Day case primary trans-urethral resection of bladder tumour (TURBT) as standard in a single UK centre. Should this be the new norm?

Austin, T.R.; Robinson, Richard; Wilby, Daniel; Hall, Stuart R.; Hodgson, Damian

doi:10.1177/2051415819890479

Cited by 3 publications

(4 citation statements)

References 14 publications

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“…The major reason was hematuria, and on multivariate analysis, a history of Foley catheterization in the operating room was the only factor found to be associated with a higher rate of unplanned readmissions. Austin et al [ 10 ] included a total of 172 patients, of whom 138 underwent TURBT as a daycare procedure. They reported the rates of readmission within 28 days to be 7.2% in daycare cases and 5.9% in inpatient cohorts.…”

Section: Discussionmentioning

confidence: 99%

A retrospective analysis of the factors associated with increased risk of readmission within 30 days after primary transurethral resection of bladder tumor

Jindal¹,

Sarwal²,

Jain³

et al. 2022

Curr Urol

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Background Transurethral resection of bladder tumor (TURBT) is associated with perioperative morbidity of 5% to 10%, which can lead to unplanned readmissions. In this study, we aimed to identify the factors that lead to an increased risk of unplanned readmissions within 30 days of primary TURBT. Materials and methods A retrospective study was conducted to identify patients who underwent primary TURBT at our institute from 2011 to 2019. Clinical and demographic factors, history of smoking, antiplatelet drugs intake, comorbidities, tumor size (<3 or >3 cm), multifocality, and histopathological type were abstracted. Patients who were readmitted were identified, and reasons for admission were recorded. Results A total of 435 patients were identified. The median age of the patients was 66 years. From 378 male patients (86.9%), 110 (25.3%) and 37 (8.5%) had a history of smoking and antiplatelet agents intake, respectively. In the cohort, 166 patients (38.2%) were diabetic, 239 (54.9%) were hypertensive, 72 (16.6%) had chronic obstructive pulmonary disease, and 78 (7.9%) had hypothyroidism. A total of 206 patients (47.4%) had a tumor >3 cm; multifocality was seen in 140 (32.2%) patients, whereas muscle invasive tumors were present in 161 patients (37%). A total of 22 patients (5.06%) had readmissions within 30 days, with hematuria being the most common etiology. On univariate and multivariate analyses, a history of smoking (p = 0.006 and p = 0.008, respectively) or antiplatelet agents intake (p < 0.001 and p < 0.001, respectively) was significantly associated with increased unplanned readmission. Conclusions Our study revealed smoking and antiplatelet agents intake as factors leading to an increased risk of unplanned readmissions.

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Section: Discussionmentioning

confidence: 99%

A retrospective analysis of the factors associated with increased risk of readmission within 30 days after primary transurethral resection of bladder tumor

Jindal¹,

Sarwal²,

Jain³

et al. 2022

Curr Urol

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“…They reported the rates of readmission within 28 days to be 7.2% in daycare cases and 5.9% in the inpatient cohorts. 10 Pereira et al analyzed 24,100 patients from the National Surgical Quality Improvement Program database which is probably the largest cohort to date. They found the rate of unplanned hospital admissions to be 3.8%.…”

Section: Discussionmentioning

confidence: 99%

A retrospective analysis of the factors associated with increased risk of readmission within 30 days following primary transurethral resection of bladder tumour

Jindal¹,

Sarwal²,

Jain³

et al. 2021

Preprint

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Background Transurethral resection of bladder tumour (TURBT) is associated with a perioperative morbidity of 5-10% which can lead to unplanned readmissions. In this study, we aim to identify factors that lead to an increased risk of unplanned readmissions within 30 days of primary TURBT. Methods A retrospective study was conducted to identify patients who had their primary TURBT at our institute from 2011-2019. The clinico-demographic factors, history of smoking, intake of anti-platelet drugs, co-morbidities, tumour size (< 3 cm or > 3cm), multifocality and histopathological type were abstracted. The patients who had a readmission were identified and reasons for admission were recorded. Results A total of 435 patients were identified. The median age was 66 years. There were 378 (86.9%) males, 110 (25.3%) had history of smoking and 37 (8.5%) had history of intake of an anti-platelet agent. In the cohort 166 (38.2%) were diabetic, 239 (54.9%) were hypertensive, 72 (16.6%) had COPD, 78 (7.9%) had hypothyroidism. A total of 206 (47.4%) had a tumour of >3cm, multifocality was seen in 140 (32.2%) while muscle invasive tumour was present in 161 (37%) patients. A total of 22 (5.06%) had re-admissions within 30 days with hematuria being the commonest etiology. On the univariate and multivariate analysis, history of smoking ( p=0.006 and 0.008, respectively) or intake of anti-platelet agents (p<0.001 and <0.001, respectively) were significantly associated with increased unplanned readmission. Conclusion Our study revealed smoking and intake of anti-platelet agents as the factors leading to increased risk of unplanned readmissions.

