MIBC and EVP

[msbbc833]

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What in the world is going on these days with urologists/med oncs with EVP? They are in cohoots with each other and with EVP. In patients who decline surgery or are not candidates for cystectomy they are treating patients with TURBT followed by EVP.

Okay it has a 50% path CR rate, great. That doesn't make it a curative treatment. CRT has a 75% pCR rate. If you want to do EVP it should be followed by RT. No where does NCCN list EVP as cat 1 treatment for MIBC.

I had a patient refusing surgery who then progressed after on EVP. The urologist's response after his second or third TURBT "well he needs better systemic therapy". Um no, he needs RT immediately

Am I missing something?? Is this common?

 

[Fpg1245]

What in the world is going on these days with urologists/med oncs with EVP? They are in cohoots with each other and with EVP. In patients who decline surgery or are not candidates for cystectomy they are treating patients with TURBT followed by EVP.

Okay it has a 50% path CR rate, great. That doesn't make it a curative treatment. CRT has a 75% pCR rate. If you want to do EVP it should be followed by RT. No where does NCCN list EVP as cat 1 treatment for MIBC.

I had a patient refusing surgery who then progressed after on EVP. The urologist's response after his second or third TURBT "well he needs better systemic therapy". Um no, he needs RT immediately

Am I missing something?? Is this common?

That’s a new one.

Urologists treat evidence as a minor inconvenience where I am.

How about upfront cryo and adt for Gleason 8 Pca?

 

[medgator]

That’s a new one.

Urologists treat evidence as a minor inconvenience where I am.

How about upfront cryo and adt for Gleason 8 Pca?

Or hifu.

 

[OTN]

Hey at least they're referring to medonc rather than just giving it themselves. Progress?