肌层浸润性和转移性膀胱癌指南（欧洲泌尿外科学会指南）：美国临床肿瘤学会临床实践指南认可。
Guideline on Muscle-Invasive and Metastatic Bladder Cancer (European Association of Urology Guideline): American Society of Clinical Oncology Clinical Practice Guideline Endorsement.
机构信息
Matthew I. Milowsky, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Christopher M. Booth, Queen's University, Kingston; Libni J. Eapen, Ottawa Hospital Cancer Centre, Ottawa, Ontario, Canada; Timothy Gilligan, Cleveland Clinic, Cleveland, OH; Ralph J. Hauke, Nebraska Cancer Specialists, Omaha, NE; Pat Boumansour, Patient Representative, Palm Coast, FL; and Cheryl T. Lee, University of Michigan, Ann Arbor, MI.
出版信息
J Clin Oncol. 2016 Jun 1;34(16):1945-52. doi: 10.1200/JCO.2015.65.9797. Epub 2016 Mar 21.
PURPOSE
To endorse the European Association of Urology guideline on muscle-invasive (MIBC) and metastatic bladder cancer. The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing clinical practice guidelines that have been developed by other professional organizations.
METHODS
The guideline on MIBC and metastatic bladder cancer was reviewed for developmental rigor by methodologists. The ASCO Endorsement Panel then reviewed the content and recommendations.
RESULTS
The ASCO Endorsement Panel determined that the recommendations from the European Association of Urology guideline on MIBC and metastatic bladder cancer, published online in March 2015, are clear, thorough, and based on the most relevant scientific evidence. ASCO endorses the guideline on MIBC and metastatic bladder cancer and has added qualifying statements, including highlighting the use of chemoradiotherapy for select patients with MIBC and recommending a preference for clinical trials in the treatment of metastatic disease in the second-line setting.
RECOMMENDATIONS
Multidisciplinary care for patients with MIBC and metastatic bladder cancer is critical. The standard treatment of MIBC (cT2-T4a N0M0) is neoadjuvant cisplatin-based combination chemotherapy followed by radical cystectomy. In cisplatin-ineligible patients, radical cystectomy alone is recommended. Adjuvant cisplatin-based chemotherapy may be offered to high-risk patients who have not received neoadjuvant therapy. Chemoradiotherapy may be offered as an alternative to cystectomy in appropriately selected patients with MIBC and in some patients for whom cystectomy is not an option. Metastatic disease should be treated with cisplatin-containing combination chemotherapy or with carboplatin combination chemotherapy or single agents in patients ineligible for cisplatin.Additional information is available at http://www.asco.org/endorsements/MIBC and www.asco.org/guidelineswiki.
目的
认可欧洲泌尿外科学会（EAU）关于肌层浸润性（MIBC）和转移性膀胱癌的指南。美国临床肿瘤学会（ASCO）有一项政策和一套程序，用于认可由其他专业组织制定的临床实践指南。
方法
方法学家对 MIBC 和转移性膀胱癌指南进行了严格的开发审查。然后，ASCO 认可小组审查了内容和建议。
结果
ASCO 认可小组确定，EAU 于 2015 年 3 月在线发布的 MIBC 和转移性膀胱癌指南中的建议明确、全面，并基于最相关的科学证据。ASCO 认可 MIBC 和转移性膀胱癌指南，并添加了限定性语句，包括强调对某些 MIBC 患者使用放化疗，并建议在二线治疗转移性疾病时优先选择临床试验。
建议
多学科治疗 MIBC 和转移性膀胱癌患者至关重要。MIBC（cT2-T4a N0M0）的标准治疗是新辅助顺铂联合化疗，然后进行根治性膀胱切除术。在不能使用顺铂的患者中，建议单独进行根治性膀胱切除术。对于未接受新辅助治疗的高危患者，可以提供辅助顺铂为基础的化疗。对于 MIBC 中选择适当的患者和不能进行膀胱切除术的某些患者，可以提供放化疗作为膀胱切除术的替代方案。转移性疾病应采用含顺铂的联合化疗或卡铂联合化疗或单药治疗，不适合顺铂的患者。更多信息请访问 http://www.asco.org/endorsements/MIBC 和 www.asco.org/guidelineswiki。
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