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. 2020 Mar 18;20(1):30.
doi: 10.1186/s12894-020-00599-1.

Can a second resection be avoided after initial thulium laser endoscopic en bloc resection for non-muscle invasive bladder cancer? A retrospective single-center study of 251 patients

Wenhao Zhou  1 , Wei Wang  1 , Wenbo Wu  1 , Tingmang Yan  1 , Guofang Du  2 , Haitao Liu  3
Affiliations

Can a second resection be avoided after initial thulium laser endoscopic en bloc resection for non-muscle invasive bladder cancer? A retrospective single-center study of 251 patients

Wenhao Zhou et al. BMC Urol. .

Abstract

Background: This study aimed to evaluate the efficacy of transurethral thulium laser en bloc resection of the bladder tumor (TmLRBT) in patients with non-muscle invasive bladder cancer (NMIBC) and to investigate whether a second resection can be avoided.

Methods: From June 2012 to June 2018, 251 newly diagnosed patients with NMIBC were enrolled in this retrospective study; all patients received regular administration of pirarubicin after the initial resection. A second transurethral resection (TUR) was performed in patients within 2-6 weeks after the initial TmLRBT in group 1. Patients in group 2 only underwent cystoscopy at 3 months.

Results: Second surgery results indicate that recurrence was detected histopathologically in 6/108 and 11/143 patients in group 1 and 2, respectively (P = 0.52); Progression was observed in 2 patients in each group (P = 0.34). The mean follow-up duration was 40.1 months, with no significant difference between the groups (P = 0.32). Recurrence was observed in 23 (21.3%) and 39 (27.3%) patients in groups 1 and 2 during the follow-up, respectively (P = 0.34); disease progression occurred in 4 (3.8%) patients in group 1 compared with 7 (4.0%) in group 2 (P = 0.20).

Conclusion: Complete removal of tumors can be achieved by TmLRBT. This technique may decrease the number of second TURs.

Keywords: Bladder cancer; Intravesical instillation; Pirarubicin; Second resection; Transurethral thulium laser en bloc resection of bladder tumor.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Transurethral thulium laser en bloc resection of a bladder tumor. a Circular incision around the tumor, b exposure of the tumor base via blunt dissection, c coagulation of the base of resection, and d cold-cup biopsy
Fig. 2
Fig. 2
Kaplan-Meier curve showing recurrence-free survival (RFS) rates between the two groups (log-rank test result: 0.287)
See this image and copyright information in PMC

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