Surgical checklist impact on recurrence-free survival of non-muscle invasive bladder cancer patients undergoing transurethral resection of bladder tumor

To evaluate the impact of an eight-item surgical checklist (SC) on the recurrence-free survival (RFS) of non-muscle invasive bladder cancer (NMIBC) patients undergoing transurethral resection of bladder tumor (TURBT).

A group of urologists at two tertiary referral centers with expertise in bladder cancer identified eight critical items that should be performed in every high quality TURBT. An eight-item SC was prospectively implemented into clinical practice and the operative reports of TURBTs performed before and after implementation were reviewed. Results from both institutions were combined to estimate the impact of introducing SC on oncological outcomes. Multivariable logistic and Cox Hazards regression analyses were performed to evaluate the impact of SC on the presence of detrusor muscle in the TURBT specimen and on RFS, respectively.

The operative reports of 266 TURBTs performed after SC implementation were reviewed and compared to those of 281 TURBTs performed prior to SC introduction. SC was independently associated with a significant improvement in RFS (p=0.02). However, the introduction of SC was not significantly associated with the presence of detrusor muscle in the surgical specimen (p=0.4).

The use of an eight-item SC during TURBT into clinical practice increases the quality of operative reports thereby potentially improving individualized risk-stratification and care resulting in lower disease recurrence-rates. Therefore, the introduction of a SC can be recommended to enhance oncological outcomes by improving surgical standardization and operative reporting. This article is protected by copyright. All rights reserved.

BJU international. 2018 Sep 24 [Epub ahead of print]

Rodrigo Suarez-Ibarrola, Francesco Soria, Mohammad Abufaraj, David D'Andrea, Mirko Preto, Kilian M Gust, Alberto Briganti, Shahrokh F Shariat, Paolo Gontero

Department of Urology and Comprehensive Cancer Center, Medical University of Vienna Vienna General Hospital., Division of Urology, University of the Studies of Turin, AOU Città della Salute e della Scienza di Torino, Presidio Molinette, Turin, Italy., Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy.