How quickly are we treating muscle invasive bladder cancer? Trends over a 17 year period

Summary 

Objective

Our aim was to measure the time from presentation to definitive treatment for muscle invasive bladder cancer in the South West Region. This was compared with previous audits of waiting times over the past 17 years.

Methods

A retrospective survey was carried out in each of the hospitals in the South West Region, to assess the interval between referral and definitive treatment of all new cases of muscle invasive bladder cancer in 2006. This was compared to the same data for 1989, 1993 [Dickinson AJ, Howe K, Bedford C, Sanders T, Prentice A, Sibley GNA. A retrospective study of the investigation and management of muscle-invasive bladder cancer in the South West Region. BJU 1996;77:70–75] and 1999.

Results

A total of 153 patients were identified. 118 (77%) underwent immediate definitive treatment. Median delay to definitive treatment was 102 days, compared with 114, 96 and 101 days in 1989, 1993 and 1999 respectively. Median delay between TURBT and definitive treatment had increased to 70 days in 2006 compared with 55, 44 and 54 days in the previous years studied.

Conclusions

The waits for initial cystoscopy and TURBT, both of which are governed by cancer wait targets, have come down over the last 17 years. However the subsequent delay from TURBT to definitive treatment has lengthened with no change in total time to treatment. Reasons might include TURBT being used as the stop the clock treatment, delay surrounding an increase in tertiary referrals and a general increase in workload.

Keywords: Invasive bladder cancer, Treatment, Waiting time