Abstract
BACKGROUND: Transurethral resection of bladder tumor (TURBT) is fundamental to the diagnosis and management of bladder cancer. The impact of tumor size on perioperative outcomes is seemingly intuitive albeit incompletely defined. OBJECTIVE: To compare outcomes following TURBT of small, medium, and large tumors to determine if larger tumors truly resulted in a greater degree of complications. METHODS: The National Surgical Quality Improvement Project (NSQIP) Participant Use File (PUF) was queried to extract all TURBT cases performed from 2011-2015. CPT codes 52234 (small), 52235 (medium), and 52240 (large) were used to stratify the data into three cohorts. Outcomes of interest included any complications, hospital length of stay (LOS), reoperation within 30-days, 30-day readmission, and mortality. RESULTS: 17,839 patients who underwent TURBT were included. 44% had small (n = 7,805), 35% had medium (n = 6,240), and 21% had large tumors (n = 3,794). Univariate analysis revealed significant differences in complications, length of stay, reoperation rate, readmission at 30-days, and mortality when stratifying TURBT by tumor size (p < 0.0001). In the multivariable regression model, medium and large tumors were associated with significantly greater odds of a postoperative complication (OR = 1.37 and 1.64; p < 0.0001), reoperation (OR = 1.33 and 1.52; p = 0.019 and p = 0.002), readmission at 30-days (OR = 1.27 and 1.56; p = 0.001 and p < 0.0001), and death (OR = 1.65 and 2.59; p = 0.015 and p < 0.0001) compared to smaller tumors. CONCLUSIONS: Larger tumor size (>5 cm) is associated with greater length of stay, reoperation, readmission, and death following TURBT. Patients should be counseled appropriately and likely warrant vigilant observation prior to and following hospital discharge.
Original language | English (US) |
---|---|
Pages (from-to) | 195-200 |
Number of pages | 6 |
Journal | Bladder Cancer |
Volume | 6 |
Issue number | 2 |
DOIs | |
State | Published - 2020 |
All Science Journal Classification (ASJC) codes
- Oncology
- Urology
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Loloi, J., Allen, J. L., Schilling, A., Hollenbeak, C., Merrill, S. B., Kaag, M. G. (2020). In the World of Bladder Tumors: Size Does Matter. Bladder Cancer, 6(2), 195-200. https://doi.org/10.3233/BLC-200273
Loloi, Justin ; Allen, Jordan L. ; Schilling, Amber et al. / In the World of Bladder Tumors : Size Does Matter. In: Bladder Cancer. 2020 ; Vol. 6, No. 2. pp. 195-200.
@article{e497113b1efd492f92bef75efbb4b23e,
title = "In the World of Bladder Tumors: Size Does Matter",
abstract = "BACKGROUND: Transurethral resection of bladder tumor (TURBT) is fundamental to the diagnosis and management of bladder cancer. The impact of tumor size on perioperative outcomes is seemingly intuitive albeit incompletely defined. OBJECTIVE: To compare outcomes following TURBT of small, medium, and large tumors to determine if larger tumors truly resulted in a greater degree of complications. METHODS: The National Surgical Quality Improvement Project (NSQIP) Participant Use File (PUF) was queried to extract all TURBT cases performed from 2011-2015. CPT codes 52234 (small), 52235 (medium), and 52240 (large) were used to stratify the data into three cohorts. Outcomes of interest included any complications, hospital length of stay (LOS), reoperation within 30-days, 30-day readmission, and mortality. RESULTS: 17,839 patients who underwent TURBT were included. 44% had small (n = 7,805), 35% had medium (n = 6,240), and 21% had large tumors (n = 3,794). Univariate analysis revealed significant differences in complications, length of stay, reoperation rate, readmission at 30-days, and mortality when stratifying TURBT by tumor size (p < 0.0001). In the multivariable regression model, medium and large tumors were associated with significantly greater odds of a postoperative complication (OR = 1.37 and 1.64; p < 0.0001), reoperation (OR = 1.33 and 1.52; p = 0.019 and p = 0.002), readmission at 30-days (OR = 1.27 and 1.56; p = 0.001 and p < 0.0001), and death (OR = 1.65 and 2.59; p = 0.015 and p < 0.0001) compared to smaller tumors. CONCLUSIONS: Larger tumor size (>5 cm) is associated with greater length of stay, reoperation, readmission, and death following TURBT. Patients should be counseled appropriately and likely warrant vigilant observation prior to and following hospital discharge.",
author = "Justin Loloi and Allen, {Jordan L.} and Amber Schilling and Christopher Hollenbeak and Merrill, {Suzanne B.} and Kaag, {Matthew G.} and Raman, {Jay D.}",
note = "Publisher Copyright: {\textcopyright} 2020 - IOS Press and the authors. All rights reserved.",
year = "2020",
doi = "10.3233/BLC-200273",
language = "English (US)",
volume = "6",
pages = "195--200",
journal = "Bladder Cancer",
issn = "2352-3727",
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}
Loloi, J, Allen, JL, Schilling, A, Hollenbeak, C, Merrill, SB, Kaag, MG 2020, 'In the World of Bladder Tumors: Size Does Matter', Bladder Cancer, vol. 6, no. 2, pp. 195-200. https://doi.org/10.3233/BLC-200273
In the World of Bladder Tumors: Size Does Matter. / Loloi, Justin; Allen, Jordan L.; Schilling, Amber et al.
