Hospital variation in the treatment of cT1a renal cancer

Objectives: To evaluate treatment patterns and inter-hospital variation of cT1a renal cell carcinoma (RCC) in seven Dutch teaching hospitals. Patients and methods: In this historical multicenter cohort study, adults diagnosed with cT1a renal cancer (2019-2022) were identified through the Netherlands Cancer Registry. Clinical data were extracted from electronic records. Primary outcome was initial treatment. Descriptive statistics and subgroup analyses assessed variation. Logistic regression analyses identified factors associated with active treatment. Results: < 0.001). Study limitations include potential selection bias and limited generalizability. Conclusions: Substantial inter-hospital variation exists in cT1a RCC management, which is not fully explained by patient- or tumour characteristics. To reduce unwarranted variation and improve care, transparent care pathways, routine outcome measurement, shared decision-making and inter-hospital benchmarking are needed.