KEY TAKEAWAYS
- The RESECT trial aimed to determine if early bladder cancer recurrence rates vary significantly between RESECT sites after accounting for tumor characteristics.
- NMIBC pts undergoing TURBT were included, excluding cases and sites without first check follow-up and ethical approval.
- The study found early bladder cancer recurrence rates vary significantly between sites, likely due to differences in surgical technique and perioperative practice.
Researchers aimed to determine if early bladder cancer recurrence rates vary significantly between RESECT sites after accounting for tumor characteristics.
The study included initial, suspected non-muscle invasive bladder cancer (NMIBC) patients (pts) who underwent transurethral resection (TURBT). They excluded cases if the first follow-up assessment still needed to be done. Sites with fewer than 10 cases with initial follow-up were also excluded. Ethical approvals were obtained from local and national authorities before the study began at each participating site.
The study included 186 sites (UK: 80; Europe: 59; North America: 18; Asia: 17; Africa: 7; South America: 3; Oceania: 2), contributing 4,597 cases (average 25 cases per site). The median recurrence rate per site was 12% [IQR 0-22] for low-grade tumors and 27% [IQR 13-42] for high-grade tumors. When adjusting for tumor size, number, stage, and grade (all independently associated with early recurrence), they found significant residual variation among sites (P<0.0001, intra-class correlation 0.1). Accounting for these site differences improved the predictive model from an area under the receiver operating characteristic curve of 0.66 to 0.74.
Initial analysis of surgical and perioperative practices revealed substantial variation. On average, 75% (IQR 66-92) of cases per site included detrusor muscle resection, and 42% (IQR 17-58) used a single instillation of intravesical chemotherapy. Additional differences in operative and perioperative practices were identified through surveys.
The study found early bladder cancer recurrence rates vary significantly between sites, likely due to differences in surgical technique and perioperative practice.
Source: https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.16_suppl.4510?af=R
Clinical Trial: https://classic.clinicaltrials.gov/ct2/show/NCT05154084
Fortis Gaba, Kevin M. Gallagher, Nikita R. Bhatt, Keiran D. Clement, Eleanor F. Zimmermann, Sinan Khadhouri, Meghana Kulkarni, Thines Anbarasan, Alexander Ng, Alexander Light, Aqua Asif, Vinson W. Chan, Arjun Nathan, Sabrina H. Ross, Tim O’Brien, Steve MacLennan, Matthew E. Nielsen, Paramananthan Mariappan, Veeru Kasivisvanathan, and RESECT Study Global Collaborators (BURST). DOI: 10.1200/JCO.2023.41.16_suppl.4510 Journal of Clinical Oncology 41, no. 16_suppl (June 01, 2023) 4510-4510.
