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Management of Muscle Invasive Bladder Cancer with Bladder Preservation in Russia: a Survey-Based Analysis of Current Practice and the Impact of an Educational Workshop on Clinical Expertise

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Abstract

Trimodality bladder preservation (BP) is an accepted alternative to radical cystectomy for patients with muscle invasive bladder cancer (MIBC). The global utilization of BP is variable, and practice patterns have not been previously studied in Russia. We sought to elucidate the contemporary BP practice patterns in Russia and determine the impact of the BP workshop on attitudes of Russian radiation oncologists (ROs) towards BP. The workshop was focused on patient workup, selection for BP, chemotherapy choices, radiation therapy (RT) contouring and planning, patient counseling. A total of 77 pre- and 32 matched post-workshop IRB-approved surveys, based on the workshop content, were analyzed using descriptive statistics to determine baseline clinical experience and patterns of care. The impact was judged by changes in participants’ responses. A total of 56% of respondents had experience with delivering bladder-directed RT, and 60% of those treated both operable and inoperable MIBC patients. Only 10% felt uncomfortable offering an operable patient BP modality. Prior to the workshop, almost half of respondents estimated universal poor bladder (44%) and erectile functions (47%) after BP. The workshop resulted in dramatic change in participants’ attitudes towards long-term urinary (Stuart-Maxwell test, p < 0.01) and sexual (exact McNemar test, p < 0.01) side effects. Prior to the workshop, only 47% of respondents routinely discussed smoking cessation (SC) with their patients, whereas after workshop, 88% agreed that SC discussion is mandatory (exact McNemar test, p = 0.04). BP for MIBC is commonly used in Russia. Our workshop resulted in dramatically improved understanding of long-term BP toxicities and inspired Russian ROs to incorporate SC counseling into routine clinical management.

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Acknowledgments

The authors would like to thank the Russian Society of Clinical Oncology (RUSSCO) for the support of our educational programs for Russian radiation oncologists. In particular, we are grateful to Yulia Egorova and Ekaterina Kharitonova for the help in organizing contouring workshops in Russia.

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Authors and Affiliations

  1. Department of Radiation Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA

    Timur Mitin, Yiyi Chen & Charles R. Thomas Jr

  2. Department of Radiotherapy, Ulyanovsk Regional Cancer Center, Ulyanovsk, Ulyanovsk oblast, Russia

    Natalia Dengina

  3. PET-Technology Podolsk, Podolsk, Russia

    Marina Chernykh

  4. Medscan Clinic, Moscow, Russia

    Sergey Usychkin

  5. Evimed Medical Center, Chelyabinsk, Russia

    Oleg Gladkov

  6. Biostatistics Shared Resources, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA

    Catherine Degnin & Yiyi Chen

  7. The Central Clinical Hospital of the Presidential Administration of the Russian Federation, Moscow, Russia

    Dmitry Nosov

  8. Kidney Cancer Research Bureau, Moscow, Russia

    Ilya Tsimafeyeu

  9. N.N. Blokhin Russian Cancer Center, Moscow, Russia

    Sergei Tjulandin

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  1. Timur Mitin
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  2. Natalia Dengina
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  7. Yiyi Chen
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  10. Charles R. Thomas Jr
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Contributions

TM conceived, performed, and interpreted data. ND, MC, SU, OG, DN, IT, CRT, and ST conceived and performed the study. CD and YC performed the study and interpreted data. All authors participated in writing the article, approved the final version, and agree to be accountable for the accuracy and integrity of the work.

Corresponding author

Correspondence to Timur Mitin.

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Conflict of Interest

TM reports research grant from Novocure, Inc. and serving on advisory board for Novocure and Janssen. He also has royalties from UpToDate, Inc.

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Electronic Supplementary Material

ESM 1

Pre-workshop survey questions (DOCX 15 kb).

ESM 2

Post-workshop survey questions (DOCX 12 kb).

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Mitin, T., Dengina, N., Chernykh, M. et al. Management of Muscle Invasive Bladder Cancer with Bladder Preservation in Russia: a Survey-Based Analysis of Current Practice and the Impact of an Educational Workshop on Clinical Expertise. J Canc Educ 36, 1005–1013 (2021). https://doi.org/10.1007/s13187-020-01728-y

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  • DOI: https://doi.org/10.1007/s13187-020-01728-y

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