Oncology

Exploring Correlations Between Holistic Needs In Lung Cancer Patients: Insights From Dependancy Tool Data (2026)

Posted on by

Type of publication:

Conference abstract

Author(s):

Rayson V.; *Greenway T.; Kelly M.; Barnett N.; Kelly S.; Dalrymple P.; Ross J.; Middleton E.; Glover S.; Smith B.; Wilson J.; Weir J.; Shepherd P.; Laguardia A.

Citation:

Lung Cancer. Conference: 24th Annual British Thoracic Oncology Group Conference 2026. EICC Edinburgh, Edinburgh United Kingdom. 212(Supplement 1) (no pagination), 2026. Article Number: 109110. Date of Publication: 01 Feb 2026.

Abstract:

Introduction Holistic assessment is central to personalised cancer care, capturing physical, emotional, practical, and family-related concerns. Understanding how these domains interact can inform integrated care planning and resource allocation. This analysis investigates correlations between patient-reported concerns using the Macmillan Holistic Needs Assessment (HNA), and an adapted dependency tool, aiming to identify patterns that influence complexity and support needs. Method A retrospective secondary analysis was conducted using patient-reported HNA data collected from 210 lung cancer patients across the UK, covering all disease stages. Five domains were examined: Physical Symptoms (0-40), Physical Concerns (0-76), Practical Concerns (0-64), Emotional Concerns (0-48), and Family Concerns (0-20). Pearson correlation coefficients were calculated, where 1.00 indicates perfect correlation and 0.00 indicates no correlation. Data interpretation focused on identifying strong, moderate, and weak associations and exploring potential drivers based on patient responses. Outcomes Strongest correlation: Physical Symptoms Physical Concerns (r = 0.75) Emotional Concerns strongly linked to Practical (r = 0.65) and Family Concerns (r = 0.62) Practical Concerns moderately correlated with Physical Symptoms (r = 0.49) and Family Concerns (r = 0.54) Weakest correlation: Physical Symptoms Family Concerns (r = 0.40) Interpretation: Physical burden drives broader physical concerns, while emotional distress is amplified by practical and family-related challenges. Variability suggests influence from coping strategies, socio-economic context, and perceived family impact. Conclusion The Dependency Tool data gathered does demonstrate a correlation between several types of patient concerns. The strongest link identified is between physical symptoms and physical concerns. Despite CNS's subjective identification of a strong link between patients' emotional concerns and their physical concerns, the evidence only demonstrates a moderate correlation. There is stronger evidence that psychosocial distress is closely tied to logistical challenges and perceived family burden. Disclosure No significant relationship.

DOI: 10.1016/j.lungcan.2026.109110

Is Follow Up for Lung Cancer Surgery Evidence Based Within the UK - a Critical Review of Protocols (2025)

Posted on by

Type of publication:

Conference abstract

Author(s):

Barton P.W.J.; *McAdam J.; James T.; Gomez S.; Morley J.; Dalrymple P.; Smith C.; Ivey S.

Citation:

Journal of Thoracic Oncology. Conference: 2025 World Conference on Lung Cancer. Barcelona Spain. 20(10 Supplement 1) (pp S873), 2025. Date of Publication: 01 Oct 2025.

Abstract:

Introduction: Our aim is to look at surgical follow-up protocols in different UK trusts to critically review and see if follow up varies postsurgical patient with lung cancer. Method(s): A literature review around this topic was conducted to establish if there was an evidence based approach. We collected follow up protocols from 10 trusts in the UK and applied 6 questions to each to allow us to compare the results. Responses were collated, compared and interpreted by the authors. Result(s): Our literature review highlighted there is limited evidence to support how lung cancer patients should be followed up post-surgery. Overall, the literature supports CT based imaging although no specific period is supported. From the protocols reviewed there were common themes identified. Post-surgical follow-up was predominantly nurse led, face to face appointments or mixed with virtual were more common. Frequency of follow-up varied between 3 and 8 months, but apart from one site was consistently over 5 years. Similarly, radiology modality predominantly used CT scan either solely or mixed with chest x-rays. Only one site only used chest x-rays to follow up patients Conclusion(s): Both the literature review and critical review of protocols highlight that further research would be beneficial, looking at a wider population of protocols could help encourage a more standardised approach across the UK to ensure optimum care for patients.

