Retrospective audit on the management of newly diagnosed non-muscle-invasive bladder cancer patients and their oncological outcomes

Abstract

BACKGROUND: Non-muscle-invasive bladder cancer (NMIBC) is a heterogenous subclassification of urothelial carcinoma with variation in risk of recurrence and progression. The aim of this audit was to assess whether the clinical management of NMIBC was being carried out according to the recommendations provided by the European Association of Urology (EAU) guidelines.

METHOD: 154 patients who were newly diagnosed with NMIBC were selected. Details about presentation, risk factors and clinical management were collected for analysis. The clinical standard of care used was the EAU Non-muscle-invasive Bladder Cancer Guidelines 2020. Oncological outcomes for this patient group was also documented. The European Organisation for Research and Treatment of Cancer (EORTIC) risk table was used to predict recurrence and progression in NMIBC. The risk group stratification table in the EAU guidelines (2020) was used to classify tumours according to their characteristics. SPSS and Kaplan Meier curves were used to analyse the results.

RESULTS: TURBT was carried out in 52.9% of indicated patients; intravesical therapy in 14.1% of indicated patients; CT-IVU follow up according to guidelines in 64.3%; urine cytology follow up according to guidelines in 66.9% patients. Cystoscopy carried out after 3 months showed a recurrence rate of 12.3%.

CONCLUSION: The clinical management of NMIBC has an important bearing on the progression of the cancer. Stricter adherence to the guidelines will enable the clinician to strike a balance between cost cutting and reduced tumour progression.