In: Bladder Cancer, Vol. 6, No. 2, 2020, p. 195-200.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - In the World of Bladder Tumors
T2 - Size Does Matter
AU - Loloi, Justin
AU - Allen, Jordan L.
AU - Schilling, Amber
AU - Hollenbeak, Christopher
AU - Merrill, Suzanne B.
AU - Kaag, Matthew G.
AU - Raman, Jay D.
N1 - Publisher Copyright:© 2020 - IOS Press and the authors. All rights reserved.
PY - 2020
Y1 - 2020
N2 - BACKGROUND: Transurethral resection of bladder tumor (TURBT) is fundamental to the diagnosis and management of bladder cancer. The impact of tumor size on perioperative outcomes is seemingly intuitive albeit incompletely defined. OBJECTIVE: To compare outcomes following TURBT of small, medium, and large tumors to determine if larger tumors truly resulted in a greater degree of complications. METHODS: The National Surgical Quality Improvement Project (NSQIP) Participant Use File (PUF) was queried to extract all TURBT cases performed from 2011-2015. CPT codes 52234 (small), 52235 (medium), and 52240 (large) were used to stratify the data into three cohorts. Outcomes of interest included any complications, hospital length of stay (LOS), reoperation within 30-days, 30-day readmission, and mortality. RESULTS: 17,839 patients who underwent TURBT were included. 44% had small (n = 7,805), 35% had medium (n = 6,240), and 21% had large tumors (n = 3,794). Univariate analysis revealed significant differences in complications, length of stay, reoperation rate, readmission at 30-days, and mortality when stratifying TURBT by tumor size (p < 0.0001). In the multivariable regression model, medium and large tumors were associated with significantly greater odds of a postoperative complication (OR = 1.37 and 1.64; p < 0.0001), reoperation (OR = 1.33 and 1.52; p = 0.019 and p = 0.002), readmission at 30-days (OR = 1.27 and 1.56; p = 0.001 and p < 0.0001), and death (OR = 1.65 and 2.59; p = 0.015 and p < 0.0001) compared to smaller tumors. CONCLUSIONS: Larger tumor size (>5 cm) is associated with greater length of stay, reoperation, readmission, and death following TURBT. Patients should be counseled appropriately and likely warrant vigilant observation prior to and following hospital discharge.
AB - BACKGROUND: Transurethral resection of bladder tumor (TURBT) is fundamental to the diagnosis and management of bladder cancer. The impact of tumor size on perioperative outcomes is seemingly intuitive albeit incompletely defined. OBJECTIVE: To compare outcomes following TURBT of small, medium, and large tumors to determine if larger tumors truly resulted in a greater degree of complications. METHODS: The National Surgical Quality Improvement Project (NSQIP) Participant Use File (PUF) was queried to extract all TURBT cases performed from 2011-2015. CPT codes 52234 (small), 52235 (medium), and 52240 (large) were used to stratify the data into three cohorts. Outcomes of interest included any complications, hospital length of stay (LOS), reoperation within 30-days, 30-day readmission, and mortality. RESULTS: 17,839 patients who underwent TURBT were included. 44% had small (n = 7,805), 35% had medium (n = 6,240), and 21% had large tumors (n = 3,794). Univariate analysis revealed significant differences in complications, length of stay, reoperation rate, readmission at 30-days, and mortality when stratifying TURBT by tumor size (p < 0.0001). In the multivariable regression model, medium and large tumors were associated with significantly greater odds of a postoperative complication (OR = 1.37 and 1.64; p < 0.0001), reoperation (OR = 1.33 and 1.52; p = 0.019 and p = 0.002), readmission at 30-days (OR = 1.27 and 1.56; p = 0.001 and p < 0.0001), and death (OR = 1.65 and 2.59; p = 0.015 and p < 0.0001) compared to smaller tumors. CONCLUSIONS: Larger tumor size (>5 cm) is associated with greater length of stay, reoperation, readmission, and death following TURBT. Patients should be counseled appropriately and likely warrant vigilant observation prior to and following hospital discharge.
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Loloi J, Allen JL, Schilling A, Hollenbeak C, Merrill SB, Kaag MG et al. In the World of Bladder Tumors: Size Does Matter. Bladder Cancer. 2020;6(2):195-200. doi: 10.3233/BLC-200273