TURBT Documentation: Impact on NMIBC Risk Stratification

What is it about?

The study aimed to examine the documentation rates of critical intraoperative findings in transurethral resection of bladder tumor (TURBT) reports according to the 2016 European Association of Urology (EAU) non-muscle-invasive bladder cancer (NMIBC) guidelines. A total of 203 TURBT and bladder biopsy procedures from January to December 2022 at Eastern Health, Melbourne, Australia, were reviewed. Insufficient data were collected intraoperatively in a significant proportion of patients, which put them at risk of being miscategorized and suboptimally managed according to the EAU guidelines. Adjuvant intravesical therapy administration was also poor, with only 54% of patients with at least one procedure classified as high risk receiving treatment. The lack of comprehensive intraoperative documentation leads to insufficient risk stratification, particularly of low- and intermediate-risk NMIBC, resulting in potentially suboptimal management. [Some of the content on this page has been created by AI]

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Why is it important?

The study underlines the crucial need for comprehensive and standardized documentation during Transurethral resection of bladder tumour (TURBT) procedures, a central technique in diagnosing and treating bladder cancer. Accurate documentation is essential for effective risk stratification, which in turn informs tailored management plans for patients according to established guidelines. This study highlights the gaps in current practices affecting risk stratification and possibly leading to suboptimal patient management, particularly for those with non-muscle-invasive bladder cancer (NMIBC). Key Takeaways: 1. Comprehensive intraoperative documentation during TURBT is crucial for accurate postoperative risk stratification and management of bladder cancer patients, as per European Association of Urology (EAU) guidelines. 2. Insufficient documentation leads to a significant number of patients being unable to be accurately risk-stratified, potentially resulting in their suboptimal management, particularly in administering adjuvant intravesical chemotherapy. 3. While high-risk patients are more likely to be correctly identified and managed due to the weight of histopathological findings in their stratification, low- and intermediate-risk patients are at risk of mismanagement due to poor documentation rates. 4. The study underscores the need for standardizing TURBT and bladder biopsy documentation practices to ensure all patients can be correctly stratified and managed according to the best practice guidelines, thereby improving healthcare outcomes.