DOI: 10.1016/j.jtho.2025.09.1695

Patient's Understanding of Follow-Up Post Curative Primary Lung Cancer Surgery (2025)

Posted on by

Type of publication:

Conference abstract

Author(s):

Barton P.W.J.; King M.; *Wassell E.; *McAdam J.

Citation:

Journal of Thoracic Oncology. Conference: 2025 World Conference on Lung Cancer. Barcelona Spain. 20(10 Supplement 1) (pp S872), 2025. Date of Publication: 01 Oct 2025.

Abstract:

Introduction: Follow up is an important part of patient care post primary lung cancer resection due to the possibility of cancer recurrence or the development of a new primary lung cancer. We aim to explore post operative patient's with a lung cancer understanding of follow-up and how we can implement and support this practice. Method(s): Between 01/08/2023 and 31/08/2023 every curative intent surgical patient was given a questionnaire to complete whilst attending follow-up clinics. This was rolled out over three UK thoracic surgical centers/Diagnostic centers and targeted patients with lung cancer undergoing follow-up post curative primary lung cancer surgery (excluding carcinoids, recurrence). 148/155 questionnaires were returned, collecting information on demographics, smoking status, operation performed, follow-up period post-surgery and patient understanding of follow-up. The responses were collated, compared and interpreted by the authors. Result(s): 148/155 (96%) patients responded. 62% female, 36% male. 80% Ex-smokers, Lobectomy most common operation 64%. 97% of patients' aware follow-up was required, and 72% identified that this would be for 5 years. 68% knew their diagnosis prior to surgery and 58% their final staging, 9% understood TNM. 58% knew their lung cancer nurse specialist (LCNS) and 54% when radiological investigations would be performed. 57% recall being given advice on improving their health and wellbeing, from (LCNS) 30%. 45% recalled a healthcare professional discussing recurrence. 34% knew the potential signs and symptoms of recurrence. Conclusion(s): This study has identified a gap in patients' knowledge and understanding of follow-up: The necessity of followup; TNM stage relevant to individuals; Schedule and frequency of radiological tests; Signs and symptoms suggestive of lung cancer recurrence. The development of a information leaflet patients with lung cancer by LCNS aims to address this need.

DOI: 10.1016/j.jtho.2025.09.1691

Incidence Trends and Survival Outcomes of Pulmonary Langerhans Cell Histiocytosis: A National Cancer Study Using SEER (2025)

Posted on by

Type of publication:

Conference abstract

Author(s):

Carpo B.; *Arunachalam J.; Gunturu K.

Citation:

Journal of Thoracic Oncology. Conference: 2025 World Conference on Lung Cancer. Barcelona Spain. 20(10 Supplement 1) (pp S864), 2025. Date of Publication: 01 Oct 2025.

Abstract:

