Variation in cT1 Renal Cancer Management by Surgical Hospital Volume

What is it about?

This study analyzed the variation in clinical management of cT1 renal cell carcinoma (RCC) in the Netherlands related to surgical hospital volume (HV). Between 2014 and 2020, 10,964 patients were diagnosed with cT1 RCC. Over time, there was a clear increase in nephron-sparing management, with partial nephrectomy (PN) being the most common treatment for cT1a, and radical nephrectomy (RN) for cT1b. High-volume hospitals showed closer adherence to guidelines compared to low and medium HV. Variation in applied treatment was found between HV categories, with high-volume hospitals performing more PN for T1b compared to medium and low HV. The study suggests that future work should be focused on a national registration of specialized care and surgery for RCC to improve clinical outcomes and decrease variations in practice patterns.

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Photo by Robina Weermeijer on Unsplash

Photo by Robina Weermeijer on Unsplash

Why is it important?

This study is important as it provides valuable insights into the variation in clinical management of cT1 renal cell carcinoma (RCC) in the Netherlands related to surgical hospital volume (HV). It highlights the significance of high-volume hospitals in adhering to guidelines and delivering better outcomes for patients. The findings emphasize the need for further research and improvements in the national registration of specialized care and surgery for RCC to enhance clinical outcomes and decrease variations in practice patterns. Key Takeaways: 1. Between 2014 and 2020, 10,964 patients were diagnosed with cT1 RCC in the Netherlands. 2. There was a clear increase in nephron-sparing management over time, with the majority of cT1a patients undergoing partial nephrectomy (PN). 3. High-volume hospitals showed closer guideline adherence compared to low and medium HV for T1 RCC. 4. Variation in the management of cT1 RCC was found across hospital volume categories, particularly in the choice of surgical approach. 5. High-volume hospitals more frequently used PN for T1b tumors compared to medium and low HV hospitals. 6. The study underscores the importance of high-volume hospitals in adhering to guidelines and delivering better outcomes for patients with cT1 RCC.