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01-07-2015 | Original Article

En bloc transurethral resection with 2-micron continuous-wave laser for primary non-muscle-invasive bladder cancer: a randomized controlled trial

Authors: Xu Chen, Jun Liao, Lingwu Chen, Shaopeng Qiu, Chengqiang Mo, Xiaopeng Mao, Yuanzhong Yang, Shiying Zhou, Junxing Chen

Published in: World Journal of Urology | Issue 7/2015

Abstract

Purpose

To evaluate the practicability of en bloc transurethral resection with 2-micron continuous-wave laser as treatment for primary non-muscle-invasive bladder cancer (NMIBC).

Methods

This was a single-center, randomized, controlled trial involving 142 patients with newly diagnosed NMIBC. All patients were randomly assigned in a 1:1 ratio to receive either laser treatment or conventional transurethral resection of bladder tumor (TURBT). All patients received intravesical chemotherapy. Follow-up was performed in 18 months. Primary outcome measure was difference of tumor recurrence rate at the end of study.

Results

Baseline characteristics did not differ between patients in two groups. Operation time was longer in laser group than in TURBT group (56.5 ± 37.4 vs. 41.0 ± 29.4 min, P = 0.017). Obturator nerve reflection was noted during TURBT in 18 patients, whereas none was noted during laser resection. Number of T1 tumors was higher in the laser group (25 vs. 15, P = 0.047). According to Kaplan–Meier survival curves, there was no statistical difference in the rate of recurrence in 18 months (P = 0.383). All recurrences were out of the site of first resection, and there was no progression in tumor grade.

Conclusion

Two-micron continuous-wave laser did not diminish tumor recurrence rate in primary NMIBC for 18-months observation. However, T1 tumors were significantly higher among laser group. Clear and complete tumor bases were easily conserved by laser resection, which may enable pathologists to distinguish the T stages of bladder cancer more easily. Further studies need to be done in future.

Cheung G, Sahai A, Billia M, Dasgupta P, Khan MS (2013) Recent advances in the diagnosis and treatment of bladder cancer. BMC Med 11:13PubMedCentralPubMedCrossRef

Si-wei Z, Jian-hui M, Ming L, Yan-qun N, Wan-qing C (2009) Bladder neoplasms incidence trend cancer registry China. J Chin J Urol 10:4

Babjuk M, Oosterlinck W, Sylvester R, Kaasinen E, Bohle A, Palou-Redorta J, Roupret M (2011) EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder, the 2011 update. Eur Urol 59:997–1008PubMedCrossRef

Shindo T, Masumori N, Kitamura H, Tanaka T, Fukuta F, Hasegawa T, Yanase M, Miyake M, Miyao N, Takahashi A et al (2013) Clinical significance of definite muscle layer in TUR specimen for evaluating progression rate in T1G3 bladder cancer: multicenter retrospective study by the Sapporo Medical University Urologic Oncology Consortium (SUOC). World J Urol [Epub ahead of print]

Roupret M, Seisen T, Comperat E, Larre S, Mazerolles C, Gobet F, Fetissof F, Fromont G, Safsaf A, d’Arcier BF et al (2013) Prognostic interest to discriminate muscularis mucosae invasion (T1a vs. T1b) in non-muscle-invasive bladder carcinomas: results from a French national multicentre study with a central pathology review. J Urol 189:2069–2076

Soloway MS, Lopez AE, Patel J, Lu Y (1994) Results of radical cystectomy for transitional cell carcinoma of the bladder and the effect of chemotherapy. Cancer 73:1926–1931PubMedCrossRef

Abd El-Latif A, Watts KE, Elson P, Fergany A, Hansel DE (2013) The sensitivity of initial transurethral resection or biopsy of bladder tumor(s) for detecting bladder cancer variants on radical cystectomy. J Urol 189:1263–1267PubMedCrossRef

Pietrow PK, Smith JA Jr (2001) Laser treatment for invasive and noninvasive carcinoma of the bladder. J Endourol 15:415–418; discussion 425–6PubMedCrossRef

Bachmann A, Woo HH, Wyler S (2012) Laser prostatectomy of lower urinary tract symptoms due to benign prostate enlargement: a critical review of evidence. Curr Opin Urol 22:22–33PubMedCrossRef

10.