Introduction: Pulmonary Langerhans cell histiocytosis (PLCH) is a rare, smoking-related neoplastic lung disease arising from clonal proliferation of dendritic cells. Initially considered a reactive disorder, the discovery of recurrent BRAF V600E mutations has led to its reclassification as a neoplasm. PLCH typically presents with nonspecific respiratory symptoms or may be incidentally detected on imaging. Diagnosis is based on high-resolution computed tomography, with histologic confirmation via biopsy. Smoking cessation remains the cornerstone of treatment, although glucocorticoids and BRAF-targeted therapies are used in selected cases. This study aims to characterize the incidence trends and survival outcomes of PLCH using a large population-based dataset in the U.S. Method(s): We performed a retrospective analysis using SEER (Surveillance, Epidemiology, and End Results) Research Plus (17 registries, 2010-2021). Patients with histologically confirmed Langerhans cell histiocytosis (ICD code 9751/ 3) with a primary site in the lung (C34) were included. Demographic and clinical data collected included age at diagnosis, sex, race/ ethnicity, stage at presentation, treatment modality, and county of residence (metropolitan vs. non-metropolitan). Incidence rates (IRs) per 100,000 were calculated using SEER*Stat and age-adjusted to the 2000 U.S. standard population. Kaplan-Meier survival analysis was performed using GraphPad Prism to evaluate overall survival (OS) and cancer-specific survival (CSS). Result(s): A total of 253 patients with PLCH were identified. The cohort was 57% female and 43% male, with 73% White, 15% Black, 6% Hispanic, 3.5% Asian/Pacific Islander, and 1% American Indian/Alaska Native. At diagnosis, 73% had localized disease and 20% presented with metastases. The overall age-adjusted IR was 0.0132 per 100,000, with the highest annual IR observed in 2016 (0.0493), followed by a decline. Females had a 33% higher IR than males (0.01509 vs. 0.01138; p = 0.028). While Black patients had a higher incidence (0.0190) compared to White patients (0.0160), the difference was not statistically significant (p = 0.37). The highest IR was observed in the 55-59 age group (IR = 0.03840), which was significantly higher than in the 40-44 (IR = 0.01419; p = 0.0004) and 35-39 (IR = 0.01261; p = 0.0001) groups, though not significantly different from those aged 45-54. Nonmetropolitan counties had a significantly higher IR (0.02507) compared to metropolitan counties (0.01185; p = 0.0004). The 5- and 10-year OS rates were 84.38% and 60.08%, respectively, while CSS rates were 96.25% and 93.39%. Adults aged >=60 years had a significantly shorter median OS (mOS) of 81 months compared to younger patients (p < 0.0001; HR 4.19, 95% CI 2.20-7.99). Conclusion(s): PLCH is an extremely rare pulmonary neoplasm with excellent cancer-specific survival but modest overall outcomes, likely reflecting comorbidities or delayed diagnosis. Incidence was highest in females, adults aged 55-59, and residents of nonmetropolitan areas, suggesting demographic and geographic disparities. These findings highlight the importance of early diagnosis and smoking cessation. The potential for disease stabilization or regression following smoking cessation differentiates PLCH from other lung neoplasms and underscores the need for timely recognition and intervention. Further investigation is warranted into the molecular framework and development of targeted therapies for this rare disease.

DOI: 10.1016/j.jtho.2025.09.1675

External validation of the novel prognostic Meet-URO score in Metastatic Renal Cell Carcinoma on First Line Immune-combination therapy (2024)

Posted on by

Type of publication:

Conference abstract

Author(s):

Ghose A.; Signori A.; Brown N.; Haywood S.; Tapia J.; Vijay A.; Cheung M.; Mahajan I.; Fiala O.; Abrol R.; Chauhan V.; Soe Y.S.Y.; Zargham A.; Ashley S.; Smith M.; Hardy O.; Johnston E.; Sarwer A.; Tun K.K.; Challapalli A.; Shrestha R.; Urun Y.; *Meegan J.; Rescigno P.; Parkes J.; Smalley B.; Anpalakhan S.; Buono F.; Poprach A.; Teoh J.Y.C.; Murianni V.; Catalano F.; Bimbatti D.; Buti S.; Fornarini G.; Banna G.; Rebuzzi S.E.

Citation:

Therapeutic Advances in Urology. Conference: Second International Urology Cancer Summit. Portsmouth United Kingdom. 16 (pp 13-14), 2024. Date of Publication: 01 Sep 2024.

