Clinical outcomes of reresection in patients with high-risk nonmuscle-invasive bladder cancer treated with en bloc transurethral resection: a retrospective study with a 1-year follow-up

Abstract Purpose: Transurethral resection of bladder tumor (TURBT) via a wire loop has been regarded as a standard procedure dealing with nonmuscle-invasive bladder cancer (NMIBC) for a long time, and en-bloc resection of bladder tumors (ERBT) is a promising alternative to conventional transurethral resection of bladder tumor. A few studys assessing the two techniques were reported. The objective of our study is to review the published literature and compare en-bloc resection for non–muscle-invasive bladder cancer (NMIBC) with conventional transurethral resection of bladder tumor (TURBT) in terms of safety and efficacy. Methods: We performed a systematic review and meta-analysis based on randomized controlled trials (RCTs) and non-randomized controlled trials(nRCTs) and some retrospective studys which were searched and sreened. A systematic search up to the 1st of March 2019 was conducted in the following databases: PubMed, Web of Science,the Cochrane Central Register of Controlled Trials and Embase. Data such as resection techniques, morbidity, specimens’ quality, and recurrence were collected from the manuscripts.Results: Sixteen studies were included in this systematic review finnally.No statistical difference is detectded between the two techniques regarding operative time,the 2-year recurrence-free survival and the occurrence of ureterostenosis.Analysis of some complications showed that ERBT was better than TURBT for NMIBC, including obturator nerve reflex, cystic stimulation rate, bladder perforation, operation time,duration of catheterization, postoperation duration of postoperation bladder irritation and length of hospital stay. In addition, detrusor miss rate is lower in ERBT group,the 1-year and 3-year recurrence-free survival improved in the ERBT group than in the TURBT group. Conclusions: This systematic review and meta-analysis suggests that ERBT technique is a feasible, safe procedures that may provide an alternative treatment for NMIBC.

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Selection criteria for second transurethral resection in nonmuscle-invasive bladder cancer patients at high risk for residual tumor

European Urology Supplements ◽

10.1016/s1569-9056(14)50016-4 ◽

2014 ◽

Vol 13 (2) ◽

pp. e1162

Author(s):

A.I. Rolevich ◽

O.G. Sukonko ◽

S.A. Krasny ◽

S.L. Polyakov ◽

T.I. Nabebina ◽

...

Keyword(s):

Bladder Cancer ◽

High Risk ◽

Cancer Patients ◽

Transurethral Resection ◽

Selection Criteria ◽

Residual Tumor ◽

Invasive Bladder Cancer ◽

Nonmuscle Invasive Bladder Cancer

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The long-term outcome of treated high-risk nonmuscle-invasive bladder cancer

Cancer ◽

10.1002/cncr.27587 ◽

2012 ◽

Vol 118 (22) ◽

pp. 5525-5534 ◽

Cited By ~ 25

Author(s):

Francis Thomas ◽

Derek J. Rosario ◽

Naomi Rubin ◽

John R. Goepel ◽

Maysam F. Abbod ◽

...

Keyword(s):

Bladder Cancer ◽

High Risk ◽

Invasive Bladder Cancer ◽

Term Outcome ◽

Long Term Outcome ◽

Nonmuscle Invasive Bladder Cancer

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BRAVO-Feasibility Study Underscores the Challenges of a Trial Comparing BCG Versus Radical Cystectomy in High-Risk Nonmuscle Invasive Bladder Cancer

Default Digital Object Group ◽

10.1200/adn.21.200567 ◽

2021 ◽

Keyword(s):

Bladder Cancer ◽

High Risk ◽

Radical Cystectomy ◽

Feasibility Study ◽

Invasive Bladder Cancer ◽

Nonmuscle Invasive Bladder Cancer

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Effectivity of intravescical thermo-chemotherapy prophylaxis for patients with high recurrence and progression risk for non-muscle invasive bladder cancer

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2017.2.102 ◽

2017 ◽

Vol 89 (2) ◽

pp. 102 ◽

Cited By ~ 3

Author(s):

Ali Serdar Gözen ◽

Paolo Umari ◽

Walter Scheitlin ◽

Fuat Ernis Su ◽

Yigit Akin ◽

...

Keyword(s):

Bladder Cancer ◽

High Risk ◽

Recurrent Disease ◽

Bladder Wall ◽

Invasive Bladder Cancer ◽

Outpatient Basis ◽

High Grade ◽

Muscle Invasive Bladder Cancer ◽

Muscle Invasive

Background&Aim: High grade non-muscle invasive bladder cancer (NMIBC) is common in urological practice. Most of these cancers are or become refractory to intravesical immunotherapy and chemotherapy. Here we evaluated the efficacy of combined local bladder hyperthermia and intravesical mitomycin-C (MMC) instillation in patients with high-risk recurrent NMIBC. Materials and methods: Between February 2014 and December 2015, 18 patients with high risk NMIBC were enrolled. Patients were treated in an outpatient basis with 6 weekly induction sessions followed by monthly maintenance sessions with intravesical MMC in local hyperthermia with bladder wall thermo-chemotherapy (BWT) system (PelvixTT system, Elmedical Ltd., Hod Hasharon, Israel). The follow-up regimen included cystoscopy after the induction cycle and thereafter with regular intervals. Time to disease recurrence was defined as time from the first intravesical treatment to endoscopic or histological documentation of a new bladder tumour. Adverse events were recorded according to CTC 4.0 (Common Toxicity Criteria) score system. Results: Mean age was 72 (32-87) years. 10 patients had multifocal disease, 9 had CIS, 6 had recurrent disease and 2 had highly recurrent disease (> 3 recurrences in a 24 months period). 6 patients underwent previous intravesical chemotherapy with MMC. The average number of maintenance sessions per patient was 7.6. After a mean follow-up of 433 days, 15 patients (83.3%) were recurrence-free. 3 patients had tumour recurrence after a mean period of 248 days without progression. Side effects were limited to grade 1 in 2 patients and grade 2 in 1 patient. Conclusions: BWT seems to be feasible and safe in high grade NMIBC. More studies are needed to identify the subgroup of patients who may benefit more from this treatment.

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