The effect of holmium laser resection versus standard transurethral resection on non-muscle-invasive bladder cancer: A systematic review and meta-analysis

Abstract Purpose: To explore the advantages and limitations of holmium laser resection of the bladder tumor (HOLRBT) versus standard transurethral resection of the bladder tumor (TURBT) in the treatment of non-muscle-invasive bladder cancer (NMIBC). Methods: The eligible studies were selected from the following databases: PubMed, Cochrane Library and Embase. Studies comparing HOLRBT and TURBT for patients with NMIBC were included. The outcomes of interest were time of operation, catheterization, and hospitalization, rates of recurrence and perioperative complications, including obturator nerve reflex, bladder perforation, bladder irritation and urethral stricture. Results of all data were compared and analyzed by Review Manager 5.3. Results: A total of 9 comparative studies were finally included for analysis. Pooled data demonstrated that HOLRBT could significantly reduce the time in catheterization and hospitalization, the rates of recurrence in 2 years of follow-up, obturator nerve reflex, bladder perforation, bladder irritation compared with those in TURBT, respectively. However, no significant difference could be found between HOLRBT and TURBT in the time of operation, rate of recurrence at 1-year follow-up and urethral stricture. Conclusions: The results of our research showed that HOLRBT would be a better choice than TURBT for patients with NMIBC.

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Two-step transurethral resection of bladder tumor can result in a better surgical quality and lower recurrence in patients with non-muscle invasive bladder cancer: a retrospective study

10.21203/rs.3.rs-16002/v1 ◽

2020 ◽

Author(s):

Wei-Lun Huang ◽

Chao-Yuan Huang ◽

Kuo-How Huang ◽

Yeong-Shiau Pu ◽

Hong-Chiang Chang ◽

...

Keyword(s):

Bladder Cancer ◽

Transurethral Resection ◽

Bladder Tumor ◽

Sampling Rate ◽

Invasive Bladder Cancer ◽

Detrusor Muscle ◽

Muscle Invasive Bladder Cancer ◽

Free Survival ◽

Muscle Invasive

Abstract Background Current protocols for transurethral resection of bladder tumor (TURBT) are still unstandardized, and outcomes are also uneven in different protocols. In our medical center, we performed two-step TURBT that the resection of bladder tumor is made in two steps- exophytic parts first and tumor bases second. The purpose is to improve tumor eradication and increase detrusor muscle sampling rates. The aim of current study is to evaluate clinical outcomes and detrusor muscle sampling rate of two-step TURBT in patients with non-muscle invasive bladder cancer (NMIBC). Methods We conducted a retrospective review from a prospective database. From January 2012 to December 2017, patients who had newly diagnosed NMIBC with a follow-up period of more than 2 years were enrolled. Patients with concomitant or subsequent upper urinary tract urothelial carcinoma (UTUC) were excluded. Patients were categorized into the two-step TURBT (TR) and the conventional TURBT (CR) groups. The primary endpoints were recurrence and progression rates. The secondary endpoints were recurrence-free survival (RFS), progression-free survival (PFS), and the detrusor muscle sampling rate. Results There were 205 patients included in our study, with 151 patients in the TR group and 54 patients in the CR group. The median follow-up period was 40.5 months. There were lower recurrence rate ( P = 0.015), higher detrusor muscle sampling rate ( P = 0.043), and better RFS (Log-Rank P= 0.007) in the TR group. Two-step TURBT was also associated with better RFS in both univariate ( P =0.009) and multivariate ( P =0.003) Cox proportional hazards regression. Conclusions In patients with NMIBC, Two-step TURBT results in higher detrusor muscle sampling rate and better disease outcomes. The findings suggest that Two-step TURBT is a better surgical method for treating NMIBC.

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Survival and oncologic outcomes of complete transurethral resection of bladder tumor prior to neoadjuvant chemotherapy for muscle-invasive bladder cancer

Urologic Oncology Seminars and Original Investigations ◽

10.1016/j.urolonc.2021.03.025 ◽

2021 ◽

Author(s):

Jamie S Pak ◽

Christopher R Haas ◽

Christopher B Anderson ◽

G Joel DeCastro ◽

Mitchell C Benson ◽

...

Keyword(s):

Bladder Cancer ◽

Neoadjuvant Chemotherapy ◽

Transurethral Resection ◽

Bladder Tumor ◽

Oncologic Outcomes ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

Muscle Invasive

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Comparison of Thulium Laser Resection of Bladder Tumors and Conventional Transurethral Resection of Bladder Tumors for Non-Muscle-Invasive Bladder Cancer

Urologia Internationalis ◽

10.1159/000514042 ◽

2021 ◽

pp. 1-6

Author(s):

Zheng Liu ◽

Yucong Zhang ◽

Guoliang Sun ◽

Wei Ouyang ◽

Shen Wang ◽

...

Keyword(s):

Bladder Cancer ◽

Transurethral Resection ◽

Invasive Bladder Cancer ◽

Perioperative Outcomes ◽

Thulium Laser ◽

Bladder Tumors ◽

Muscle Invasive Bladder Cancer ◽

Laser Resection ◽

Baseline Characteristics ◽

Muscle Invasive

Introduction: The thulium laser resection of bladder tumors (TmLRBT) was increasingly used in the treatment of non-muscle-invasive bladder cancer (NMIBC) recently, and here we report the relevant outcomes of our institution to evaluate its efficacy and safety. Methods: We retrospectively collected the data of NMIBC patients who underwent either TmLRBT or transurethral resection of bladder tumor (TURBT). The baseline characteristics and perioperative outcomes were compared in these 2 groups. Results: The TmLRBT had a higher rate of detrusor identification than TURBT (97.4 vs. 87.6%, p = 0.001). After screening, 134 patients who underwent TmLRBT and 152 patients who received TURBT were enrolled in the analysis, and their baseline characteristics were similar. During the TURBT, 24 (15.8%) obturator nerve reflexes and 9 (5.9%) bladder perforations occurred, while none happened during the TmLRBT. After surgery, TmLRBT patients had fewer postoperative gross hematuria (38.1 vs. 96.7%, p < 0.001) and postoperative irrigation (27.6 vs. 92.7%, p < 0.001), and its irrigation duration was significantly shorter (2.3 vs. 3.3 day, p < 0.001). During the follow-up, no significant difference in the recurrence rate was detected (p = 0.315). Conclusions: TmLRBT is a safer technique than conventional TURBT in the treatment of NMIBC, and it could offer better specimens for pathologic assessment while the cancer control was not compromised.

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