Open radical cystectomy in England: the current standard of care – an analysis of the British Association of Urological Surgeons (BAUS) cystectomy audit and Hospital Episodes Statistics (HES) data

Abstract

This is the largest, contemporary cohort of ORCs in England, encompassing >80% of all performed operations. We now know the current standard for ORC in England. This provides the basis for individual surgeons and units to compare their outcomes and a standard with which future techniques and modifications can be compared.

Outcomes following radical cystectomy: a population‐based study from Queensland, Australia

“…These findings are in keeping with a large study of 39 000 patients in the USA . In our study, 71% of patients had a lymph node dissection, similar to an English study where approximately 74% of patients received a lymph node dissection . We found the proportion of patients undergoing lymph node dissection increased significantly over time.…”

Open radical cystectomy: lessons from the British Association of Urological Surgeons (BAUS) registry

“…In their recent paper published on the BJU International , Jefferies et al performed a very interesting analysis of the British Association of Urological Surgeons (BAUS) radical cystectomy (RC) registry capturing approximately 83% of all open RC (ORC) cases performed in England in the period between 2014 and 2015 ( 1 ). This study provides a comprehensive focus on the current status of ORC in England, representing an important benchmark for any future comparison with emerging minimally invasive techniques and/or novel perioperative care pathways.…”

“…Therefore, based on the above data, procedures performed within 5 hours with an EBL between 500 and 1,000 mL not requiring blood transfusions and with a 30-day mortality rate <2% represent the current status of ORC with ileal conduit in England. Moreover, PLND with 11–20 retrieved nodes seem to be an acceptable quality metric ( 1 ).…”

“…More recently, Waingankar et al considered centres performing >30 cystectomies/year as high-volume ( 8 ). The BAUS audit showed that more than 10 years after the IOG recommendations, several centres in England performed <30 cystectomies per year with a median number of 23 (range, 1–187) cases ( 1 ). We believe that hospital volume should be an important variable for patients candidate to RC, and it should be declared as a potential quality indicator.…”

National database of patients treated with radical cystectomy provides a current standard and comparison for future technologies

“…Based on patient records, it is possible to establish whether low-volume surgeons have ceased to perform this procedure and sites assisting fewer patients have referred their patients to an appropriate center nearby. After the IOG recommendation, the median number of cystectomies carried out was 13 patients per surgeon and 23 surgeries per center over a 2-year period ( 3 ). In addition, 30- and 90-day mortality rates improved from 2.2% to 1.3% and 5.8% to 2.6%, respectively, between 2003 and 2013.…”