Posted: Tuesday, June 6, 2023
Efforts to identify the variability in recurrence rates of non–muscle-invasive bladder cancer after transurethral resection across clinical sites have revealed significant variability not attributable to currently understood tumor features, according to a presentation on the RESECT trial at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract #4510). Fortis Gaba, MPH, MBChB, of Harvard School of Public Health, Boston, and colleagues speculated that the identified preoperative practice and surgical technique differences may explain the observed variability, but additional investigative efforts are warranted to elucidate their impact on recurrence rates.
Data on 4,597 cases of non–muscle-invasive bladder cancer were collected across 186 clinical sites and served as the focus of this multicenter observational study. All cases required the completion of a first-check follow-up appointment, and all clinical sites required at least 10 cases with a first-check follow-up appointment for inclusion. A logistic regression analysis was used to assess tumor grade, tumor number, tumor size, and tumor stage as fixed effects that were fit to the clinical sites.
Median recurrence rates of 12% and 27% were revealed for low- and high-grade tumors, respectively, after transurethral resection. Significant associations were identified among the rates of early recurrence and tumor grade, tumor number, tumor size, and tumor stage. After the investigators controlled for these factors, a significant variation was still identified across clinical sites (intraclass correlation = 0.1). In addition, an increased variation in preoperative practice and surgical technique was revealed, since 42% of cases used a single installation of intravesical chemotherapy, and 75% of cases required resection of the detrusor muscle, respectively.
Disclosure: For full disclosures of the study authors are not available.