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En-bloc resection of bladder tumour as primary treatment for patients with non-muscle-invasive bladder cancer: routine implementation in a multi-centre setting

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Abstract

Purpose

To investigate the technical success rate and 30-day complications of en-bloc resection of bladder tumour (ERBT) upon routine implementation regardless of tumour size.

Methods

This is a prospective, multi-centre, study on routine implementation of ERBT for patients with bladder tumours requiring transurethral surgery. Surgeons were allowed to cross over to conventional transurethral resection of bladder tumour (TURBT) when necessary. We performed an analysis for patients who had ERBT/TURBT as the definitive treatment. Study outcomes included the technical success rate of ERBT and 30-day complication rate. Multivariate logistic regression analysis was performed to investigate for predictors of a successful ERBT and factors associated with 30-day complications.

Results

A total of 135 patients were included in this study. The majority of the patients (80.0%) had bladder tumours of ≤ 3 cm. ERBT was successful in 99 patients, resulting in an overall technical success rate of 73.3%. When stratified according to tumour size, the technical success rates of ERBT were 94.3%, 82.2%, 75%, 84.3% and 29.6% for bladder tumour sizes of < 1 cm, 1.01–2 cm, 2.01–3 cm, ≤ 3 cm and > 3 cm respectively. Upon multivariate analysis, tumour size was the only significant factor predicting the success of ERBT (OR 0.920, 95% CI 0.882–0.960, p < 0.001). Moreover, ERBT was not a significant factor associated with 30-day complications.

Conclusion

EBRT achieved a good technical success rate for the majority of patients with bladder tumours ≤ 3 cm. Regardless of tumour size, EBRT-first approach was safe to implement into routine clinical practice.

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Acknowledgements

None.

Funding

This study is supported by the General Research Fund and Early Career Scheme 2018–2019 (Reference No. 24116518), and the General Research Fund and Early Career Scheme 2020–2021 (Reference No. 14120620).

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Authors and Affiliations

  1. Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China

    Jeremy Yuen-Chun Teoh & Chi-Fai Ng

  2. Department of Urology, Royal Surrey County Hospital, Guildford, Surrey, UK

    Nikhil Mayor & Hugh Mostafid

  3. Department of Surgery, North District Hospital, Hong Kong, China

    Kai-Man Li & Ka-Lun Lo

Authors
  1. Jeremy Yuen-Chun Teoh
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  2. Nikhil Mayor
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  3. Kai-Man Li
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  4. Ka-Lun Lo
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  5. Chi-Fai Ng
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  6. Hugh Mostafid
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Contributions

All authors read and approved the final manuscript. JYCT: project development, data collection and analysis, manuscript writing. NM: data collection, manuscript editing. KML: data collection, manuscript editing. KLL: data collection, manuscript editing. CFN: project development, manuscript editing. HM: project development, data collection and analysis, manuscript writing.

Corresponding authors

Correspondence to Jeremy Yuen-Chun Teoh or Hugh Mostafid.

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Conflict of interest

Jeremy Yuen-Chun Teoh has received honorarium from Olympus and Boston Scientific, travel grants from Olympus and Boston Scientific, and research grants from Olympus and Storz. Hugh Mostafid has received honorarium from Olympus.

Ethical approval

This research involves human participants but not animals. This study was classed as a service evaluation, and formal consent was not required.

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Teoh, J.YC., Mayor, N., Li, KM. et al. En-bloc resection of bladder tumour as primary treatment for patients with non-muscle-invasive bladder cancer: routine implementation in a multi-centre setting. World J Urol 39, 3353–3358 (2021). https://doi.org/10.1007/s00345-021-03675-9

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  • DOI: https://doi.org/10.1007/s00345-021-03675-9

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