{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:23:49Z","timestamp":1787775829643,"version":"build-2784847793"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      The objective is to learn how Saudi Arabia\u2019s urologists treat patients with\n                      <jats:italic toggle=\"yes\">Bacillus<\/jats:italic>\n                      Calmette\u2013Gu\u00e9rin (BCG)-unresponsive nonmuscle invasive bladder cancer (NMIBC) and their choices in management for BCG-naive patients during the BCG shortage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A 10-min web-based survey was sent through the King Saud bin Abdul-Aziz University for Health Sciences\u2019 College of Medicine Clinical Affairs to urologists treating NMIBC based on the Saudi Urologic Association Database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The questionnaire was completed by 19 urologists, most of whom (68%) were self-identified as urologic oncologists. In the 6 months before survey administration, the majority of urologists (67% of those surveyed) had treated over five NMIBC patients who had failed BCG therapy. The preferred course of treatment for these patients was a radical cystectomy, as advised by 79% of the participants. Other preferred options were intravesical chemotherapy (16%) and repeat BCG therapy (5%). Clinical trials were never chosen. Sixty percent gemcitabine (Gem), 20% mitomycin C, 10% docetaxel (Doce), and 10% sequential Gem\/Doce were rated as the most preferred intravesical chemotherapy regimens used. Saudi urologists were most reluctant to utilize intravesical chemotherapy because of uncertainty about the treatment\u2019s clinical effectiveness (oncological safety) and the absence of specific guidelines from urology societies regarding the use of these drugs. BCG shortages are still a problem in Saudi Arabia, as 79% of respondents reported shortages. Most commonly, during BCG shortages, Saudi urologists rationed BCG to patients with high-risk disease, preferring pT1and\/or carcinoma\n                      <jats:italic toggle=\"yes\">in situ<\/jats:italic>\n                      to Ta high grade. The minority (16%) switch to intravesical chemotherapy in these circumstances.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Saudi urologists have begun employing a bladder-sparing strategy, particularly intravesical chemotherapy, for BCG-unresponsive disease. To properly select treatment for this condition, there is an urgent need to implement initiatives to open clinical trials and provide guideline-based protocols to Saudi Arabia and throughout the Arab world.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ua.ua_43_24","type":"journal-article","created":{"date-parts":[[2025,1,18]],"date-time":"2025-01-18T04:00:18Z","timestamp":1737172818000},"page":"58-63","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Saudi urologists\u2019 treatment pattern for high-risk Bacillus Calmette\u2013Gu\u00e9rin na\u00efve and Bacillus Calmette\u2013Gu\u00e9rin unresponsive nonmuscle invasive bladder cancer"],"prefix":"10.4103","volume":"17","author":[{"given":"Mohammad","family":"Alghafees","sequence":"first","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"Department of Surgery, Division of Urology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad Abou","family":"Chakra","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Iowa, Iowa City, Iowa, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Alkhayal","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"Department of Surgery, Division of Urology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Moussa","sequence":"additional","affiliation":[{"name":"Department of Urology, Lebanese University, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Alkhamees","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"Department of Surgery, Division of Urology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bader","family":"Alsaikhan","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"Department of Surgery, Division of Urology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Alasker","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"Department of Surgery, Division of Urology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman","family":"Alsayyari","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"Department of Surgery, Division of Urology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Alsaghyir","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard 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America"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,1,18]]},"reference":[{"key":"R1-20260423","doi-asserted-by":"crossref","first-page":"12596","DOI":"10.3390\/ijms241612596","article-title":"BCG-unresponsive non-muscle-invasive bladder cancer: Current treatment landscape and novel emerging molecular targets","volume":"24","author":"Claps","year":"2023","journal-title":"Int J Mol Sci"},{"key":"R2-20260423","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1016\/j.juro.2016.06.049","article-title":"Diagnosis and treatment of non-muscle invasive bladder cancer: AUA\/SUO guideline","volume":"196","author":"Chang","year":"2016","journal-title":"J Urol"},{"key":"R3-20260423","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.eururo.2021.08.010","article-title":"European association of urology guidelines on non-muscle-invasive bladder cancer (Ta, T1, and carcinoma in 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