Surgeon Scorecards Improve Muscle Sampling on Transurethral Resection of Bladder Tumor and Recurrence Outcomes in Patients with Nonmuscle Invasive Bladder Cancer

No AccessJournal of UrologyAdult Urology1 Mar 2021Surgeon Scorecards Improve Muscle Sampling on Transurethral Resection of Bladder Tumor and Recurrence Outcomes in Patients with Nonmuscle Invasive Bladder CancerThis article is commented on by the following:Editorial Comment Arighno Das, Jason E. Cohen, Oliver S. Ko, Brian J. Jordan, Alexander P. Glaser, Gregory B. Auffenberg, and Joshua J. Meeks Arighno DasArighno Das Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Department of Urology, Northwestern University Feinberg School of Medicine, Jesse Brown VAMC, Chicago, Illinois , Jason E. CohenJason E. Cohen Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin , Oliver S. KoOliver S. Ko Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin , Brian J. JordanBrian J. Jordan Department of Urology, University of Washington, Seattle, Washington , Alexander P. GlaserAlexander P. Glaser Division of Urology, Department of Surgery, NorthShore University HealthSystem, Evanston, Illinois , Gregory B. AuffenbergGregory B. Auffenberg Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin , and Joshua J. MeeksJoshua J. Meeks *Correspondence: Department of Urology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Chicago, Illinois 60611 E-mail Address: [email protected] Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin View All Author Informationhttps://doi.org/10.1097/JU.0000000000001372AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The presence of detrusor muscle is essential for accurate staging of T1 cancers. Detrusor muscle presence can be a quality indicator of transurethral resection of bladder tumor for nonmuscle invasive bladder cancer. We hypothesized that increasing surgeon awareness of personal and institutional detrusor muscle sampling rates could improve resection quality and long-term oncologic outcomes. Materials and Methods: A retrospective review of transurethral resections of bladder tumor from 1/2006 to 2/2018 was performed. The presence of detrusor muscle in the pathology report and transurethral resection specimen were extracted from records. Individual surgeon scorecards were created and distributed. Rates of detrusor muscle sampling were compared prior to and 12 months after distribution. Chart review was done to compare 3-year recurrence and progression outcomes before and after distribution of scorecards. Results: The rate of detrusor muscle sampling increased from 36% (1,250/3,488) to 54% (202/373) (p=0.001) in the 12 months after scorecard distribution, ie from 30% (448/1,500) to 55% (91/165) (p <0.001) in Ta tumors and from 47% (183/390) to 72% (42/58) (p <0.001) in T1 tumors. Pathological reporting of muscle also improved for all samples (73%, 2,530/3,488 to 90%, 334/373, p <0.001), Ta (75%, 1,127/1,500 to 94%, 155/165, p <0.001) and T1 (93%, 362/390 to 100%, 58/58, p=0.04). On multivariate Cox regression analysis, the surgeon scorecard was associated with decreased 3-year risk of recurrence (HR 0.63, 95% CI 0.40–0.99). Conclusions: Creation and distribution of individual surgeon scorecards improved detrusor muscle sampling on transurethral resection and was associated with decreased risk of disease recurrence. Quality evaluation of transurethral resection of bladder tumor may contribute to improved outcomes of patients with nonmuscle invasive bladder cancer. 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Google Scholar © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited BySmith J (2020) This Month in Adult UrologyJournal of Urology, VOL. 205, NO. 3, (647-648), Online publication date: 1-Mar-2021.Related articlesJournal of UrologyDec 28, 2020, 12:00:00 AMEditorial Comment Volume 205Issue 3March 2021Page: 693-700Supplementary Materials Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.Keywordsquality improvementneoplasm stagingurinary bladder neoplasmscystoscopyMetricsAuthor Information Arighno Das Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Department of Urology, Northwestern University Feinberg School of Medicine, Jesse Brown VAMC, Chicago, Illinois More articles by this author Jason E. Cohen Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author Oliver S. Ko Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author Brian J. Jordan Department of Urology, University of Washington, Seattle, Washington More articles by this author Alexander P. Glaser Division of Urology, Department of Surgery, NorthShore University HealthSystem, Evanston, Illinois More articles by this author Gregory B. Auffenberg Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author Joshua J. Meeks Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin *Correspondence: Department of Urology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Chicago, Illinois 60611 E-mail Address: [email protected] More articles by this author Expand All Advertisement Loading ...