Role of Surgical Centralisation on Renal Cancer Survival
Research type
Research Study
Full title
The Role and Impact of Surgical Centralisation on Renal Cancer Survival: A Multifactorial Analysis
IRAS ID
185885
Contact name
Ray Hsu
Contact email
Sponsor organisation
University of Cambridge
Duration of Study in the UK
2 years, months, days
Research summary
Renal cancer is the eighth most common cancer in the UK. Over 10,000 new cases and 4,000 deaths occur each year due to renal cancers, and these numbers are rising. UK also has one of the lowest five-year relative survival for renal cancers amongst European countries. Removal of the kidney (nephrectomy) provides patients with the best chance of cure.
Despite the development of multiple renal cancer risk prognostic models, they have not been widely adopted for clinical use in the UK. Restraints on the models targeting only populations with metastases or specific histological subtype reduce their clinical utilities. Current models were also developed using single institution or small multi-centre data, with the majority comprised of only North American population. This limits the international transferability of the models especially with a lack of local validation and differences in healthcare provisions.
NHS recently centralised many key cancer services to specialist centres, including operations to remove the bladder or the prostate. Evidence that centres performing high volumes of complex operations have more favourable perioperative outcomes compared to low-volume hospitals supports this reconfiguration. However, the volume-outcome relationship is less clear in nephrectomies and there is currently no evidence that nephrectomy regionalisation in the UK produces long-term survival benefits.
This project will examine how centralisation have affected nephrectomy outcomes and determine whether alternative service configuration would benefit patients. Our study will also develop a novel renal cancer risk prediction model using UK data. We will also test whether incorporating variables on case volume will improve the accuracy of the model in predicting renal cancer outcomes. The project will utilise linked datasets consisted of the Hospital Episode Statistics, National Cancer Data Repository and Office of National Statistics, examining surgical and oncological outcomes in patients who underwent nephrectomies for renal cancer from 1998 until 2013.
REC name
East Midlands - Derby Research Ethics Committee
REC reference
15/EM/0340
Date of REC Opinion
17 Aug 2015
REC opinion
Favourable Opinion