Contemporary management of XXXX in the United States: a pattern of care analysis.

@entity1 @entity150
OBJECTIVES: To assess the practice preferences among urologists treating @entity150 in the United States. METHODS: We surveyed 226 urologists using a specially designed survey instrument. The type of practice, number of urologists in group practice, annual volume of @entity1 with @entity150 , and those treated with intravesical therapy were assessed. We also obtained information on the American Urological Association section and year of graduation from urology residency training. RESULTS: Of the 226 contacted urologists, 105 (46%) returned a completed survey instrument. Seventeen percent were practicing in academic institutions and 63% were in independent community practice. Forty-five percent had graduated from urology training in or before 1985. Thirty-six percent were in small and 37% were in moderate-size groups. Thirty-five percent were treating a moderate number of @entity1 with @entity150 , and 44% were treating a large number of @entity1 annually. Thirty-two percent had a moderate number and 40% had a large number of @entity1 receiving intravesical therapy annually. Immunotherapy was preferred in @entity1 at high risk of recurrence. Intravesical chemotherapy was preferred by many for immunotherapy failure. The type of practice and year of graduation were the factors most frequently affecting treatment choice. CONCLUSIONS: Practice preferences for the management of @entity150 are in general agreement with the American Urological Association Bladder Cancer Guidelines Panel recommendations. However, 81% of surveyed urologists were still reluctant to refer @entity1 with high-grade Ta-T1 disease with failure after intravesical immunotherapy twice for more aggressive therapy such as cystectomy or radiotherapy.
