Zachary Bessette

GU Oncology Now

Betty Wang, MD, BS, University of Alberta, and colleagues reported significant inter-site variation&mdash;independent of differences in tumor factors&mdash;in recurrence of non-muscle-invasive bladder cancer (NMIBC) after transurethral resection of bladder tumor (TRUBT) in the RESECT study.<a href="https://www.auajournals.org/doi/10.1097/JU.0000000000003223.10" target="_blank" rel="noopener">Their study</a> won the best poster for the Bladder Cancer: Non-Invasive session at the American Urological Association 2023 meeting.RESECT is an international, multi-center, observational study that sought to determine if audit and feedback can improve the quality of TURBT surgery and reduce early recurrence rates in NMIBC. A mixed effects logistic regression model with tumor size, number, grade, and stage as fixed effects, as well as site as a random effect, was fitted. Cases with first, presumed NMIBC undergoing TURBT were included, while cases in which first check follow-up had not been completed were excluded.Researchers noted that local and national approvals or ethical exemptions were obtained prior to study initiation at participating sites. After such exemptions, a total of 186 international sites contributing 4597 cases were included.Dr. Wang and colleagues reported the median recurrence rate per site was 12% for low-grade tumors and 27% for high-grade tumors. After controlling for tumor size, number, stage, and grade, they found significant residual variation that was attributable to site (P&lt;.0001).Furthermore, they added that adjustment for sites improved the regression model from an area under the receiver operating characteristic curve of 0.66 to 0.74.&ldquo;There is significant variation in the early recurrence rate of NMIBC after TURBT surgery between sites that could not be explained by currently understood tumor features,&rdquo; Dr. Wang and colleagues concluded, acknowledging that this variation may be related to site-specific surgical technique or perioperative practice.&ldquo;Further investigation is warranted to understand the influence of these factors,&rdquo; they added.

Global Variation in Early Recurrence After TURBT in the RESECT Study

AUA 2023: Focus on Bladder Cancer

Dr. Betty Wang reported significant inter-site variation—independent of differences in tumor factors—in recurrence of NMIBC after TRUBT in the RESECT study.

Global Variation in Early Recurrence After TURBT in RESECT

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