Urothelial cancer accounts for approximately 3% of new cancer cases worldwide, with a high burden of disease in countries with medium and low human development indexes where its incidence and mortality are increasing. The purpose of this consensus is to develop statements on the evaluation and treatment of locally advanced and metastatic urothelial carcinoma that would further guide the clinical practice in Latin America.
A systematic review of the literature was conducted by an independent team of methodologists. Then, a modified Delphi method was developed with clinical specialists from different Latin American countries.
Forty-two consensus statements, based on evidence, were developed to address the staging, the evaluation (suitability for chemotherapy, risk assessment, and biomarkers), and systemic treatment (first-line and subsequent therapies) of locally advanced or metastatic urothelial carcinoma. The statements made in this consensus are suggested practice recommendations in the Latin American context; however, the importance of a complete and individualized patient evaluation as a guide for therapeutic selection is highlighted. The availability and affordability of support tools for the evaluation of the disease, as well as specific therapies, may limit the application of the best practices suggested.
Therapeutic decisions need to be tailored to the context-specific clinical setting and availability of resources. Local research is promoted to improve outcomes for patients with this challenging cancer in Latin America.
JCO global oncology. 2024 Jan [Epub]
Ray Manneh Kopp, Fernando Galanternik, Fabio A Schutz, Fabio Kater, Allan Ramos-Esquivel, Silvia Neciosup, Nora Sobrevilla-Moreno, Laura Bernal Vaca, Linda Ibatá-Bernal, Susan Martínez-Rojas, Maria T Bourlon
Sociedad de Oncología y Hematología del Cesar, Valledupar, Colombia., Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno" (CEMIC), Buenos Aires, Argentina., Beneficência Portuguesa de São Paulo, Sao Paulo, SP, Brazil., Hospital San Juan de Dios, Caja Costarricense de Seguro Social, San José, Costa Rica., Instituto Nacional del Enfermedades Neoplásicas, Lima, Perú., Instituto Nacional de Cancerología, Clínica de Tumores Genitourinarios, Ciudad de México, México., Clínica Universitaria Colombia y Clínica de Marly, Bogotá, Colombia., InValue Health Solutions, Bogotá, Colombia., Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.