title: National nephrectomy registries: Reviewing the need for population-based data.
abstract: Nephrectomy is the cornerstone therapy for renal cell carcinoma (RCC) and continued refinement of the procedure through research may enhance patient outcomes. A national nephrectomy registry may provide the key information needed to assess the procedure at a national level. The aim of this study was to review nephrectomy data available at a population-based level in Australia and to benchmark these data against data from the rest of the world as an examination of the national nephrectomy registry model. A PubMed search identified records pertaining to RCC nephrectomy in Australia. A similar search identified records relating to established nephrectomy registries internationally and other surgical registries of clinical importance. These records were reviewed to address the stated aims of this article. Population-based data within Australia for nephrectomy were lacking. Key issues identified were the difficulty in benchmarking outcomes and no ongoing monitoring of trends. The care centralization debate, which questions whether small-volume centers provide comparable outcomes to high-volume centers, is ongoing. Patterns of adherence and the effectiveness of existing protocols are uncertain. A review of established international registries demonstrated that the registry model can effectively address issues comparable to those identified in the Australian literature. A national nephrectomy registry could address deficiencies identified in a given nation's nephrectomy field. The model is supported by evidence from international examples and will provide the population-based data needed for studies. Scope exists for possible integration with other registries to develop a more encompassing urological or surgical registry. Need remains for further exploration of the feasibility and practicalities of initiating such a registry including a minimum data set, outcome indicators, and auditing of data.
authors.affiliation: Department of Surgery, University of Melbourne, Austin Hospital, Melbourne, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Pearson
authors.affiliation: Department of Surgery, University of Melbourne, Austin Hospital, Melbourne, Australia.
authors.forename: Timothy
authors.initials: T
authors.lastname: Williamson
authors.affiliation: Department of Surgery, University of Melbourne, Austin Hospital, Melbourne, Australia.
authors.forename: Joseph
authors.initials: J
authors.lastname: Ischia
authors.affiliation: Department of Surgery, University of Melbourne, Austin Hospital, Melbourne, Australia.
authors.forename: Damien M
authors.initials: DM
authors.lastname: Bolton
authors.affiliation: Department of Surgery, Monash University, Melbourne, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Frydenberg
authors.affiliation: Department of Surgery, University of Melbourne, Austin Hospital, Melbourne, Australia. ; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia. ; Olivia Newton-John Cancer Research Institute, Melbourne, Australia.
authors.forename: Nathan
authors.initials: N
authors.lastname: Lawrentschuk
mesh_terms: D001315:Australia; D019985:Benchmarking; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D019983:Guideline Adherence; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008962:Models, Theoretical; D009392:Nephrectomy / Q000592:standards* / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D012042:Registries; D016896:Treatment Outcome
keywords: Kidney neoplasms; Nephrectomy; Registries