Rodolfo Hurle1, Massimo Lazzeri2, Piergiuseppe Colombo3, NicolòMaria Buffi1, Emanuela Morenghi4, Roberto Peschechera1, Luigi Castaldo1, Luisa Pasini1, Paolo Casale1, Mauro Seveso1, Silvia Zandegiacomo1, Gianluigi Taverna1, Alessio Benetti1, Giovanni Lughezzani1, Girolamo Fiorini1, Giorgio Guazzoni5. 1. Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, Rozzano (Milan), Italy. 2. Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, Rozzano (Milan), Italy. Electronic address: massimo.lazzeri@humanitas.it. 3. Department of Pathology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, Rozzano (Milan), Italy. 4. Biostatistic Unit, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, Rozzano (Milan), Italy. 5. Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, Rozzano (Milan), Italy; Department of Pathology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, Rozzano (Milan), Italy; Biostatistic Unit, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, Rozzano (Milan), Italy; Department of Urology, Humanitas Clinical and Research Center, Humanitas University, Rozzano (Milan), Italy.
Abstract
OBJECTIVE: 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.
OBJECTIVE: 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.
Authors: Rodolfo Hurle; Paolo Casale; Massimo Lazzeri; Marco Paciotti; Alberto Saita; Piergiuseppe Colombo; Emanuela Morenghi; David Oswald; Daniela Colleselli; Michael Mitterberger; Thomas Kunit; Martina Hager; Thomas R W Herrmann; Lukas Lusuardi Journal: World J Urol Date: 2019-05-21 Impact factor: 4.226
Authors: Sławomir Poletajew; Wojciech Krajewski; Paweł Stelmach; Jan Adamowicz; Łukasz Nowak; Marco Moschini; Piotr Zapała; Tomasz Drewa; Andrzej Paradysz; Piotr Radziszewski; Romuald Zdrojowy; Piotr Kryst Journal: Wideochir Inne Tech Maloinwazyjne Date: 2020-05-15 Impact factor: 1.195