Perioperative chemotherapy for bladder cancer in the general population: Are practice patterns finally changing?

Putting guidelines into practice: has the era of perioperative chemotherapy arrived?

“…Peri-operative chemotherapy offers additional benefit in disease free interval and overall survival ( 2 ), however utilization rates continue to be relatively low worldwide. The study by Booth et al is a large population-based analysis of time trends in use of peri-operative chemotherapy for MIBC in Ontario, Canada ( 3 ).…”

“…In addition to the controversy regarding the timing of chemotherapy in relation to cystectomy, other factors that may limit its usage include patient fitness and preferences as well as clinician preferences. In an effort to understand these factors further, Booth et al conducted a retrospective analysis of 5,582 cystectomy patients treated in Ontario over a 20-year period from 1994–2013 ( 3 ). Such a substantial collection of data allows for comprehensive analysis of practice patterns in the field of MIBC treatment.…”

Increasing Rates of Perioperative Chemotherapy are Associated With Improved Survival in Men With Urothelial Bladder Cancer With Prostatic Stromal Invasion

“…The increasing rates of use of CHT is consistent with other studies that examined the same topic. For example, Booth et al 17…”

Refining the use of neoadjuvant chemotherapy in locally advanced bladder cancer: from conviction to optimization

“…Potential reasons include patient ineligibility related to renal dysfunction, toxicity of NAC, delay in performing RC, patient preference against chemotherapy, and probably most importantly low propensity of urologists and medical oncologists to use NAC. After many years of practice lagging behind evidence, more recent surveys suggest that the use of NAC has been increasing worldwide during the 2010s ( 3 - 6 ). However, it remains clear that not all patients who are likely to benefit from NAC receive it, suggesting that continuous efforts are required to convince more urologists and oncologists to use it.…”