“En Bloc‿Resection of Nonmuscle Invasive Bladder Cancer: A Prospective Single-center Study

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• 作者：Rodolfo Hurle^a ; Massimo Lazzeri^a ; ^{massimo.lazzeri@humanitas.it" class="auth_mail" title="E-mail the corresponding author} ; Piergiuseppe Colombo^b ; Nicolò ; Maria Buffi^a ; Emanuela Morenghi^c ; Roberto Peschechera^a ; Luigi Castaldo^a ; Luisa Pasini^a ; Paolo Casale^a ; Mauro Seveso^a ; Silvia Zandegiacomo^a ; Gianluigi Taverna^a ; Alessio Benetti^a ; Giovanni Lughezzani^a ; Girolamo Fiorini^a ; Giorgio Guazzoni^a ; ^b ; ^c ; ^d
• 刊名：Urology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：90
• 期：Complete
• 页码：126-130
• 全文大小：161 K

文摘

To describe our “en bloc” technique for nonmuscle invasive bladder cancer (NMIBC), assess the quality of resection, and report the midterm oncological outcome.

Materials and Methods

This is an observational prospective longitudinal study, from June 2010 to February 2014, enrolling patients with clinically NMIBC, having tumors of ≤3 cm and ≤4 lesions who underwent electrical en bloc bladder resection. The primary study end point was recurrence-free survival. Secondary outcomes were feasibility, safety, the presence of detrusor muscle, and the recurrence rate at the first follow-up cystoscopy (3 months). Statistical analysis was complemented with multivariable analysis.

Results

Of 87 enrolled patients, 2 showed a nonurothelial carcinoma and 11 showed muscle invasive bladder carcinoma at the definitive pathology. The study cohort consisted of 74 transitional cell carcinoma NMIBC cases, mean age 71 years ± 8, presenting with a mean tumor diameter of 1.98 ± 0.59 cm and a median number of resected tumors per patients of 1 (range 1-4). The 2-year recurrence-free survival was 85.59%. All the en bloc resection of bladder tumor samples showed the presence of detrusor muscle and the recurrence rate at the first follow-up cystoscopy (3 months) was 5.4% (4/74). An extraperitoneal bladder perforation occurred in only one patient. At multivariable analysis, only gender and the presence of carcinoma in situ were independent predictors of recurrence. The midterm follow-up and the absence of a control group are the main limitations.

Conclusion

Our findings confirmed the feasibility and safety of en bloc resection of bladder tumor, with a recurrence-free survival of 85% after 2 years.