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. 2023 Mar 30;15(7):2055.
doi: 10.3390/cancers15072055.

Comparison of Pathological Outcome and Recurrence Rate between En Bloc Transurethral Resection of Bladder Tumor and Conventional Transurethral Resection: A Meta-Analysis

Chi-Wei Wang  1 , Ping-Jui Lee  1 , Chih-Wei Wu  1 , Chen-Hsun Ho  1   2
Affiliations

Comparison of Pathological Outcome and Recurrence Rate between En Bloc Transurethral Resection of Bladder Tumor and Conventional Transurethral Resection: A Meta-Analysis

Chi-Wei Wang et al. Cancers (Basel). .

Abstract

Current treatment for non-muscle invasive bladder cancer (NMIBC) is the conventional transurethral resection of bladder tumor (CTURBT), but the en bloc transurethral resection of bladder tumor (ERBT) has been gaining more attraction in recent years considering better specimen integrity. Thus, we conducted this meta-analysis to compare the safety and efficacy of ERBT versus CTURBT. Trials were collected from an online database. The primary outcomes included identification of detrusor muscle in specimen, residual tumor, 3, 12, and 24-month recurrence rates and same-site recurrence rate. A total of 31 trials were included. The ERBT group had a higher rate of identification of detrusor muscle in specimens (p = 0.003) and lower residual tumor (p < 0.001). Other than that, lower rates of 3-month (p = 0.005) and 24-month recurrence rate (p < 0.001), same-site recurrence rate (p < 0.001) and complications were also observed. For perioperative outcomes, shorter hospitalization time (HT) (p < 0.001), and catheterization time (CT) (p < 0.001) were also revealed in the ERBT group. No significant difference was found in operative time (OT) (p = 0.93). The use of ERBT showed better pathological outcomes and fewer complications, so it could be considered a more effective treatment option for NMIBC.

Keywords: detrusor muscle; en bloc resection of bladder tumor; non-muscle invasive bladder cancer.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram.
Figure 2
Figure 2
The forest plot of tumor complete resection outcome between the two groups. (a) Forest plot of identification of detrusor muscle. (b) Forest plot of residual tumor rate.
Figure 3
Figure 3
The forest plot of recurrence related parameters between the two groups. (a) The forest plot of 3-month recurrence rate. (b) The forest plot of 12-month recurrence rate. (c) The forest plot of 24-month recurrence rate. (d) The forest plot of same-site recurrence rate.
Figure 4
Figure 4
The forest plot of perioperative outcomes. (a) The forest plot of operation time. (b) The forest plot of hospitalization time. (c) The forest plot of catheterization time.
Figure 5
Figure 5
The forest plot of complications. (a) The forest plot of bladder perforation. (b) The forest plot of obturator nerve reflex. (c) The forest plot of bladder irritation.
See this image and copyright information in PMC

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