Abstract:

Objective: First-line immune-combination therapy based on immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) are the new mainstay in metastatic renal cell cancer (mRCC). In this setting, there is a dearth of standard prognostic/predictive parameters to guide treatment choice. The novel prognostic Meet-URO score (IMDC score + bone metastases and neutrophil-to-lymphocyte ratio – NLR) showed a higher prognostic accuracy than IMDC in 306 patients on first-line nivolumab + ipilimumab in the Italian Expanded Access Program (PMID: 36493602). Hence, the necessity to externally validate and expand to other first-line immune-combination settings. Method(s): Twenty-seven European centres were included. Baseline patient and tumour characteristics were collected, including the IMDC score along with the presence of pre-treatment bone metastases, neutrophils, and lymphocytes for calculating the Meet-URO score. The prognostic performance of Meet-URO and IMDC scores were compared and defined by the Harrell's c-index. Result(s): 1174 mRCC patient data was retrospectively collected. The median age was 64. 72.8% were male, 54.2% received nephrectomy, 62% were metastatic at diagnosis and 86.7% had clear-cell histology. 35% had bone metastases and 51.6% had NLR >= 3.2. 672 (57.2%) patients received ICI-ICI (nivolumab + ipilimumab) whereas 502 (42.8%) an ICI-TKI combination, mainly avelumab + axitinib (27.1%) and pembrolizumab + lenvatinib (14.3%). Overall, median overall survival (mOS) was 36.2 months (95% CI 31.1 – 38.5) with a median follow up of 15.5 months. The c-index of Meet-URO resulted higher than IMDC score (0.68 vs 0.65). In particular, the mOS resulted more distinctive within the Meet-URO prognostic groups: 45.8 months for group 1 (12.9% of patients), 55.0 for group 2 (25.7%), 38.1 for group 3 (23.5%), 20.9 months for group 4 (29.6%) and 10.4 for group 5 (8.2%). On the other hand, mOS was 45.8 months for IMDC favorable-risk (19.5% of patients), 38.2 for intermediate-risk (53.7%) and 16.2 for poor-risk (26.8%). Conclusion(s): In this large-scale real-world external validation analysis on mRCC patients receiving first-line immune-combinations, Meet-URO confirmed higher prognostic accuracy compared to IMDC. A further validation is planned in the ongoing Italian prospective Meet-URO 33 (REGAL) study (PMID: 38914928).

DOI: 10.1177/17562872241277067

Link to full-text [no password required]

Checkpoint Inhibitors and Beyond: A Systematic Review of Immunotherapy in Cutaneous Malignancies (2025)

Posted on by

Type of publication:

Systematic Review

Author(s):

Rashid, Yasir; Devi S, Kartika; Gonzalez-Espinosa, Tomas Faustino; Jain, Juhi; Dalain, Mujahed; Baig, Rayyan; D'Amico, Giuseppe Antonio; Mowo-Wale, Adetola G; Khomchenko, Mariia; Baby, Nima; *Yateem, Dana; Duhamel, Axel; Ali, Ramsha.

Citation:

Cureus. 17(12):e98959, 2025 Dec.

Abstract:

Skin cancers represent a major health concern, and there is a need for more effective treatment approaches, among which immune checkpoint inhibitors have become a particularly important recent development. This study aimed to explore the efficacy and tolerability of immune checkpoint inhibitors, intratumoral immunotherapies, targeted agents, and their combinations in advanced cutaneous malignancies. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-conform review of PubMed (2012-2024) identified 26 studies, including randomized trials, observational cohorts, network meta-analyses, and systematic reviews, evaluating checkpoint inhibitors, anti-PD-1/PD-L1and anti-CTLA-4. Outcomes included progression-free survival (PFS), objective response rate (ORR), overall survival (OS), biomarkers, and treatment-related adverse events. This meta-analysis of 26 studies (2012-2024) evaluated treatments for cutaneous malignancies, including melanoma, basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC), and Merkel cell carcinoma (MCC), covering systemic immunotherapies (PD-1, CTLA-4), combination checkpoint inhibitors, and novel approaches like IL-12 electroporation. Melanoma: PD-1 therapies showed durable benefits; ipilimumab retreatment yielded 42% two-year survival. MCC: Avelumab achieved a median OS of 12.9 months. cSCC: Nivolumab PFS 8.2 months; cemiplimab 12-month PFS >53%. Targeted therapy: BRAF/MEK inhibitors reached OS ~33 months. Emerging strategies: TIL-based and neoadjuvant immunotherapy showed high pathological and durable responses. Overall, combination therapies consistently outperformed monotherapies in survival and response. Adverse events were common, especially with combination therapy, with severe immune-related toxicities reported in 30-59% of cases, while monotherapies were generally safer. Overall, immunotherapy offers substantial, often long-lasting benefits, though careful patient selection and monitoring are essential to balance efficacy and toxicity. Combination immunotherapies and targeted regimens are more effective for advanced melanoma, although they have increased toxicity.

