PD09-07: Insights into Short-term Postoperative Recovery after Transurethral Resection of Bladder Tumor: Harnessing Data from a Real-time Symptom Assessment Platform

Abstract

Information

Authors: Marshall Strother, Evan Bloom, Jennifer Lee, Ryan Barlotta, Seyed Jazayeri, Adrien Bernstein, Elizabeth Handorf, David Y T Chen, Andres Correa, Richard Greenberg, Marc Smaldone, Rosalia Viterbo, Robert Uzzo, Alexander Kutikov

Introduction: Short-term recovery after transurethral resection of bladder tumors (TURBT) is poorly understood. We measured patient-reported outcomes (PROs) for 14 days after TURBT using a novel real-time education and symptom-assessment platform.

Methods: Patients undergoing TURBT received text messages at fixed days in the perioperative period linking them to a web-based interface which included instructions, educational materials, and PRO surveys. Nine PROs were measured 7 days before surgery and on postoperative days 1, 2, 3, 5, 7, 10, and 14 using a 5-point Likert scale ranging from “Not at all” to “Very much”. These assessed pain, dysuria, frequency of urination, control of urination, bladder emptying, ability to sleep, ability to work, overall quality of life, and subjective overall recovery from surgery. Patients undergoing small (<2cm) or large (>=2cm) resections were compared using cumulative incidence analysis of first report of function equal to or better than baseline (or first report of at least 4 on the Likert scale for the “recovered” metric).

Results: 165 unique patients participated in the monitoring system between April 2020 and January 2021. Of these, 79 underwent large and 67 underwent small resections (13 size unknown, 11 no resection). There were no clinically meaningful differences between resection sizes in any metric on any postoperative day (Figure 1). Patients undergoing smaller resections reported marginally faster return to baseline in terms of urinary control and bladder emptying (Figure 2, p = 0.011 and 0.034). Recovery was rapid overall with >65% of patients in both groups reporting feeling recovery =4/5 by postoperative day 3.

Conclusions: Novel real-time symptom assessment platform affords unprecedented insights into symptoms and functional decline following TURBT.  Symptoms are generally mild and short-lived. Importantly, these are only minimally worse in patients undergoing larger resections.

Source of Funding: None



Therapeutic Area
Oncology: Bladder/Urothelium/Urethra