Impact of surgical experience on recurrence and progression after transurethral resection of bladder tumour in non-muscle-invasive bladder cancer
2014 (English)In: SCANDINAVIAN JOURNAL OF UROLOGY, ISSN 2168-1805, Vol. 48, no 3, 276-283 p.Article in journal (Refereed) Published
Introduction: To evaluate the impact of experience in transurethral resection of bladder tumor (TUR-BT) on recurrence and progression in primary Ta/T1 urinary bladder cancer.
Methods: Clinical and pathological characteristics of patients with primary Ta/T1 urinary bladder cancer were recorded prospectively from 1992 to 2007 inclusive. Data on surgeons’ experience were categorized as follows: (a) experience by training status (residents or specialists); (b) number of TUR-BTs performed by each surgeon during the registration period, with cut-off levels at > 100, > 150, > 200, > median, and > third quartile of surgical volume; (c) lifetime high-volume surgeons (> 100 TUR-BTs). Hazard ratios (HRs) were estimated using Cox regression with 95% confidence intervals (CIs) in both univariate and multivariate analysis.
Results: The analysis included 768 evaluable patients with a median follow-up of 60 months. Recurrence was observed in 478 patients (62%) and progression in 71 (9%). Surgery was performed by residents in 100 cases and specialists in 668, with recurrence in 75 (75%) and 403 (60%) patients, and progression in 9 (9%) and 62 (9%), respectively. Surgery performed by residents was statistically associated with recurrence (HR = 0.69, 95% CI = 0.54-0.89) but not progression (HR = 0.72, 95% CI = 0.35-1.48). Surgical volume (b and c) was not found to have a significant impact on recurrence or progression in any of the analyses at the chosen cut-offs.
Conclusions: Surgical experience (specialist/resident) was a predictive factor for recurrence after TUR-BT for Ta/T1 bladder cancer. However, surgeon volume was not associated with recurrence at the chosen cut-off levels. Training programs, checklist
Place, publisher, year, edition, pages
Informa Healthcare, 2014. Vol. 48, no 3, 276-283 p.
Clinical Medicine Surgery Cancer and Oncology
IdentifiersURN: urn:nbn:se:liu:diva-89145DOI: 10.3109/21681805.2013.864327ISI: 000336457500007OAI: oai:DiVA.org:liu-89145DiVA: diva2:607292