Absence of Tumor on Repeat Transurethral Resection of Bladder Tumor Does Not Predict Final Pathologic T0 Stage in Bladder Cancer Treated with Radical Cystectomy

Kukreja, Janet Baack; Porten, Sima P.; Golla, Vishnukamal; Ho, Philip Levy; Noguera-Gonzalez, Graciela; Kamat, Ashish M.; Dinney, Colin P.; Shah, Jay B.

doi:10.1016/j.euf.2016.12.005

Cited by 30 publications

(20 citation statements)

References 14 publications

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“…As reported, the circulating cancer cells increased during TURBT, and complete TURBT exhibited potential to increase tumor cell spreading, especially when bladder perforation occurred [18]. Compared to TURBT, RC could remove bladder cancer radically for organ-con ned disease and is considerably more reliable than complete TURBT [15,19]. Based on this study, we had con rmed that complete TURBT did not improve survival for organ-con ned bladder cancer patients before RC.…”

Section: Discussionsupporting

confidence: 57%

Complete TURBT Before Radical Cystectomy Did Not Improve Oncological Outcome for Organ-Confined Bladder Cancer

Heng

Zhou

Lin

et al. 2020

Preprint

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Background To investigate the role of complete transurethral resection of bladder tumor (TURBT) before radical cystectomy for organ-confined bladder cancer.Patients and Methods Patients who underwent radical cystectomy (RC) in our center from January 2008 to December 2018 were retrospectively reviewed. Those with disease >T2N0M0 or positive surgical margin and those who were administrated neoadjuvant/adjuvant chemotherapy or radiotherapy were excluded. Complete TURBT was defined as no visible lesion under endoscopic examination after TURBT or specimen of RC. Kaplan–Meier and log-rank tests assessed disease-free survival. Logistic and Cox regression analysis were performed to identify potential predictors.Results In total, 236 patients were included, and 207 patients were male. The median age was 61 years old. The median number and size were 1 and 3cm respectively, and maximal pathological T stage was T2 in 94 patients. Complete TURBT was related to tumor size (p=0.041), histological variants (p=0.026) and downstaging (p<0.001). Tumor size, grade and histological variants were independent predictors of complete TURBT. With a median follow-up of 42.7 months, 30 patients experienced recurrence. Age and histological variantswere independent predictors of disease-free survival (p=0.022 and 0.032, respectively), and complete TURBT was not an independent predictor of disease-free survival (p=0.156). Downstaging was not associated with survival outcome.Conclusions Complete TURBT is related to an increased rate of downstaging before radical cystectomy, and it was not associated with better oncological outcomes for patients with organ-confined bladder cancer.

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Section: Discussionsupporting

confidence: 57%

Complete TURBT Before Radical Cystectomy Did Not Improve Oncological Outcome for Organ-Confined Bladder Cancer

Heng

Zhou

Lin

et al. 2020

Preprint

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“…For ≤ pT2N0M0 disease, complete TURBT was related to a higher rate of downstaging after RC, and it was associated with good outcomes [10][11][12][13] . However, in a recent study, the role of complete TURBT in oncological outcome was not signi cant, and incomplete TURBT was associated with a higher rate of pT3/4, which was a greater predictor of worse outcome than incomplete TURBT 14,15 . In clinical practice, advanced stage tied to poor prognosis, as well as incomplete TURBT.…”

Section: Introductionmentioning

confidence: 85%

“…As reported, the circulating cancer cells increased during TURBT, and complete TURBT exhibited potential to increase tumor cell spreading, especially when bladder perfusion occurred 18 . Compared to TURBT, RC could remove bladder cancer radically for organ-con ned disease and is considerably more reliable than complete TURBT 15,19 . Based on this study, we had con rmed that complete TURBT did not improve survival for organ-con ned bladder cancer patients before RC.…”

Section: Commentsmentioning

confidence: 99%

The role of complete TURBT before radical cystectomy for organ-confined bladder cancer

Heng

Chen

Zhou

et al. 2020

Preprint

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ObjectiveTo investigate the role of complete transurethral resection of bladder tumor (TURBT) before radical cystectomy.Patients and MethodsPatients who underwent radical cystectomy in our center from January 2008 to December 2018 were retrospectively reviewed. Those with disease >T2N0M0 or positive surgical margin and those who were administrated neoadjuvant/adjuvant chemotherapy or radiotherapy were excluded. Complete TURBT was defined as no visible lesion under endoscopic examination after TURBT, presence of muscle layer in the specimen or no tumor in a specimen separated from the base. Kaplan–Meier and log-rank tests assessed disease-free survival. Logistic and Cox regression analysis were performed to identify potential predictors.ResultsIn total, 236 patients were included, and 207 patients were male. The median age was 61 years old. The median number and size were 1 and 3cm respectively, and maximal pathological T stage was T2 in 94 patients. Complete TURBT was related to tumor size (p=0.041), histological variants (p=0.026) and downstaging (p<0.001). Tumor size, grade and histological variants were independent predictors of complete TURBT. With a median follow-up of 42.7 months, 30 patients experienced recurrence. Age and histological variants were independent predictors of disease-free survival (p=0.027 and 0.041, respectively). Complete TURBT was associated with poor prognosis, however, the result was not significant (p=0.068). Downstaging was not associated with survival outcome.ConclusionsComplete TURBT is related to an increased rate of downstaging before radical cystectomy, and both of these factors did not improve oncological outcomes for patients with organ-confined bladder cancer.

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“…It has been shown that pT0 rates post RC are influenced by NAC regimens and prior TURBTs being performed [14]. Kukereja et al [14] evaluated pT0 status following NAC on final pathology can be attributed to the absence of residual disease (cT0) on transurethral resection of bladder tumor (TURBT) or to the effects of NAC. The authors found [14] that a complete TURBT may not predict pT0 at RC.…”

Section: Cismentioning

confidence: 99%

“…Kukereja et al [14] evaluated pT0 status following NAC on final pathology can be attributed to the absence of residual disease (cT0) on transurethral resection of bladder tumor (TURBT) or to the effects of NAC. The authors found [14] that a complete TURBT may not predict pT0 at RC. A notable fraction of patients with cT0 bladders have locally advanced and/or lymph node-positive disease.…”

Section: Cismentioning

confidence: 99%

Concomitant CIS on TURBT does not impact oncological outcomes in patients treated with neoadjuvant or induction chemotherapy followed by radical cystectomy

et al. 2018

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Absence of Tumor on Repeat Transurethral Resection of Bladder Tumor Does Not Predict Final Pathologic T0 Stage in Bladder Cancer Treated with Radical Cystectomy

Cited by 30 publications

References 14 publications

Complete TURBT Before Radical Cystectomy Did Not Improve Oncological Outcome for Organ-Confined Bladder Cancer

Complete TURBT Before Radical Cystectomy Did Not Improve Oncological Outcome for Organ-Confined Bladder Cancer

The role of complete TURBT before radical cystectomy for organ-confined bladder cancer

Concomitant CIS on TURBT does not impact oncological outcomes in patients treated with neoadjuvant or induction chemotherapy followed by radical cystectomy

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