The American Urological Association (AUA), together with the American Society of Clinical Oncology (ASCO), the American Society for Radiation Oncology (ASTRO) and the Society of Urologic Oncology (SUO), released a new clinical guideline on non–metastatic muscle–invasive bladder cancer (MIBC). This guideline, which marks the first time these four groups have developed a joint cancer guideline that provides instruction to practitioners on diagnosis, treatment, patient surveillance and more as it relates to MIBC. It will be presented at the 2017 AUA Annual Meeting in Boston.

"Thousands of patients are diagnosed with bladder cancer each year and 25 percent of those patients have muscle–invasive disease that traditionally has a low survival rate," said Sam S. Chang, MD, MBA, who chaired the MIBC guideline panel. "We know that, in order to achieve the best outcomes, we must take a multi–disciplinary, collaborative approach. This joint guideline brings together urology and urologic surgeons, medical oncology, as well as radiation oncology to help guide that approach."

The guideline makes recommendations in the following areas:

• Initial patient evaluation and counseling (including laboratory and imaging diagnostics and staging tests and procedures such as genitourinary pathology, physical exams, CT etc. Treatment (surgery, chemotherapy and radiation)
• Patient surveillance and follow up (including post–treatment surveillance techniques, quality of life concerns and counseling)

The guideline also addresses approaches to bladder preservation (including patient selection), as well as special considerations for patients diagnosed with variant histology.

"MIBC is a highly varied disease that truly requires an individualized approach and, in many cases, involves urologic, medical and radiation oncology," said Jeff Holzbeierlein, MD, FACS, vice chair of the panel that developed the guideline. "By bringing our specialties together, we've integrated evidence–based statements, expert opinions and patient desires and interests into what we believe to be a strong clinical framework for the management of MIBC."

The full guideline is available online at http://www.auanet.org/guidelines/muscle–invasive–bladder–cancer.