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Swedish national guidelines on urothelial carcinoma : 2024 update on advanced and metastatic disease

Ullén, Anders ; Aljabery, Firas ; Dahlman, Pär ; Falkman, Karin ; Gårdmark, Truls ; Jerlström, Tomas ; Holst, Susanna LU ; Kjellström, Sofia ; Lind, Anna Karin LU and Papantoniou, Dimitrios , et al. (2025) In Scandinavian Journal of Urology 60. p.76-82
Abstract

Objective: To overview and summarise the Swedish National Guidelines on Urothelial Carcinoma 2024. Methods: A narrative review of the updated guidelines was performed, highlighting new treatment recommendations for advanced and metastasized disease. Results: Compared to the previous guideline version, the current update includes recommendations for standardised radiological reporting when urothelial carcinomas are detected at CT-urography (CTU), to early identify locally advanced patients and accelerate the care pathway for these patients. The Swedish guidelines apply a more structured and liberal recommendation for the use of18F-fluorodeoxyglucose-positron emission tomography/computed tomography in patients with locally... (More)

Objective: To overview and summarise the Swedish National Guidelines on Urothelial Carcinoma 2024. Methods: A narrative review of the updated guidelines was performed, highlighting new treatment recommendations for advanced and metastasized disease. Results: Compared to the previous guideline version, the current update includes recommendations for standardised radiological reporting when urothelial carcinomas are detected at CT-urography (CTU), to early identify locally advanced patients and accelerate the care pathway for these patients. The Swedish guidelines apply a more structured and liberal recommendation for the use of18F-fluorodeoxyglucose-positron emission tomography/computed tomography in patients with locally advanced urothelial carcinomas compared to the EAU-guidelines and recommend such examinations prior to transurethral resection. Improved outcomes for radical cystectomy in Sweden after centralised cystectomy care have led to a recommendation for performing more than six nephroureterectomies (NUs) per year for upper tract urothelial carcinomas (UTUC)-based associations with decreased use of invasive diagnostic modalities and better survival outcomes. Additionally, updated recommendations regarding adjuvant systemic therapies for muscle-invasive disease have been included. Whilst awaiting national regulatory approval for enfortumab vedotin/pembrolizumab, the present guideline version aligns with EAU-guidelines by endorsing cisplatin-gemcitabine-nivolumab as a new first-line treatment option in cisplatin-fit patients with unresectable or metastatic urothelial carcinoma. Conclusions: The current version of the Swedish national guidelines on urothelial carcinoma introduces standardised reporting at CTU to facilitate early identification of advanced disease, includes recommendations for centralisation of NU for UTUC and updated recommendations for adjuvant systemic treatment of muscle-invasive disease and endorses cisplatin-gemcitabine-nivolumab as a new first-line treatment option for non-resectable locally advanced and metastatic disease.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
advanced, Bladder cancer, guidelines, metastatic
in
Scandinavian Journal of Urology
volume
60
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • scopus:105001590087
  • pmid:40131172
ISSN
2168-1805
DOI
10.2340/sju.v60.43236
language
English
LU publication?
yes
id
c8c7d8a6-540a-4e14-a0a3-0a034e6de1b1
date added to LUP
2025-09-09 14:14:23
date last changed
2025-09-09 14:15:13
@article{c8c7d8a6-540a-4e14-a0a3-0a034e6de1b1,
  abstract     = {{<p>Objective: To overview and summarise the Swedish National Guidelines on Urothelial Carcinoma 2024. Methods: A narrative review of the updated guidelines was performed, highlighting new treatment recommendations for advanced and metastasized disease. Results: Compared to the previous guideline version, the current update includes recommendations for standardised radiological reporting when urothelial carcinomas are detected at CT-urography (CTU), to early identify locally advanced patients and accelerate the care pathway for these patients. The Swedish guidelines apply a more structured and liberal recommendation for the use of<sup>18</sup>F-fluorodeoxyglucose-positron emission tomography/computed tomography in patients with locally advanced urothelial carcinomas compared to the EAU-guidelines and recommend such examinations prior to transurethral resection. Improved outcomes for radical cystectomy in Sweden after centralised cystectomy care have led to a recommendation for performing more than six nephroureterectomies (NUs) per year for upper tract urothelial carcinomas (UTUC)-based associations with decreased use of invasive diagnostic modalities and better survival outcomes. Additionally, updated recommendations regarding adjuvant systemic therapies for muscle-invasive disease have been included. Whilst awaiting national regulatory approval for enfortumab vedotin/pembrolizumab, the present guideline version aligns with EAU-guidelines by endorsing cisplatin-gemcitabine-nivolumab as a new first-line treatment option in cisplatin-fit patients with unresectable or metastatic urothelial carcinoma. Conclusions: The current version of the Swedish national guidelines on urothelial carcinoma introduces standardised reporting at CTU to facilitate early identification of advanced disease, includes recommendations for centralisation of NU for UTUC and updated recommendations for adjuvant systemic treatment of muscle-invasive disease and endorses cisplatin-gemcitabine-nivolumab as a new first-line treatment option for non-resectable locally advanced and metastatic disease.</p>}},
  author       = {{Ullén, Anders and Aljabery, Firas and Dahlman, Pär and Falkman, Karin and Gårdmark, Truls and Jerlström, Tomas and Holst, Susanna and Kjellström, Sofia and Lind, Anna Karin and Papantoniou, Dimitrios and Stenlund, Jonas and Ströck, Viveka and Söderkvist, Karin and Thulin, Helena and Trägårdh, Elin and Verbiene, Ingrida and Wallström, Jonas and Öfverholm, Elisabeth and Liedberg, Fredrik}},
  issn         = {{2168-1805}},
  keywords     = {{advanced; Bladder cancer; guidelines; metastatic}},
  language     = {{eng}},
  pages        = {{76--82}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Urology}},
  title        = {{Swedish national guidelines on urothelial carcinoma : 2024 update on advanced and metastatic disease}},
  url          = {{http://dx.doi.org/10.2340/sju.v60.43236}},
  doi          = {{10.2340/sju.v60.43236}},
  volume       = {{60}},
  year         = {{2025}},
}