Katharina Keogh
Introduction
Follow-up flexible cystoscopy (FC) for low-risk bladder cancer should be offered at 3 and 12 months. If there is no recurrence, patients can be discharged.
Methods
Clinical practice at a district general hospital was audited. Inclusion criteria were (1) histology-confirmed diagnosis of low-risk bladder cancer and (2) transurethral resection of bladder tumour (TURBT) within specified timeframes in 2012-2013 (cycle 1, n = 51) or 2020-2021 (cycle 2, n = 35). Data was collected via electronic records. In cycle two, records were additionally screened for documentation of (1) reasons for deviation in follow-up duration and (2) size and number of lesions. Data was analysed at least 72 (cycle 1) and 50 (cycle 2) months post-TURBT.
Results
Cycle one showed an average follow-up of 58 months, with an average 4.57 extra FCs. Only 27% of patients had been discharged at the time of audit, none of them at 12 months. Average follow-up reduced to 21 months in cycle two, with an average 1.39 extra FCs. 46% of patients had been discharged at the time of audit; 18% at or before 12 months. Number and size of lesions at TURBT were documented in 69% and 51% of cases, respectively.
Conclusion
Cycle one showed poor concordance with NICE guidance, with no patient being discharged at the recommended time point. This improved to 18% in cycle two. However, average follow-up duration remains longer than recommended. As the cost of FC has been estimated at £386.00, there is a savings potential in improving surveillance practice.
Authors
Katharina Keogh, Kristian Arak, Marshall Wang
Rotherham NHS Foundation Trust, Rotherham, United Kingdom