THE INTRAVESICAL RECURRENCE AFTER 3-DAY CONSECUTIVE INTRAVESICAL INSTILLATION OF PIRARUBICINE HYDROCHLORIDE (THP) FOLLOWING TRANSURETHRAL RESECTION OF BLADDER TUMOR (TURBT) FOR NON-MUSCLE-INVASIVE BLADDER CANCER

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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Should intravesical Bacillus Calmette–Guerin (BCG) treatment be administered to patients with T0 after repeat transurethral resection of bladder tumor in patients with high-risk non-muscle invasive bladder cancer?

PLoS ONE ◽

10.1371/journal.pone.0208267 ◽

2018 ◽

Vol 13 (11) ◽

pp. e0208267 ◽

Cited By ~ 2

Author(s):

Hyeong Dong Yuk ◽

Chang Wook Jeong ◽

Cheol Kwak ◽

Hyeon Hoe Kim ◽

Ja Hyeon Ku

Keyword(s):

Bladder Cancer ◽

High Risk ◽

Transurethral Resection ◽

Bladder Tumor ◽

Invasive Bladder Cancer ◽

Bacillus Calmette Guerin ◽

Muscle Invasive Bladder Cancer ◽

Muscle Invasive

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Intra-Arterial Chemotherapy for Muscle-Invasive Bladder Cancer Following Transurethral Resection

Urologia Internationalis ◽

10.1159/000369301 ◽

2015 ◽

Vol 94 (4) ◽

pp. 406-411 ◽

Cited By ~ 6

Author(s):

Shengjie Liang ◽

Qingsong Zou ◽

Bangmin Han ◽

Yifeng Jing ◽

Di Cui ◽

...

Keyword(s):

Bladder Cancer ◽

Transurethral Resection ◽

Clinical Stage ◽

Complete Response ◽

Intravesical Instillation ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

Bladder Preservation ◽

Muscle Invasive

Purpose: To assess the efficacy of intra-arterial chemotherapy as a bladder-preservation treatment in patients with muscle-invasive bladder cancer (MIBC) following transurethral resection of bladder tumors (TURBT). Materials and Methods: From 2005 June to 2012 November, 46 patients diagnosed with MIBC (clinical stage T2-T3N0M0) underwent three courses of cisplatin-based intra-arterial chemotherapy as a remedial approach for bladder preservation after TURBT. All patients also received intravesical instillation of chemotherapy as a maintenance strategy. Results: All 46 patients completed the treatment with minor complications. The median follow-up time was 34.5 months (range, 8-87 months). Thirty-two patients (69.6%) demonstrated complete response. The three-year and five-year overall survival was 70.65 and 61.23%, and the disease-specific survival over the same periods was 78.03 and 67.62%, respectively. During the entire follow-up period, more than 80% preserved their bladder. Conclusions: Intra-arterial chemotherapy can be performed as a remedial treatment for MIBC patient following TURBT. Combined with TURBT, it offers an option for bladder preservation therapy on patients who are unable or unwilling to undergo radical cystectomy.

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