DOI: 10.7759/cureus.98959

Link to full-text [open access - no password required]

Tumour immune microenvironment prognostic factors in locally advanced rectal cancer, a systematic review (2025)

Posted on by

Type of publication:

Systematic review

Author(s):

Ball, Alasdair; *Lefroy, Rebecca; Price, Malcolm; McArthur, David; Beggs, Andrew.

Citation:

Frontiers in Oncology. 15:1688696, 2025.

Abstract:

Introduction: Understanding factors influencing individual survival outcomes following surgical resection of locally advanced (LARC) rectal cancer remains challenging. Novel biomarkers could show emerging promise in this setting. This study aimed to systematically review the literature on immune prognostic factors in LARC.

Methods: The review protocol was preregistered on the PROSPERO database (CRD42023460541). Included studies were required to report overall survival and at least one immune prognostic factor for at least ten patients with LARC. Final searches of MEDLINE, EMBASE and Central were concluded on 8th September 2023. The risk of bias was assessed using the QUIPS tool.

Results: 22 retrospective cohort studies involving 2,622 LARC patients were included in the review. We did not find any published data on immune prognostic factors in locally recurrent rectal cancer. Due to inconsistency of immune prognostic factor definitions and measurement methods, meta-analysis would not be meaningful. Instead, the results are presented descriptively. Risk of bias was concentrated in the participation, attrition, and confounding domains. Greater cytotoxic cell infiltration was associated with improved overall survival. There was inconsistent evidence of an association of PD-L1 expression and survival. M2 macrophage infiltration and homozygous germline FPR1 loss-of-function were associated with worse survival.

Discussion: These findings support a role for both innate and acquired immune systems in mediating outcomes following surgery for LARC and suggest that further work into immunomodulation may show promise in improving LARC treatment.

DOI: 10.3389/fonc.2025.1688696

Link to full-text [open access - no password required]

Artificial Intelligence in Colonoscopy: A Systematic Review of Adenoma Versus Polyp Detection Rates (2025)

Posted on by

Type of publication:

Systematic Review

Author(s):

Rabba, Waseem; *Asif, Fatima; Younis, Muhammad Y; Nasrullah, Haris; Fatima, Laraib; Arif, Muhammad A.

Citation:

Cureus. 17(12):e98528, 2025 Dec.

Abstract:

