Benchmarking radical cystectomy – analysis of the British Association of Urological Surgeons national database.
BAUS ePoster online library. John J. 11/10/20; 304108; P12-10 Disclosure(s): None
Mr. Joseph John
Mr. Joseph John
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Benchmarking radical cystectomy – analysis of the British Association of Urological Surgeons national database.

John J1, Pascoe J1, Fowler S2, Colquhoun A3, Rowe E4, Challacombe B2,5, Dickinson A2,6, McGrath J1,2
1Royal Devon and Exeter NHS Foundation Trust, United Kingdom, 2British Association of Urological Surgeons, London, United Kingdom, 3Cambridge University Hospitals, United Kingdom, 4North Bristol NHS Trust, United Kingdom, 5Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom, 6University Hospitals Plymouth, United Kingdom

Introduction:
The BAUS complex operations database for radical cystectomy (RC) is a national repository of mandated RC data, made publicly available via the 'Clinical Outcomes Publication'. A near complete and detailed dataset exists for RC practice across England, providing contemporary benchmarking data.

Objectives:
To produce comprehensive RC benchmarking data, delivering transparency for patients and a reference resource for surgeons.
Materials and Methods: BAUS manage the RC complex operations database. Surgical departments upload data describing patient, disease, surgical, pathological and outcome factors. Surgeons can review and amend their data before lockdown and data cleansing. Analysis of 2016-18 data was performed for 5,288 patients undergoing RC in England.

Results:
Using Hospital episode statistics, the BAUS RC dataset was deemed 93% complete. Median patient age was 70 (IQR 62 – 75), and 75% were male. Charlson comorbidity index ≤2 was reported in 66%. Indications included; primary treatment of muscle-invasive bladder cancer (MIBC) (44%), non-muscle invasive bladder cancer (NMIBC) (31%). Commonest disease stages were T2N0 (30%) and T1N0 (21%). RARC conversion rate was 5%. High (>60) and low (<30) annual volume centres each accounted for 29% of RCs. Post-operative histology upstaged 22% and downstaged 23%. NMIBC and MIBC were lymph node positive in 7% and 22% respectively.

Conclusions:
Analysis of this comprehensive dataset offers the first set of UK national RC standards, allowing procedure, patient and disease-specific comparisons. Technology adoption and specific aspects of surgical practice are observed, including operative modality, LND and reconstruction techniques. Public facing analysis will enhance informed patient decision-making.
Benchmarking radical cystectomy – analysis of the British Association of Urological Surgeons national database.

John J1, Pascoe J1, Fowler S2, Colquhoun A3, Rowe E4, Challacombe B2,5, Dickinson A2,6, McGrath J1,2
1Royal Devon and Exeter NHS Foundation Trust, United Kingdom, 2British Association of Urological Surgeons, London, United Kingdom, 3Cambridge University Hospitals, United Kingdom, 4North Bristol NHS Trust, United Kingdom, 5Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom, 6University Hospitals Plymouth, United Kingdom

Introduction:
The BAUS complex operations database for radical cystectomy (RC) is a national repository of mandated RC data, made publicly available via the 'Clinical Outcomes Publication'. A near complete and detailed dataset exists for RC practice across England, providing contemporary benchmarking data.

Objectives:
To produce comprehensive RC benchmarking data, delivering transparency for patients and a reference resource for surgeons.
Materials and Methods: BAUS manage the RC complex operations database. Surgical departments upload data describing patient, disease, surgical, pathological and outcome factors. Surgeons can review and amend their data before lockdown and data cleansing. Analysis of 2016-18 data was performed for 5,288 patients undergoing RC in England.

Results:
Using Hospital episode statistics, the BAUS RC dataset was deemed 93% complete. Median patient age was 70 (IQR 62 – 75), and 75% were male. Charlson comorbidity index ≤2 was reported in 66%. Indications included; primary treatment of muscle-invasive bladder cancer (MIBC) (44%), non-muscle invasive bladder cancer (NMIBC) (31%). Commonest disease stages were T2N0 (30%) and T1N0 (21%). RARC conversion rate was 5%. High (>60) and low (<30) annual volume centres each accounted for 29% of RCs. Post-operative histology upstaged 22% and downstaged 23%. NMIBC and MIBC were lymph node positive in 7% and 22% respectively.

Conclusions:
Analysis of this comprehensive dataset offers the first set of UK national RC standards, allowing procedure, patient and disease-specific comparisons. Technology adoption and specific aspects of surgical practice are observed, including operative modality, LND and reconstruction techniques. Public facing analysis will enhance informed patient decision-making.
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