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ESMO/EAU consensus project in muscle invasive or metastatic bladder cancer report at EMUC 2018 by Prof. Witjes

Urological and oncological societies produce every year several recommendations reported in the guidelines. However, not all recommendations have a level 1 evidence and therefore a consensus should be reached to agree on several important research topic. European Society for medical oncology (ESMO) and European Association of Urology (EAU) joined forces to address several open issues in metastatic and muscle invasive bladder cancer. Alan Horwich represented the ESMO and Fred Witjes the EAU as co-chairs of the session where 6 topics were identified. For every topic 2 sub-chairs were identified, one from ESMO and one from EAU

Two chairs per session were asked to develop 20 questions, each question was fitted in a Delphi process (for every question was possible to give a score from 1 to 9, where 1 mean Disagree and 9 Agree). In case of doubts, it was also possible to select `unable to answer`.

At the end, 115 were developed, 221 stake holders were identified among Oncologists, Urologists and others (specialist nurses, pathologists, radiologists). Of those 106 responded in the round one. In the round 2, 97 responded, with the opportunity to answer to the same questions but seeing how the other persons who took part to the round 1 responded. 

As a part of the Delphi process scoring system a consensus is defined I either the situations below:

  1. an agreement higher than 70% and a disagreement lower than 15%
  2. a disagreement higher than 70% and an agreement lower than 15%

In the round 1, an agreement was reached in 16% of the questions, 30% considering only relevant responders (surgery questions for urologists, chemotherapy to oncologist, etc..)

In the round 2, the agreement increased to 28% in the overall group and to 42% considering only relevant responders.

Therefore, an increment of 12% was recorded from round 1 to round 2.

On 8th November, the sub chairs of topic were asked to look at their list, without a consensus and to select topic that almost reached consensus and were relevant for both urologist and medical oncology 

Of the remaining 65 questions, 27 were voted upon and 21 reached a consensus.

All answers and consensus will be presented and discussed in two manuscripts, one lead by ESMO and one by EAU. 

Watch also the webcast “EAU-ESMO Bladder Cancer consensus report”.