Colonoscopy is the gold standard in the prevention of colorectal cancer, but the miss rates of adenoma are high, which restricts its efficacy. To improve lesion recognition, artificial intelligence (AI), especially computer-aided detection (CADe) systems, has been introduced. The aim of this systematic review was to compare AI-assisted colonoscopy in terms of its ability to improve adenoma detection rate (ADR) and polyp detection rate (PDR). An extensive search was performed on PubMed, Embase, and Cochrane Library from 2015 to 2025. There were 17 randomized controlled trials (RCTs) comparing the use of AI-assisted colonoscopy with normal colonoscopy. The methodological quality measure of the included RCTs was Cochrane Risk of Bias 2.0 (RoB 2.0), which subdivided the studies based on low risk, some concerns, or high risk of bias based on whether they were biased in this or that domain. The robVis tool was used to produce the visual summaries. AI-aided colonoscopy effectively enhanced both adenoma detection rate (ADR) and polyp detection rate (PDR) in all of the included studies over conventional colonoscopy. In adenoma detection, accuracy was more than 85%, and in polyp detection, more than 90%. The advantage was also found especially in the detection of small and flat adenomas, which are very often missed in routine practice. The use of AI in colonoscopy is strongly associated with an increase in the detection rate of adenoma and polyps, minimizing the risk of underdiagnosis. The results highlight the clinical promise of AI in the form of a decision-support tool across gastroenterologists and suggest that AI can be applied to enhance the outcomes of preventive and screening colorectal cancer. Future research should be cost-efficient and practical, and combined with some clinical activities.

DOI: 10.7759/cureus.98528

Link to full-text [open access - no password required]

RESECT: A Randomised Controlled Trial of Audit and Feedback in Non-muscle-invasive Bladder Cancer Surgery (2025)

Posted on by

Type of publication:

Randomised controlled trial

Author(s):

