The following is a summary of “One Year Oncological Outcome Updated Analysis Of A Single-Center Prospective, Randomized, Controlled, Non-Inferiority Trial: En Bloc Vs. Conventional Transurethral Resection Of Bladder Tumor,” published in the April 2023 issue of Urology by Diana et al.
Numerous randomized controlled trials (RCTs) have presented conflicting findings when comparing en-bloc resection of bladder tumor (ERBT) and conventional transurethral resection of bladder tumor (cTURBT), showcasing varying 1-year recurrence rates. These rates ranged from 5-40% for ERBT and 11-31% for cTURBT. This study offers an updated analysis derived from a single-center prospective, randomized, controlled, non-inferiority trial aiming to assess the oncological outcomes between ERBT and cTURBT at the 1-year follow-up (FU) mark.
The trial involved patients with bladder cancer (BC) undergoing ERBT or cTURBT, focusing on tumors ≤3 Cm, with a maximum of three lesions and no indications of muscle invasion or ureteral involvement. The Institutional Review Board (2017/09c) approved this trial registered under NCT04712201. Recurrence-free survival was illustrated through Kaplan-Meier (KM) curves, with the log-rank test used for univariable differences in recurrence-free survival and technique assessment.
A total of 248 patients were evaluated between April 2018 and June 2021. After excluding certain diagnoses, a cohort of 219 patients was established: 123 (56.2%) underwent ERBT, and 96 (43.8%) received cTURBT. Within these groups, patients were categorized by grade (low-grade (LG), high-grade (HG), carcinoma in situ (CIS)). At the 1-year FU, 201 patients were reviewed. The median follow-up for patients without recurrence was 19 months (IQR 14-35). Bladder recurrence occurred in 11 (8.9%) ERBT cases (5 LG; 6 HG) and 12 (12.5%) cTURBT cases (5 LG; 6 HG). The median time to recurrence was 14 months (IQR 8-22). KM curve analysis displayed similar recurrence-free survival between ERBT and cTURBT groups, including LG/HG assessments.
Source: auajournals.org/doi/10.1097/JU.0000000000003321.04
