Dobé Tom-Régis, Califano Gianluigi, von Rundstedt Friedrich-Carl, Ouzaid Idir, Albisinni Simone, Aziz Atiqullah, Di Trapani Ettore, Hendricksen Kees, Krajewski Wojciech, Mari Andrea, Moschini Marco, Necchi Andrea, Noon Aidan P, Poyet Cedric, Pradère Benjamin, Rink Michael, Roghmann Florian, Sargos Paul, Seiler Roland, Soria Francesco, Vetterlein Malte W, Xylinas Evanguelos
Urology Department, Bichat-Claude Bernard Hospital, Assistance-Publique Hôpitaux de Paris, Paris University, Paris, France.
Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy.
Eur Urol Open Sci. 2020 Nov 6;22:45-50. doi: 10.1016/j.euros.2020.10.003. eCollection 2020 Dec.
Level 1 evidence supports the administration of single postoperative intravesical chemotherapy (pIVC) following radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC), in order to decrease intravesical recurrence risk.
The Young Academic Urologist Urothelial Cancer Group aimed to investigate the use of pIVC in daily practice among European colleagues.
An online survey was shared with European Association of Urology Section of Oncological Urology (ESOU) 2017 participants via e-mail. Submissions were accepted from April to June 2017. The topics for 15 questions of this survey included the habit of delivering pIVC, the choice of drug, its dosage, related doubts or concerns, reasons not to perform pIVC, knowledge of the evidence, and surgical preferences for RNU.
Survey software was used for analyses. Logistic regression analyses were used to investigate the association between surgeons' experience and caseloads with pIVC utilization.
Overall, 127 responses were collected (11.6%). About half of the participants (47%) regularly administered pIVC following RNU. The drug most commonly utilized was mitomycin (85%); 82% adhered to the standard dosage of 40 mg. Different administration protocols were adopted: ≤48 h (39%), 7-10 postoperative days (35%), >10 d (11%), and intraoperatively (10%). The evidence was supported by prospective randomized clinical trials for only 65% of responders. Among interviewees who did not deliver pIVC, the most commonly reported reasons were lack of supporting data (55%), fear of potential side effects (18%), and organizational hurdles (15%).
Our research highlights the limited use of pIVC following RNU for UTUC, raising the question of how the compliance with level 1 evidence in the urological community may be promoted.
Level 1 evidence supports the administration of single postoperative intravesical chemotherapy (pIVC) following radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC), in order to decrease intravesical recurrence risk. The Young Academic Urologist Urothelial Cancer Group aimed to investigate the use of pIVC in daily practice among European colleagues. Our research highlights the limited use of pIVC (47%) following RNU for UTUC, raising the question of how the compliance with level 1 evidence in the urological community may be promoted.
一级证据支持对上尿路尿路上皮癌（UTUC）行根治性肾输尿管切除术（RNU）后进行单次术后膀胱内化疗（pIVC），以降低膀胱内复发风险。
青年学术泌尿外科医生尿路上皮癌小组旨在调查欧洲同行在日常实践中对pIVC的使用情况。
设计、设置和参与者：通过电子邮件向欧洲泌尿外科协会肿瘤泌尿外科分会（ESOU）2017年参会者分享了一项在线调查。2017年4月至6月接受提交。该调查15个问题的主题包括进行pIVC的习惯、药物选择、剂量、相关疑问或担忧、不进行pIVC的原因、对证据的了解以及RNU的手术偏好。
使用调查软件进行分析。采用逻辑回归分析来研究外科医生的经验和病例量与pIVC使用之间的关联。
总体而言，共收集到127份回复（11.6%）。约一半的参与者（47%）在RNU后定期进行pIVC。最常用的药物是丝裂霉素（85%）；82%遵循40mg的标准剂量。采用了不同的给药方案：≤48小时（39%）、术后7 - 10天（35%）、>10天（11%）和术中（10%）。只有65%的回复者的证据得到前瞻性随机临床试验的支持。在未进行pIVC的受访者中，最常报告的原因是缺乏支持数据（55%）、担心潜在副作用（18%）和组织障碍（15%）。
我们的研究突出了RNU后对UTUC进行pIVC的使用有限，这引发了如何促进泌尿外科界对一级证据的依从性的问题。
一级证据支持对上尿路尿路上皮癌（UTUC）行根治性肾输尿管切除术（RNU）后进行单次术后膀胱内化疗（pIVC），以降低膀胱内复发风险。青年学术泌尿外科医生尿路上皮癌小组旨在调查欧洲同行在日常实践中对pIVC的使用情况。我们的研究突出了RNU后对UTUC进行pIVC的使用有限（47%），这引发了如何促进泌尿外科界对一级证据的依从性的问题。