Gallagher K.; MacLennan S.; Bhatt N.; Clement K.; Zimmermann E.; Khadhouri S.; Kulkarni M.; Gaba MPhil F.; Anbarasan T.; Asif A.; Light A.; Ng A.; Chan V.W.-S.; Nathan A.; Cooper D.; Aucott L.; Sakthivel D.; Akand M.; Piazza P.; Marcq G.; O'Brien T.; Nielsen M.; Giudice F.D.; Simpson K.; Orecchia L.; Teixeira B.; Geisenhoff A.; Hill G.; Fukuokaya W.; Hidalgo B.G.; El-Hajj A.; Elgamal M.; Fanshawe J.; Wang B.; Lee T.; Manecksha R.; Rivas J.G.; Arda E.; Elhadi M.; Rossi S.; Teoh J.Y.-C.; Kasivisvanathan V.; Hussein I.; Longshaw A.; Kostakopoulos N.; Khadhouri S.A.S.; Kruczynska A.E.; Dimitropoulos K.K.D.; McPhee A.; Gilanliogullari K.P.; Natalie S.; Rutigliani L.; Shallcross O.R.; Dokubo I.I.; Lamb B.W.; Jimie J.H.; Hussein B.; O'Neill C.; Nelson A.R.; MacLeod A.; Arumainayagam N.; Maqboul F.; Agrawal S.; Burns H.; Bekarma H.J.; Mohammad S.; Misurati M.O.; Raslan M.Y.; Anwar A.; Gkikas C.; Alexander C.; Warren H.; Byrnes K.; Edison M.; Croghan S.; Oo E.; Beder D.; Thurtle D.R.; Janebdar H.; Reeves F.; Chua C.U.; Mcalindon J.; Hasan H.; Ng P.Y.; Mayor N.; Attar H.A.; Delacave H.S.T.; Atiyah A.; Atiyah Z.; Jelski J.E.R.; Peacock J.; Davenport K.; Shipstone D.; Malla R.A.; Krishna K.K.I.; Nizov A.; Somov P.; Ahmed Z.; McCann C.; Glackin A.J.; Asaad W.; Bain A.J.; Bordenave M.G.; Ray E.R.; Ghonaimy A.S.; Madaan S.; Fontaine C.L.L.; Daggamseh A.M.K.; Pascoe J.J.; Horn C.; Fuge O.; Laoye A.; Deytrikh A.; Thomas A.G.; Ravishankar K.; Clark M.C.; Panayi Z.; Shillito S.H.; Srirangam S.J.; Bradley C.; Lee X.W.J.W.J.; Mcilhenny C.; Leask J.; sarkar S.; chetwood A.S.A.; Paramore L.; Ali A.S.A.; Odey J.; Sheweita M.S.S.; Ekwueme K.C.; Yogeswaran C.; Mohamed Y.; Trimboli M.; Shafii M.; Duffy S.A.; Morton S.; Bandeira de Mello K.L.; Harris A.; Bruce A.; Fanshawe J.R.; Tan N.J.; Mensah E.; Walters U.; Lami M.; Omar M.A.; Kadhim H.; Gami M.N.; Hawizy A.A.M.H.; Devadoss B.J.; Breish M.; Pina I.; Cresswell J.; Simoes A.; Papadopolous G.G.; Thomas M.M.T.; Ahmed I.I.A.; Sekhon N.C.; Alleemudder A.; Okwuchi D.D.; Willmott S.V.; Majumdar P.; Coyle M.; Simson N.; Egbe A.; Nair A.; Nair M.A.N.; Kailavasan M.; Douglas-Moore J.L.; Elajnaf M.R.; Jackson B.L.; Hamami H.; Hemmant J.; Siraj M.; Craciun M.E.; Lyttle M.; Shendy M.S.; Abdalla A.; Mukherjee R.; Mihuna A.; Kantartzi A.; Atkins C.R.M.; Uddin J.; Motiwala F.; Fanshawe J.B.; Mxxxensah E.; Chan K.H.Y.; Vasdev N.N.V.; Hassan M.M.; Pushkaran A.K.; Salik M.; Barrass B.J.R.; Jones A.; Shakir J.; Waterhouse R.H.; Tan S.; Shah S.; Simpson R.G.; Mohee A.R.; Smith P.M.; Middela S.G.; Gunendran T.; Bhat T.; Mehmood S.M.; Masood S.; Karna S.; Ibiok I.A.; Ollandini G.; Yarwood A.; Hill G.T.; Kanda Swamy G.V.; Healy R.; Faek Halaseh S.A.; Lee S.-M.; Hughes C.M.; Ali O.H.; Boaz R.J.; Gabriel M.M.; Finch W.; Hammad O.O.; Heba S.T.; Yun J.W.; Pandian S.K.; Oliver R.L.; Almpanis S.S.A.; Boxall N.E.; Adamu-Biu F.I.; Pushpa-Rajah J.A.; Miakhil I.; Mera Z.; Sultana A.; Potter J.J.; Coombs L.; Laghari S.; Khan I.A.; Warner R.M.; Olaitan O.; Akman J.; Green W.J.F.; Dooldeniya M.D.; Turo R.K.; Kabia A.A.; Onowa V.E.; Anand C.V.; Tanasescu G.G.T.; Sells L.A.; Acyatan M.G.; Smith T.G.; Lokman U.U.L.; Ramachandra M.; Hodgson D.J.; *Sid Ahmed M.A.M.B.; *Moghe D.; *Ong K.K.; *Tasleem A.M.; Blick C.; Toia B.B.T.; Maduwe Gedara S.R.K.R.K.; Mohsin H.; Bleakley C.; McGrath M.J.; Ng M.G.; Parsons B.; Lindsay J.S.; Volanis D.; Wijayasuriya D.S.C.R.; Wilkinson J.; White A.; Cox A.; Calmuc A.; Fung C.; Taktak S.; Lazarowicz H.P.; Starmer B.; Chippagiri A.S.; Gallegos C.; Kerr E.; Penny N.M.; Green E.A.; Jones C.M.; Colvin H.V.; David R.; Davies M.; Qamar B.Q.; Humayun-Zakaria N.K.; Hussain A.; Dhanasekaran A.K.; Mangera A.F.; Pereca J.L.P.; Akinjise-Ferdinand O.; Rosario D.J.; *Dhother J.; *Mohamed G.; *Jenny Bo Y.N.; *Chin Chin Y.F.Y.F.; *Varma R.K.; *Elves A.; Elmansouri A.J.N.V.; Edris F.F.E.; Voss J.; Parfitt C.M.; Buckland G.R.E.; Antoniou V.; Sinha M.M.; Douglas J.; Campbell J.M.; Bondad J.; Khuoge S.; Gipson C.; Dawam D.; Lecoyte A.; Waley L.G.; Hawthorne R.; Ridgway A.; Warren K.S.; Maniarasu S.; Mistry R.; Stroman L.; Hassan M.; Ayres B.; Pinkney R.T.M.; El-Taji O.; McCabe J.; Oliyide A.E.; Chibuzo I.N.C.; Vaggers S.N.; Dyer J.E.; MacKenzie K.R.; Miller A.; Tait C.D.; Thorman H.E.; Ippoliti S.; Ilie P.C.; Babawale O.D.; Mitchell V.; O'Rourke S.; Ross A.; O'Halloran R.; Hayes J.; Gray S.B.; Day E.K.; Shirwac H.; jaibaji R.; Tang S.C.; Kennedy C.; Szabados B.; Baldini C.; Nowers J.; Sarmah P.P.B.; Williams K.G.; Tan L.J.; Boden A.K.; Simpkins S.J.; Clement K.D.; Khan R.S.S.; Ravindraanandan M.; Lango A.; Kitchen M.; Gommersall L.M.; Thomas M.; Al-Mitwalli A.; Featherstone J.M.; Catto J.; Chari N.; Nikolinakos P.; Ellis D.S.J.; Papadopoulos D.I.; Charitopoulos K.; Carey M.M.; Gordon E.M.; Lau D.H.W.H.; El-Koubani O.; Ayers J.R.S.; Hina S.; Gartner T.; James J.E.G.; Simpson K.R.S.; Mariappan P.; Ibrahim M.E.; Dallash M.H.; Jallad S.; Bencatova Z.; Karanjia R.N.; Whiting D.; Frymann R.J.; Farag S.S.F.; Whitburn J.A.S.; Miah S.; Khattab H.; Kondylis F.; Amin Alsayed Alkhawalka M.A.

