{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T15:02:34Z","timestamp":1790002954482,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,3,1]],"date-time":"2013-03-01T00:00:00Z","timestamp":1362096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2013,10]]},"abstract":"\n Objectives<\/jats:title>\n \n \n \n \n To examine the management of intermediate\u2010 and high\u2010risk non\u2010muscle\u2010invasive bladder cancer (\n NMIBC<\/jats:styled-content>\n ), particularly with regard to the use of bacillus\n C<\/jats:styled-content>\n almette\u2010\n G<\/jats:styled-content>\n u\u00e9rin (\n BCG<\/jats:styled-content>\n ) therapy, in\n N<\/jats:styled-content>\n orth\n A<\/jats:styled-content>\n merica and\n E<\/jats:styled-content>\n urope.\n <\/jats:p>\n <\/jats:list-item>\n \n \n To compare\n NMIBC<\/jats:styled-content>\n management practices to\n E<\/jats:styled-content>\n uropean\n A<\/jats:styled-content>\n ssociation of\n U<\/jats:styled-content>\n rology (\n EAU<\/jats:styled-content>\n ) and\n A<\/jats:styled-content>\n merican\n U<\/jats:styled-content>\n rological\n A<\/jats:styled-content>\n ssociation (\n AUA<\/jats:styled-content>\n ) guideline recommendations for the management of intermediate\u2010 and high\u2010risk\n NMIBC<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n \n \n \n \n In all, 102 urologists from\n E<\/jats:styled-content>\n urope and\n N<\/jats:styled-content>\n orth\n A<\/jats:styled-content>\n merica participated in this retrospective on\u2010line chart review, which was conducted between 1\n A<\/jats:styled-content>\n pril 2011 and 30\n A<\/jats:styled-content>\n pril 2012.\n <\/jats:p>\n <\/jats:list-item>\n \n \n Participants selected the charts of the first 10 intermediate\u2010 (defined as multiple or recurrent low\u2010grade tumours) or high\u2010risk (defined as any\n T<\/jats:styled-content>\n 1 and\/or high\u2010grade\/\n G<\/jats:styled-content>\n 3 tumours and\/or carcinoma\n in situ<\/jats:italic>\n ) patients who underwent transurethral resection of bladder tumour in 2009.\n <\/jats:p>\n <\/jats:list-item>\n \n Physicians retrospectively reviewed the charts and completed an on\u2010line survey consisting of questions related to diagnosis, planned treatment, treatment status and follow\u2010up.<\/jats:p>\n <\/jats:list-item>\n \n In all, 971 patients (197 intermediate\u2010risk; 774 high\u2010risk) were included in the analysis; frequency counts and associated percentages were used to analyse treatment variables.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n \n \n \n In all, 47% of intermediate\u2010risk patients received\n EAU<\/jats:styled-content>\n or\n AUA<\/jats:styled-content>\n guideline\u2010recommended intravesical therapy: intravesical chemotherapy,\n BCG<\/jats:styled-content>\n induction therapy or\n BCG<\/jats:styled-content>\n induction plus maintenance.\n <\/jats:p>\n <\/jats:list-item>\n \n \n Of the high\u2010risk patients, 50% received maintenance\n BCG<\/jats:styled-content>\n as recommended by the\n EAU<\/jats:styled-content>\n and the\n AUA<\/jats:styled-content>\n ; although not recommended for high\u2010risk\n NMIBC<\/jats:styled-content>\n , 12.5% received intravesical chemotherapy.\n <\/jats:p>\n <\/jats:list-item>\n \n \n Of patients prescribed maintenance\n BCG<\/jats:styled-content>\n , 93% were scheduled for at least 1 year of therapy.\n <\/jats:p>\n <\/jats:list-item>\n \n \n Notably, only 15% discontinued\n BCG<\/jats:styled-content>\n maintenance and, of these discontinuations, 65% were due to reasons unrelated to\n BCG<\/jats:styled-content>\n \u2010associated adverse events.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n \n \n \n There is significant non\u2010adherence to\n EAU<\/jats:styled-content>\n and\n AUA<\/jats:styled-content>\n guideline recommendations for\n BCG<\/jats:styled-content>\n use in intermediate\u2010 and high\u2010risk\n NMIBC<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:list-item>\n \n \n However, most of those patients prescribed\n BCG<\/jats:styled-content>\n maintenance therapy are scheduled for at least 1 year of therapy, as recommended by current guidelines for\n NMIBC<\/jats:styled-content>\n management, and\n BCG<\/jats:styled-content>\n maintenance discontinuation is low.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.12012","type":"journal-article","created":{"date-parts":[[2013,3,1]],"date-time":"2013-03-01T20:32:35Z","timestamp":1362169955000},"page":"742-750","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":85,"title":["Current clinical practice gaps in the treatment of intermediate\u2010 and high\u2010risk non\u2010muscle\u2010invasive bladder cancer (\n NMIBC<\/scp>\n ) with emphasis on the use of bacillus\n C<\/scp>\n almette\u2010\n G<\/scp>\n u\u00e9rin (\n BCG<\/scp>\n ): results of an international individual patient data survey (\n IPDS<\/scp>\n )"],"prefix":"10.1111","volume":"112","author":[{"given":"J. Alfred","family":"Witjes","sequence":"first","affiliation":[{"name":"Department of Urology Radboud University Nijmegen Medical Centre Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Palou","sequence":"additional","affiliation":[{"name":"Department of Urology, Fundaci\u00f3 Puigvert Universitat Aut\u00f2noma de Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Soloway","sequence":"additional","affiliation":[{"name":"Department of Urology University of Miami School of Medicine Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Lamm","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Arizona BCG Oncology Phoenix AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish M.","family":"Kamat","sequence":"additional","affiliation":[{"name":"Department of Urology MD Anderson Cancer 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