC was administered among 14 urologic training courses. Survey construction and realization followed the checklist for reporting results of internet e-surveys and was approved by an internal review board. Results: Between January 2018 and June 2019, a total of 307 urologists responded to the questionnaire, with a mean response rate of 71%. The data showed a weak role of urine cytology (54%) for initial diagnostics although it is strongly recommended by the guideline. The most frequently used supporting diagnostic tool during transurethral resection of the bladder was hexaminolevulinate (95%). Contrary to the guideline recommendation, 38% of the participants performed a second resection in the case of pTa low-grade NMIBC. Correct monitoring of Bacille Calmette-Guerin (BCG) response with cystoscopy and cytology was performed by only 34% of the urologists. Conclusions: We found a discrepancy between certain guideline recommendations and daily routine practice concerning the use of urine cytology for initial diagnostics, instillation therapy with a low monitoring rate of BCG response, and follow-up care with unnecessary second resection after pTa low-grade NMIBC in particular. Our survey showed a moderate overall adherence rate of 73%. These results demonstrate the need for sharpening awareness of German guideline recommendations by promoting more intense education of urologists to optimize NMIBC care thus decreasing morbidity and mortality rates.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Struck, Julian P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hennig, Martin J. P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hupe, Marie C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moharam, NadimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Paffenholz, PiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nestler, TimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Frank, TanjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Worst, Thomas S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grabbert, MarkusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pohlmann, Philippe-FabianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dogan, SerkanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hofbauer, Sebastian L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kalogirou, CharisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mattigk, AngelikaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brandt, Maximilian P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krabbe, Laura-MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reis, HenningUNSPECIFIEDorcid.org/0000-0003-1373-5295UNSPECIFIED
Dressler, Franz F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kramer, Mario W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Salem, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-602254
DOI: 10.1159/000518166
Journal or Publication Title: Urol.Int.
Publisher: KARGER
Place of Publication: BASEL
ISSN: 1423-0399
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
BACILLUS-CALMETTE-GUERIN; HIGH-RISK; PHOTODYNAMIC DIAGNOSIS; PROGRESSION; NMIBC; HEXAMINOLEVULINATE; RECURRENCE; ADHERENCEMultiple languages
Urology & NephrologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60225

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