Citation:

European Urology. (no pagination), 2025. Date of Publication: 2025.

Abstract:

Background and objective We aimed to determine whether audit, feedback, and education improves surgical performance after transurethral resection of bladder tumour surgery for non-muscle-invasive bladder cancer and as a secondary aim if it reduced recurrence rates. Methods This cluster randomised controlled trial compared audit and feedback plus peer comparison and education, with audit alone for four coprimary outcomes: (1) Single-instillation chemotherapy, (2) detrusor muscle sampling, (3) documentation of tumour features, and (4) resection completeness. Early recurrence was a secondary outcome. Key findings and limitations A total of 100 sites were randomised to intervention and 101 to control. In total, 14 915 patients were included. Intervention sites significantly improved documentation of tumour features (adjusted mean difference [95% confidence interval {CI}]: 6.0 [1.8, 10], p = 0.005) and of resection completeness (adjusted mean difference [95% CI]: 5.5 [1.5, 9.5], p = 0.007). There was no statistically significant difference in chemotherapy use (adjusted mean difference [95% CI]: 0.3 [-4.7, 5.3], p = 0.9) or detrusor muscle sampling (adjusted mean difference [95% CI]: 2.6 [-1.3, 6.4], p = 0.2). There was no statistically significant difference in early recurrence rate between arms (adjusted odds ratio [95% CI]: 1.02 [0.8, 1.4], p = 0.9); however, in the control arm, the early recurrence rate reduced compared with baseline (adjusted odds ratio [95% CI]: 0.7 [0.6, 0.9]). Conclusions and clinical implications Audit and feedback with education improved the documentation of important surgical findings that influence clinical management, but not the performance of detrusor muscle sampling, adjuvant chemotherapy use, or early recurrence rates. Improvements observed in the control arm may explain a lack of effect of the intervention in some outcomes.

DOI: 10.1016/j.eururo.2025.09.4174

Link to full-text [open access - no password required]

Altmetrics: