Journal: Nature reviews. Urology
This publication reports an international, two-round Delphi consensus effort among 51 bladder cancer experts to define how active surveillance should be used for recurrent low‑grade non–muscle‑invasive bladder cancer (LG‑NMIBC).
Key points:
- Rationale: Standard management of recurrent LG‑NMIBC often involves repeated procedures and treatment intensity that is disproportionate to the typically indolent disease course. Active surveillance is viewed as a way to reduce overtreatment but lacks uniform guidance.
- Methods: Using a structured Delphi process, experts reviewed and refined statements over two rounds to reach consensus on fundamental aspects of active surveillance in this setting.
- Main outcomes: Consensus was reached on 20 statements that:
- Clarify terminology around active surveillance for LG‑NMIBC.
- Define inclusion and exclusion criteria for which patients are appropriate candidates.
- Recommend how follow-up and monitoring should be conducted while on surveillance.
- Establish exit criteria that should trigger intervention rather than continued surveillance.
- Implications: The resulting statements provide an initial, expert-driven framework to standardize the clinical use of active surveillance in LG‑NMIBC. They are intended both to guide current practice in appropriately selected patients and to harmonize protocols in future clinical trials evaluating de‑intensified management strategies.