title: Underutilization of immediate intravesical chemotherapy following TURBT: results from NSQIP.
abstract: BACKGROUND
  A single perioperative dose of intravesical chemotherapy (IVC) following transurethral resection of bladder tumors (TURBT) for non-muscle invasive bladder cancer has demonstrated a reduction in tumor recurrence. In this study, we investigate the contemporary (2010) utilization of IVC following TURBT using a prospective national database.
  
  
  METHODS
  Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database, we identified patients with bladder cancer using ICD-9 codes. From this group, patients undergoing TURBT based on Current Procedural Terminology (CPT) codes were analyzed. We then identified those patients who underwent TURBT and also received intravesical therapy. Operative time, length of hospital stay, and perioperative complications were evaluated.
  
  
  RESULTS
  From January 1 to December 31, 2010, 1273 patients at participating ACS-NSQIP sites underwent TURBT for bladder cancer. There were 417 (33%) small, 486 (38%) medium, and 370 (29%) large tumors treated. In total, 33 (2.6%) patients received IVC. When comparing patients who received perioperative IVC to those who did not, there was no difference in median operative times (27 mins versus 28 mins, p = 0.899). There was one urinary tract infection in the IVC group.
  
  
  CONCLUSIONS
  IVC remains greatly underutilized despite current data documenting its efficacy in reducing tumor recurrence for TaT1 bladder cancer. Instillation of IVC following TURBT does not increase morbidity. Our findings support the continued need to explore ways of improving rates of perioperative IVC administration following TURBT.
authors: Institute of Urology, Burlington, Massachusetts, USA.
authors: Casey
authors: C
authors: Kowalik
authors: Jason R
authors: JR
authors: Gee
authors: Andrea
authors: A
authors: Sorcini
authors: Alireza
authors: A
authors: Moinzadeh
authors: David
authors: D
authors: Canes
mesh_terms: D000283:Administration, Intravesical; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D015653:Cystectomy / Q000379:methods*; D016208:Databases, Factual; D004358:Drug Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D016896:Treatment Outcome; D014481:United States; D014521:Urethra / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000601:surgery*
chemical_list: D000970:Antineoplastic Agents