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“…16,17,27,31,33,34,36,37,42,45,46,[50][51][52]54,59,63,65,68,69,72,74,75,77 Twelve studies reported the use of mitomycin C in high-risk patients. 23,28,30,46,48,64,66,70,72,[79][80][81] Treatment rates ranged from 2% to 53% in 9 studies, with few studies reporting its use in all patients (rate of 100% in 3 studies). In 7 of the 11 studies (64%), mitomycin C 23,28,46,48,64,66,72 Adjuvant and intravesical chemotherapy in HR-NMIBC (not including mitomycin C) were rarely used and reported in a small number of studies (4 55,58,66,67 and 8, 23,28,32,33,51,70,…”

Section: Treatment Patternsmentioning

confidence: 99%

“…16,27,36,37,41,42,46,54,72,81,103,104 The highest RFS rate was seen in a single-center study conducted in Spain in patients who completed BCG maintenance. 34 Lower rates were seen in patients with high rates of disease recurrence and in those with a high disease burden, as based on the Notes: These results for RFS, 16,27,34,36,37,41,42,46,54,72,81,104 PFS, 16,27,30,[34][35][36][37]41,42,46,54,60,72,[79][80][81]95,97,104,107 CSS, 27,37,41,42,46,…”

Section: Five-year Outcomesmentioning

confidence: 99%

Treatment Outcomes of High-Risk Non-Muscle Invasive Bladder Cancer (HR-NMIBC) in Real-World Evidence (RWE) Studies: Systematic Literature Review (SLR)

Musat¹,

Kwon²,

Masters³

et al. 2022

CEOR

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Background: To date, there has been limited synthesis of RWE studies in high-risk nonmuscle invasive bladder cancer (HR-NMIBC). The objective of this research was to conduct a systematic review of published real-world evidence to better understand the real-world burden and treatment patterns in HR-NMIBC. Methods: An SLR was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with the scope defined by the Population, Intervention Comparators, Outcomes, and Study design (PICOS) criteria. EMBASE, MEDLINE, and Cochrane databases (Jan 2015-Jul 2020) were searched, and relevant congress abstracts (Jan 2018-Jul 2020) identified. The final analysis only included studies that enrolled ≥100 patients with HR-NMIBC from the US, Europe, Canada, and Australia. Results: The SLR identified 634 RWE publications in NMIBC, of which 160 studies reported data in HR-NMIBC. The average age of patients in the studies was 71 years, and 79% were males. The rates of BCG intravesical instillations ranged from 3% to 86% (29-95% for induction and 8-83% for maintenance treatment). Five-year outcomes were 17-89% recurrence-free survival (longest survival in patients completing BCG maintenance), 58-89% progression-free survival, 71-96% cancer-specific survival (lowest survival in BCG-unresponsive patients), and 28-90% overall survival (lowest survival in patients who did not receive BCG or instillation therapy). Conclusion: BCG treatment rates and survival outcomes in patients with HR-NMIBC vary in the real world, with better survival seen in patients completing maintenance BCG, responding to treatment, and not progressing to muscle-invasive disease. There is a need to better understand the factors associated with BCG use and discontinuation and for an effective treatment that improves outcomes in HR-NMIBC. Generalization of these results is limited by variations in data collection, reporting, and methodologies used across RWE studies.

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Day case primary trans-urethral resection of bladder tumour (TURBT) as standard in a single UK centre. Should this be the new norm?

Cited by 3 publications

References 14 publications

A retrospective analysis of the factors associated with increased risk of readmission within 30 days after primary transurethral resection of bladder tumor

A retrospective analysis of the factors associated with increased risk of readmission within 30 days after primary transurethral resection of bladder tumor

A retrospective analysis of the factors associated with increased risk of readmission within 30 days following primary transurethral resection of bladder tumour

Treatment Outcomes of High-Risk Non-Muscle Invasive Bladder Cancer (HR-NMIBC) in Real-World Evidence (RWE) Studies: Systematic Literature Review (SLR)

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