Consensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology on the management of muscle-invasive and advanced urothelial carcinoma
BackgroundMuscle-invasive and advanced urothelial carcinoma (UC) are notorious for their high propensity for recurrence and metastasis. Recent advances in novel medications, surgical procedures, and radiotherapy techniques have substantially transformed the treatment landscape of muscle-invasive and...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1564487/full |
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| author | Darren M.C. Poon Darren M.C. Poon Peter K.F. Chiu Marco T.Y. Chan Brian S.H. Ho K.S. Law Angus K.C. Leung Clarence L.H. Leung R. Na Kenneth C.W. Wong Philip Y. Wu Philip W.K. Kwong Jeremy Y.C. Teoh |
| author_facet | Darren M.C. Poon Darren M.C. Poon Peter K.F. Chiu Marco T.Y. Chan Brian S.H. Ho K.S. Law Angus K.C. Leung Clarence L.H. Leung R. Na Kenneth C.W. Wong Philip Y. Wu Philip W.K. Kwong Jeremy Y.C. Teoh |
| author_sort | Darren M.C. Poon |
| collection | DOAJ |
| description | BackgroundMuscle-invasive and advanced urothelial carcinoma (UC) are notorious for their high propensity for recurrence and metastasis. Recent advances in novel medications, surgical procedures, and radiotherapy techniques have substantially transformed the treatment landscape of muscle-invasive and advanced UC. It is crucial to navigate the optimal management approaches for muscle-invasive and advanced UC through the increasingly complex matrix of variables.MethodsTwo professional organisations convened a consensus panel of six urologists and six clinical oncologists with extensive experience in treating urological malignancies. They reviewed the literature on the management of i) non-metastatic, muscle-invasive, and locally advanced UC of the bladder; ii) locally advanced upper tract UC (UTUC); and iii) unresectable locally advanced or metastatic UC (mUC). The panel held multiple meetings to discuss and draft consensus statements using the modified Delphi method. Each drafted statement was anonymously voted on by every panellist. A consensus statement was accepted if ≥ 80% of the panellists chose ‘accept completely’ or ‘accept with some reservation’ from the five options, which also included ‘accept with major reservation’, ‘reject with reservation’, and ‘reject completely’.ResultsThe panel reached a consensus on 63 statements based on current evidence and expert insights. These statements addressed the considerations for different treatment modalities, including surgical approaches, radiotherapy, radiosensitisers, platinum-based chemotherapy, immune checkpoint inhibitors, and antibody–drug conjugates, in the management of different disease entities, including muscle-invasive UC of the bladder, cN1 disease, locally advanced UTUC, unresectable locally advanced/mUC, and oligometastatic bladder cancer.ConclusionThese consensus statements are anticipated to serve as a practical recommendation for clinicians in Hong Kong, and possibly the Asia-Pacific region, regarding the management of muscle-invasive and advanced UC. |
| format | Article |
| id | doaj-art-62ff9889d3bb472b9aa17c2d4d2c4a56 |
| institution | OA Journals |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj-art-62ff9889d3bb472b9aa17c2d4d2c4a562025-08-20T02:16:07ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-05-011510.3389/fonc.2025.15644871564487Consensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology on the management of muscle-invasive and advanced urothelial carcinomaDarren M.C. Poon0Darren M.C. Poon1Peter K.F. Chiu2Marco T.Y. Chan3Brian S.H. Ho4K.S. Law5Angus K.C. Leung6Clarence L.H. Leung7R. Na8Kenneth C.W. Wong9Philip Y. Wu10Philip W.K. Kwong11Jeremy Y.C. Teoh12Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaComprehensive Oncology Centre, Hong Kong Sanatorium and Hospital, Hong Kong, Hong Kong SAR, ChinaS.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaDivision of Urology, Department of Surgery, Tuen Mun Hospital, Hong Kong, Hong Kong SAR, ChinaDivision of Urology, Department of Surgery, Queen Mary Hospital, Hong Kong, Hong Kong SAR, ChinaDepartment of Clinical Oncology, Princess Margaret Hospital, Hong Kong, Hong Kong SAR, ChinaAMO Oncology Centre, Hong Kong, Hong Kong SAR, ChinaeFLO Urology, Hong Kong, Hong Kong SAR, ChinaDivision of Urology, Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong SAR, China0Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China1Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong SAR, China2Hong Kong Integrated Oncology Centre, Hong Kong, Hong Kong SAR, ChinaS.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaBackgroundMuscle-invasive and advanced urothelial carcinoma (UC) are notorious for their high propensity for recurrence and metastasis. Recent advances in novel medications, surgical procedures, and radiotherapy techniques have substantially transformed the treatment landscape of muscle-invasive and advanced UC. It is crucial to navigate the optimal management approaches for muscle-invasive and advanced UC through the increasingly complex matrix of variables.MethodsTwo professional organisations convened a consensus panel of six urologists and six clinical oncologists with extensive experience in treating urological malignancies. They reviewed the literature on the management of i) non-metastatic, muscle-invasive, and locally advanced UC of the bladder; ii) locally advanced upper tract UC (UTUC); and iii) unresectable locally advanced or metastatic UC (mUC). The panel held multiple meetings to discuss and draft consensus statements using the modified Delphi method. Each drafted statement was anonymously voted on by every panellist. A consensus statement was accepted if ≥ 80% of the panellists chose ‘accept completely’ or ‘accept with some reservation’ from the five options, which also included ‘accept with major reservation’, ‘reject with reservation’, and ‘reject completely’.ResultsThe panel reached a consensus on 63 statements based on current evidence and expert insights. These statements addressed the considerations for different treatment modalities, including surgical approaches, radiotherapy, radiosensitisers, platinum-based chemotherapy, immune checkpoint inhibitors, and antibody–drug conjugates, in the management of different disease entities, including muscle-invasive UC of the bladder, cN1 disease, locally advanced UTUC, unresectable locally advanced/mUC, and oligometastatic bladder cancer.ConclusionThese consensus statements are anticipated to serve as a practical recommendation for clinicians in Hong Kong, and possibly the Asia-Pacific region, regarding the management of muscle-invasive and advanced UC.https://www.frontiersin.org/articles/10.3389/fonc.2025.1564487/fullantibody-drug conjugatecarboplatinchemotherapycisplatinen bloc resectionimmune checkpoint inhibitor |
| spellingShingle | Darren M.C. Poon Darren M.C. Poon Peter K.F. Chiu Marco T.Y. Chan Brian S.H. Ho K.S. Law Angus K.C. Leung Clarence L.H. Leung R. Na Kenneth C.W. Wong Philip Y. Wu Philip W.K. Kwong Jeremy Y.C. Teoh Consensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology on the management of muscle-invasive and advanced urothelial carcinoma Frontiers in Oncology antibody-drug conjugate carboplatin chemotherapy cisplatin en bloc resection immune checkpoint inhibitor |
| title | Consensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology on the management of muscle-invasive and advanced urothelial carcinoma |
| title_full | Consensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology on the management of muscle-invasive and advanced urothelial carcinoma |
| title_fullStr | Consensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology on the management of muscle-invasive and advanced urothelial carcinoma |
| title_full_unstemmed | Consensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology on the management of muscle-invasive and advanced urothelial carcinoma |
| title_short | Consensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology on the management of muscle-invasive and advanced urothelial carcinoma |
| title_sort | consensus statements from the hong kong urological association and the hong kong society of uro oncology on the management of muscle invasive and advanced urothelial carcinoma |
| topic | antibody-drug conjugate carboplatin chemotherapy cisplatin en bloc resection immune checkpoint inhibitor |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1564487/full |
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