Quality Improvement Could Reduce Variability Among Renal Cancer Treatment

MIAMI—The high level of variability among treatment of renal cancer could benefit from strategic quality improvement, according to a presentation at the 14^th International Kidney Cancer Symposium (IKCS).¹

When only considering the treatment of small renal masses, there is variability among utilization of percutaneous biopsy, utilization of active surveillance, optimal imaging during active surveillance, management of small renal masses, and follow-up imaging and surveillance for treated patients. There is even more variability in the treatment of larger or metastatic renal cell carcinoma. This variability could benefit from quality improvement work, explained Brian I. Lane, MD, PhD, FACS, a urologist at Spectrum Health Regional Cancer Center in Grand Rapids, MI, during a presentation.

“Current models for quality improvement are descriptive analyses of variability,” said Dr. Lane. “I would propose clinical trials and collaborative quality improvement (CQI) to further increase quality.”

One example of collaborative physician learning is the Michigan Urologic Surgical Improvement Collaborative (MUSIC), which evaluated variability in prostate cancer treatment. MUSIC is beginning to start research on kidney cancer, particularly in regards to the management of small renal masses.

MUSIC will evaluate the appropriateness of radiological assessment of incidentally detected small renal masses, study utilization of biopsy in categorizing these tumors, assess the use of active surveillance in small renal mass management, describe decision-making in directing surgical and percutaneous treatment, and evaluate follow-up protocols.

“CQI is a tested and proven way to provide value in health care,” Dr. Lane concluded. “Physician collaboration appears to be a solid choice to improve health care delivery for patients with kidney cancer.”