Clinical outcomes in NMIBC following 3 years of Scotland's Bladder Cancer Quality Performance Indicators (QPI) programme: a multicentre experience.
BAUS ePoster online library. Mariappan P. Jun 24, 2019; 259505; P2-10 Disclosure(s): No disclosures in relation to this work.
Mr. Paramananthan Mariappan
Mr. Paramananthan Mariappan
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Abstract
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INTRODUCTION:

Cancer outcomes, particularly recurrence and progression in NMIBC are determined by the quality of the initial surgical intervention. To support a culture of continuous quality improvement and address in-equalities, Scotland introduced QPIs – 11 were developed for Bladder Cancer and enforced since April 2014. As part of a series of studies on clinical outcomes and prognosis in bladder cancer, this analysis aimed to evaluate, within the Scottish QPI cohort: (1) recurrence at first follow up cystoscopy (RR-FFC); (2) residual cancer (R2-6w) and (3) under-staging (T2-6w) at early re-TURBT in high risk NMIBC.

Materials & Methods:

For benchmarking against the nationally mandated QPIs, data on all new bladder cancers in Scotland were collected prospectively in individual hospitals with annual regional evaluation. Data fields included tumour demographics (size, number, grade, stage, presence or absence of Detrusor Muscle). Follow up data was obtained by clinical teams.

Results:

In all, 4246 new bladder cancer patients were included in this QPI cohort between April 2014 and March 2017 – a single dose of post-TURBT Mitomycin C was used in 66.8% patients. Detrusor muscle was sampled in 75% of initial resections and the usage of a bladder diagram during TURBT increased by 50% over the 3 years. Preliminary results from available follow up data revealed that compliance with NMIBC-specific QPIs was associated with a lower RR-FFC and R2-6w, with an overall risk of T2-6w being low.

Conclusion:

Early recurrence and residual disease following initial TURBT appear low in this contemporary Scottish QPI-benchmarked cohort.
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