Centralization and prospective audit of cystectomy are necessary: a commentary on the case for centralization, supported by a contemporary series utilizing the ANZUP cystectomy database.
Pravin ViswambaramSteve P McCombieCynthia HawksD Michael A WallaceShomik SenguptaDickon HaynePublished in: Asia-Pacific journal of clinical oncology (2022)
Bladder cancer (BC) outcomes are unacceptably poor. In Australia, BC survival is actually deteriorating. There is an urgent need to improve outcomes in BC patients, which requires a multipronged approach. One area deserving closer scrutiny is radical cystectomy. Audit is necessary to identify areas for improvement and without it, outcomes remain unknown. Evidence convincingly shows high-volume surgeons and centers improve cystectomy outcomes including overall survival, yet centralization has still not occurred. The Australia and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group cystectomy database has been established to facilitate cystectomy audit in Australia and New Zealand. We present initial data from the ANZUP cystectomy database from a single high-volume center, discuss the benefits of centralization and its challenges in the Asia-Pacific context.
Keyphrases
- robot assisted
- neoadjuvant chemotherapy
- prostate cancer
- ejection fraction
- end stage renal disease
- squamous cell carcinoma
- locally advanced
- adverse drug
- minimally invasive
- emergency department
- machine learning
- prognostic factors
- radiation therapy
- young adults
- adipose tissue
- deep learning
- big data
- free survival
- data analysis