En bloc transurethral resection of bladder tumor: A review of the literature

2021 ◽  
pp. 205141582199373
Author(s):  
Jonathan Kopel ◽  
Pranav Sharma

Bladder cancer remains one of the most common malignancies of the genitourinary tract. Transurethral resection of the bladder tumor (TURBT) via cystoscopy with examination under anesthesia remains the primary method for determining the diagnosis and clinical stage of bladder cancer. Given the substantial cost of treatment and risk of bladder cancer recurrence after TURBT, novel approaches to transurethral resection, such as the en bloc technique, have been developed in an attempt to address these limitations. In this review, we examined the postoperative and oncological outcomes of en bloc TURBT compared to traditional resection techniques. Further prospective clinical studies, however, are still necessary to determine whether these alternative technologies or surgical techniques may improve treatment in bladder cancer patients. Level of evidence: Not applicable.

2019 ◽  
Author(s):  
Ting Huang ◽  
Haixiao Wu ◽  
Qing Yang ◽  
Han Wu ◽  
Heng Zhang

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.


2019 ◽  
Author(s):  
Jiangchuan Chen ◽  
Zhigang Xu ◽  
Xiao-Dong Meng ◽  
Jie Li ◽  
Yin Chen

Abstract Background:There is an unmet need for additional biomarkers for stratifying tumors based on their risk of recurrence and progression. Stromal antigen 2 (STAG2) and p53 are the most common mutations in bladder cancer and their association with the prognosis of bladder cancer remains unclear.Methods:Patients were divided into two cohorts according to stage and surgical procedure. The value of combined STAG2 expression (+/-) and P53 mutation (+/-) was evaluated for prediction of recurrence in 334 patients diagnosed by transurethral resection of bladder tumor (TURBT) and for prediction of survival in 144 patients who underwent radical cystectomy and pelvic lymphadenectomy( RCPLT).Results:We found that,in the 334 TURBT-treated patients, recurrence rate was significantly greater for STAG2(+) tumors than STAG2(-) tumors (73.5% vs. 55.0%, P=0.001). Of 144 RCPLT-treated patients, 127 (88.2%) were STAG2(+), of which 71 (55.9%) survived 5 years, compared to none of the 17 STAG2(-) patients. Patients with combined STAG2(+)/P53 mutation(+) tumors had the highest recurrence rate (83.5%) while patients with STAG2(-)/P53(-) tumors had the lowest recurrence rate (50%). Patients with STAG2(+)/P53(-) tumors achieved the highest 5-year survival rate (69.7%). Systemic chemotherapy did not improve prognosis of RCPLT-treated patients, but appeared to benefit STAG2(-) patients.Conclusions: Our results suggest that combined STAG2 expression and P53 status is a valuable biomarker for BCa prognosis, accurately predicting recurrence in TURBT-treated patients. STAG2(+)/P53(-) predicted a higher five-year survival and STAG2(-) predicted low five-year survival in RCPLT-treated patients. Chemotherapy may interfere with this predictive efficacy, especially in STAG2(-) patients.


2021 ◽  
Vol 8 ◽  
Author(s):  
Christian Daniel Fankhauser ◽  
Marian Severin Wettstein ◽  
Luca Afferi ◽  
Nico Christian Grossmann ◽  
Hugh Mostafid

Transurethral resection of bladder tumors (TURBT) represents the cornerstone in diagnosis and treatment of bladder cancer but recurrence is observed in up to 80% and over- or understaging with TURBT is common. A more recent development to overcome these limitations represents en-bloc resection of bladder tumors (ERBT) which offers several advantages over TURBT. In this report, we briefly review studies assessing outcomes of bladder cancer patients undergoing ERBT. Most randomized and non-randomized trial demonstrate improvement in clinical outcomes for ERBT over TURBT, however more pathological and translational studies are warranted.


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