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Purpose of Review <p>Single-dose intravesical chemotherapy (IVC) following transurethral resection of bladder tumor (TURBT) reduces recurrence by 35% with a number needed to treat of 7, yet utilization remains limited at less than 30% in the United States. This review examines why this evidence-practice gap persists and identifies proven strategies to increase implementation.</p> Recent Findings <p>National utilization evaluations of IVC after TURBT demonstrate consistently sub-optimal rated of treatment delivery among eligible patients. Cochrane systematic review and multiple meta-analyses confirm efficacy of intravesical gemcitabine, mitomycin C, and docetaxel to prevent bladder cancer recurrence with favorable safety profiles. Multi-level barriers are primarily organizational, with lack of recovery room protocols ranking as the most influential obstacle. The Commission on Cancer implemented a quality measure in 2024 requiring intravesical chemotherapy administration within 24&#xa0;h of TURBT for low-grade Ta disease, with compliance monitoring beginning in 2025.</p> Summary <p>Underutilization represents a significant quality gap requiring system-based interventions. Proven implementation frameworks incorporating bundled strategies, stakeholder engagement, and accountability mechanisms offer pathways to deliver evidence-based care.</p>

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Intravesical Chemotherapy Post-TURBT for Non-Muscle Invasive Bladder Cancer: Understanding and Addressing the Utilization Gap

  • 期刊论文

  • 发表日期：

    2026年5月22日

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  • Peter Evancho,
  • Jason Kozarek,
  • M. Minhaj Siddiqui

摘要

Purpose of Review

Single-dose intravesical chemotherapy (IVC) following transurethral resection of bladder tumor (TURBT) reduces recurrence by 35% with a number needed to treat of 7, yet utilization remains limited at less than 30% in the United States. This review examines why this evidence-practice gap persists and identifies proven strategies to increase implementation.

Recent Findings

National utilization evaluations of IVC after TURBT demonstrate consistently sub-optimal rated of treatment delivery among eligible patients. Cochrane systematic review and multiple meta-analyses confirm efficacy of intravesical gemcitabine, mitomycin C, and docetaxel to prevent bladder cancer recurrence with favorable safety profiles. Multi-level barriers are primarily organizational, with lack of recovery room protocols ranking as the most influential obstacle. The Commission on Cancer implemented a quality measure in 2024 requiring intravesical chemotherapy administration within 24 h of TURBT for low-grade Ta disease, with compliance monitoring beginning in 2025.

Summary

Underutilization represents a significant quality gap requiring system-based interventions. Proven implementation frameworks incorporating bundled strategies, stakeholder engagement, and accountability mechanisms offer pathways to deliver evidence-based care.