Editorial Comment from Dr Saito to Use of surgical checklist during transurethral resection increases detrusor muscle collection rate and improves recurrence‐free survival in patients with non‐muscle‐invasive bladder cancer

2021 ◽  
Author(s):  
Ryoichi Saito
Keyword(s):  
Bladder Cancer ◽  
Editorial Comment ◽  
Transurethral Resection ◽  
Detrusor Muscle ◽  
Recurrence Free Survival ◽  
Muscle Invasive Bladder Cancer ◽  
Free Survival ◽  
Collection Rate ◽  
Muscle Invasive ◽  
Surgical Checklist

scholarly journals Restaging Transurethral Resection of Bladder Tumours after BCG Immunotherapy Induction in Patients with T1 Non-Muscle-Invasive Bladder Cancer Might not Be Associated with Oncologic Benefit

2020 ◽  
Vol 9 (10) ◽  
pp. 3306
Author(s):  
Wojciech Krajewski ◽  
Marco Moschini ◽  
Łukasz Nowak ◽  
Sławomir Poletajew ◽  
Andrzej Tukiendorf ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Tertiary Care ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Recurrence Free Survival ◽  
Muscle Invasive Bladder Cancer ◽  
Free Survival ◽  
Muscle Invasive ◽  
Bladder Tumours

Background and Purpose: The European Association of Urology guidelines recommend restaging transurethral resection of bladder tumours (reTURB) 2–6 weeks after primary TURB. However, in clinical practice some patients undergo a second TURB procedure after Bacillus Calmette-Guérin immunotherapy (BCG)induction. To date, there are no studies comparing post-BCG reTURB with the classic pre-BCG approach. The aim of this study was to assess whether the performance of reTURB after BCG induction in T1HG bladder cancer is related to potential oncological benefits. Materials and Methods: Data from 645 patients with primary T1HG bladder cancer treated between 2001 and 2019 in 12 tertiary care centres were retrospectively reviewed. The study included patients who underwent reTURB before BCG induction (Pre-BCG group: 397 patients; 61.6%) and those who had reTURB performed after BCG induction (Post-BCG group: 248 patients, 38.4%). The decision to perform reTURB before or after BCG induction was according to the surgeon’s discretion, as well as a consideration of local proceedings and protocols. Due to variation in patients’ characteristics, both propensity-score-matched analysis (PSM) and inverse-probability weighting (IPW) were implemented. Results: The five-year recurrence-free survival (RFS) was 64.7% and 69.1% for the Pre- and Post-BCG groups, respectively, and progression-free survival (PFS) was 82.7% and 83.3% for the Pre- and Post-BCG groups, respectively (both: p > 0.05). Similarly, neither RFS nor PFS differed significantly for a five-year period or in the whole time of observation after the PSM and IPW matching methods were used. Conclusions: Our results suggest that there might be no difference in recurrence-free survival and progression-free survival rates, regardless of whether patients have reTURB performed before or after BCG induction.

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

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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