Surgical waiting time for radical cystectomy: a New Zealand experience.
BACKGROUND
The New Zealand Ministry of Health (MOH) has issued recommendations under the new 'Faster Cancer Treatment Programme' specifically mandating that 'treatment begin within 31 days of a decision being made to have that treatment'. In preparation to plan compliance with these targets and identify delays, the wait-times for radical cystectomy (RC) for bladder cancer at our institution were reviewed.


METHODS
Patient data were collected for all patients who underwent radical cystectomy in Wellington Hospital from 2006 to 2013. Three interval periods for RC were defined and reviewed. The cause of delay was assessed. We looked at survival based upon delay periods.


RESULTS
There were 43 RC during the study period. The median time from recommendation to RC was 29 days (range 2-97). Seventeen (40%) were outside this time period due to requirement for further medical investigation (n = 7), patient-related factors (n = 3), other speciality input needed (n = 3), scheduling factors (n = 2) and unknown factors (n = 2).


CONCLUSIONS
The median wait-time to RC was 29 days in our institution, within the MOH period. A significant proportion (40%) of patients had a delay of >31 days commonly due to patient factors such as co-morbidities needing additional investigations. A delay of >31 days did not confer a worse survival outcome in this cohort.
Department of Urology, Wellington Hospital, Capital and Coast District Health Board, Wellington, New Zealand.
Arman
A
Kahokehr
Department of Urology, Wellington Hospital, Capital and Coast District Health Board, Wellington, New Zealand.
Julius
J
Glasson
Department of Urology, Wellington Hospital, Capital and Coast District Health Board, Wellington, New Zealand.
Rodney
R
Studd
D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000601:surgery*; D014850:Waiting Lists
bladder cancer; radical cystectomy; survival; waiting time