Keiichiro Mori1, David D'Andrea, Dmitry V Enikeev, Shin Egawa, Shahrokh F Shariat. 1. Department of Urology, Medical University of Vienna, Vienna, Austria Department of Urology, The Jikei University School of Medicine, Tokyo, Japan Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia Department of Urology, Weill Cornell Medical College, New York, New York Department of Urology, University of Texas Southwestern, Dallas, Texas, USA Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Abstract
PURPOSE OF REVIEW: Conventional transurethral resection of bladder tumor (cTURBT) is the standard approach to the diagnosis and treatment of nonmuscle invasive bladder cancer. However, it suffers from inherent limitations such as insufficient assessment of resection depth and the need for intravesical tumor fragmentation that hampers histopathological evaluation. We summarize recent clinical data on en bloc resection of bladder tumor (ERBT), a method that promises to overcome these limitations. RECENT FINDINGS: The PubMed/Medline databases were searched for reports on ERBT focusing on trends in the last 2 years. ERBT provides greater resection quality, making up to 95% of detrusor muscle available for pathological evaluation. ERBT also allows detection of the muscularis mucosae thus facilitating T1 substaging. Available data demonstrate no significant difference in perioperative morbidity. No conclusions can be drawn on the impact of either modality on tumor recurrence and progression, as the available data is too underpowered. SUMMARY: ERBT is gaining acceptances as there is increasing evidence that it improves the quality of resected specimens. There seems to be no difference in perioperative morbidity between ERBT and cTURBT. The impact of ERBT on important endpoints such as recurrence and progression remains to be fully elucidated in further studies.
PURPOSE OF REVIEW: Conventional transurethral resection of bladder tumor (cTURBT) is the standard approach to the diagnosis and treatment of nonmuscle invasive bladder cancer. However, it suffers from inherent limitations such as insufficient assessment of resection depth and the need for intravesical tumor fragmentation that hampers histopathological evaluation. We summarize recent clinical data on en bloc resection of bladder tumor (ERBT), a method that promises to overcome these limitations. RECENT FINDINGS: The PubMed/Medline databases were searched for reports on ERBT focusing on trends in the last 2 years. ERBT provides greater resection quality, making up to 95% of detrusor muscle available for pathological evaluation. ERBT also allows detection of the muscularis mucosae thus facilitating T1 substaging. Available data demonstrate no significant difference in perioperative morbidity. No conclusions can be drawn on the impact of either modality on tumor recurrence and progression, as the available data is too underpowered. SUMMARY: ERBT is gaining acceptances as there is increasing evidence that it improves the quality of resected specimens. There seems to be no difference in perioperative morbidity between ERBT and cTURBT. The impact of ERBT on important endpoints such as recurrence and progression remains to be fully elucidated in further studies.
Authors: Keiichiro Mori; Takafumi Yanagisawa; Satoshi Katayama; Ekaterina Laukhtina; Benjamin Pradere; Hadi Mostafaei; Fahad Quhal; Pawel Rajwa; Marco Moschini; Francesco Soria; David D'andrea; Mohammad Abufaraj; Simone Albisinni; Wojciech Krajewski; Wataru Fukuokaya; Jun Miki; Takahiro Kimura; Shin Egawa; Jeremy Yc Teoh; Shahrokh F Shariat Journal: World J Urol Date: 2022-08-13 Impact factor: 3.661
Authors: Marco Paciotti; Paolo Casale; Piergiuseppe Colombo; Vittorio Fasulo; Alberto Saita; Giovanni Lughezzani; Roberto Contieri; Nicolò Maria Buffi; Massimo Lazzeri; Giorgio Guazzoni; Rodolfo Hurle Journal: Eur Urol Open Sci Date: 2021-02-24