Multi-institutional quality-of-care initiative for nonmetastatic, muscle-invasive, transitional cell carcinoma of the bladder: Phase I.

240 Background: Evidence supports multimodality treatment for muscle invasive bladder cancer [MIBC] with the strongest evidence (level 1) existing for cisplatin-based neoadjuvant chemotherapy. Although reflected in guidelines for the management of MIBC, little is known about the variation of actual practice patterns among academic institutions. We thus evaluated treatment variation among 14 academic centers in the management of patients with MIBC. Methods: Retrospective data were collected for centralized analysis. All patients who underwent radical cystectomy for clinical T2-4 N0M0 MIBC from 2003–2008 were eligible for inclusion. Specific endpoints for analysis included: rates of neoadjuvant and adjuvant therapy, cisplatin use, number of cycles and rates of pelvic lymphadenectomy. Results: 14 institutions participated and data on 4,541 patients who met inclusion criteria were tabulated. Overall 34% of patients received perioperative chemotherapy. The overall use of neoadjuvant and adjuvant therapy was 12...