Bader MJ, Sroka R, Gratzke C, Seitz M, Weidlich P, Staehler M, Becker A, Stief CG, Reich O (2009) Laser therapy for upper urinary tract transitional cell carcinoma: indications and management. Eur Urol 56:65–71PubMedCrossRef

11.

Herrmann TR, Liatsikos EN, Nagele U, Traxer O, Merseburger AS (2012) EAU guidelines on laser technologies. Eur Urol 61:783–795PubMedCrossRef

12.

Yang Y, Wei ZT, Zhang X, Hong BF, Guo G (2009) Transurethral partial cystectomy with continuous wave laser for bladder carcinoma. J Urol 182:66–69PubMedCrossRef

13.

Liu H, Xue S, Ruan Y, Sun X, Han B, Xia S (2011) 2-micrometer continuous wave laser treatment for multiple non-muscle-invasive bladder cancer with intravesical instillation of epirubicin. Laser Surg Med 43:15–20CrossRef

14.

Zhong C, Guo S, Tang Y, Xia S (2010) Clinical observation on 2 micron laser for non-muscle-invasive bladder tumor treatment: single-center experience. World J Urol 28:157–161PubMedCrossRef

15.

Bol MG, Baak JP, Buhr-Wildhagen S, Kruse AJ, Kjellevold KH, Janssen EA, Mestad O, Ogreid P (2003) Reproducibility and prognostic variability of grade and lamina propria invasion in stages Ta, T1 urothelial carcinoma of the bladder. J Urol 169:1291–1294PubMedCrossRef

16.

Lipponen PK, Eskelinen MJ, Jauhiainen K, Harju E, Terho R, Haapasalo H (1993) Grading of superficial bladder cancer by quantitative mitotic frequency analysis. J Urol 149:36–41PubMed

17.

Lamm DL, Blumenstein BA, Crawford ED, Montie JE, Scardino P, Grossman HB, Stanisic TH, Smith JA Jr, Sullivan J, Sarosdy MF et al (1991) A randomized trial of intravesical doxorubicin and immunotherapy with bacille Calmette-Guerin for transitional-cell carcinoma of the bladder. N Engl J Med 325:1205–1209PubMedCrossRef

18.

Ukai R, Kawashita E, Ikeda H (2000) A new technique for transurethral resection of superficial bladder tumor in 1 piece. J Urol 163:878–879PubMedCrossRef

19.

Saito S (2001) Transurethral en bloc resection of bladder tumors. J Urol 166:2148–2150PubMedCrossRef

20.

Wilby D, Thomas K, Ray E, Chappell B, O’Brien T (2009) Bladder cancer: new TUR techniques. World J Urol 27:309–312PubMedCrossRef

21.

Maurice MJ, Ponsky LE (2013) En bloc transurethral resection of bladder lesions: a trick to retrieve specimens up to 4.5 cm. BJU Int 111:E15–E16PubMedCrossRef

22.

Nieder AM, Meinbach DS, Kim SS, Soloway MS (2005) Transurethral bladder tumor resection: intraoperative and postoperative complications in a residency setting. J Urol 174:2307–2309PubMedCrossRef

23.

Syed HA, Biyani CS, Bryan N, Brough SJ, Powell CS (2001) Holmium:YAG laser treatment of recurrent superficial bladder carcinoma: initial clinical experience. J Endourol 15:625–627PubMedCrossRef

Title: En bloc transurethral resection with 2-micron continuous-wave laser for primary non-muscle-invasive bladder cancer: a randomized controlled trial
Authors: Xu Chen
Jun Liao
Lingwu Chen
Shaopeng Qiu
Chengqiang Mo
Xiaopeng Mao
Yuanzhong Yang
Shiying Zhou
Junxing Chen
Publication date: 01-07-2015
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 7/2015
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-014-1342-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

En bloc transurethral resection with 2-micron continuous-wave laser for primary non-muscle-invasive bladder cancer: a randomized controlled trial

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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