“Active Surveillance for Low Risk Non-muscle Invasive Bladder Cancer: A Confirmatory and Resource Consumption Study from the BIAS Project”: this is the title of the study recently published in The Journal of Urology, whose first author is Dr. Rodolfo Hurle, urologist of Humanitas.


As Dr. Hurle himself explains, “this prospective observational study is further confirmation of the validity of active surveillance in patients with bladder cancer.


Active surveillance is an alternative to endoscopic surgery in patients with low-grade recurrent bladder cancer. It is based on regular and frequent checks and does not involve surgery if the disease does not progress or remains asymptomatic. The results of this approach, devised by Dr. Hurle himself, were published for the first time in 2016 in the British Journal of Urology International. Humanitas is the Italian reference center and currently the only one to adopt active surveillance in bladder cancer.


After the publication of the work in the official magazine of the Association of American Urologists, The Journal of Urology, Medpage Today, a prestigious independent online newspaper dealing with medical information, hosted an interview with the specialists of Humanitas about the results of their work. This is further evidence of how important the issue is for the medical community and patients because active surveillance can really be a solution to avoid, in selected patients with recurrent bladder tumors of low grade, frequent surgical interventions, helping to keep the disease under control, without increasing the risk of progression.


Predictive bankruptcy factors and hospital costs

“We first investigated the predictive factors of failure of active surveillance for non-muscle-invasive bladder cancer, where failure means the need to subject the patient to surgery. We therefore determined the number and percentage of patients who remained within the active surveillance protocol and who did not require surgery.


In parallel with this work, we conducted an analysis of the use of hospital resources in patients under active surveillance. In synergy with the Humanitas office for operational management, we have carried out a savings study, assessing for example the days of hospitalization of patients, the time in hours of staff working in the operating theatre, the consumption in terms of diagnostics, drugs and materials, in an attempt to calculate the amount and value of the hospital resources involved and evaluate the savings achieved with active surveillance for each patient.


The results showed that active surveillance can be an effective clinical strategy in selected patients, because it allows to keep the tumor under control, avoiding to subject the patient to non-solutionary or dangerous interventions, as in the case of elderly people often affected by this neoplasm, whose picture is made even more delicate by the presence of comorbidities and in which the surgical intervention and anesthesia related to it are not always recommended. In addition, restricting the use of unnecessary surgery also results in cost savings for hospital facilities,” explained Dr. Hurle.