Snapshot of transurethral resection of bladder tumours in the United Kingdom Audit (STUKA).
OBJECTIVE
To determine the quality of transurethral resection of bladder tumour (TURBT) in the UK. To evaluate the utility of a novel 'snapshot' methodology in carrying out national audits.


METHODS
Every consultant Urologist in the UK was asked to contribute details of their first patient with a new bladder cancer treated with TURBT after midnight of 31st January 2010. Responses were received from 192 consultants.


RESULTS
The median (range) time from referral to first Urology appointment was 11 (0-161) days, and the median (range) time from first appointment to TURBT was 27 (1-588) days. In all, 12 (6.3%) patients underwent photodynamic diagnosis-assisted TURBT and 119 patients (61%) received a dose of Mitomycin C after TURBT. The rate of major complications was low, with five incidences (2.6%) of bladder perforation. There was no record of muscle present in resected specimens in 40 cases (20.8%) and resection was considered incomplete in 26 cases (13.5%). In all, 31 patients (16.1%) underwent early re-resection with residual tumour or carcinoma in situ detected in 17 cases, although no tumour was upstaged. Of the 37 patients classified with intermediate-risk non-muscle-invasive bladder cancer (NMIBC), there were nine recurrences (24.3%) at 3 months, and 13 recurrences (35.1%) at 1 year. Newly presenting MIBC managed with currently available treatments has a high mortality rate of 33.3% at 1 year.


CONCLUSIONS
The quality of TURBT in the UK is high. Areas for improvement include the timeliness of diagnosis and treatment, and improved care of patients with intermediate-risk NMIBC and MIBC. The 'snapshot' methodology is promising but widening participation is a priority.
British Association of Urological Surgeons Section of Oncology.
Christine
C
Gan
Amit
A
Patel
Sarah
S
Fowler
James
J
Catto
Derek
D
Rosario
Timothy
T
O'Brien
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000379:methods* / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D006113:United Kingdom; D014521:Urethra; D001749:Urinary Bladder Neoplasms / Q000601:surgery*
bladder cancer; quality; transurethral resection of bladder tumour