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

Teoh, Jeremy Yuen‐Chun; Mayor, Nikhil; Li, Kai-Man; Lo, Kwok-Tung; Ng, Chi‐Fai; Mostafid, Hugh

doi:10.1007/s00345-021-03675-9

Cited by 16 publications

(11 citation statements)

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“…According to our inclusion criteria, we finally identified 29 studies comprising 4,484 patients for meta-analysis. 9–16,24,25,29,36–50,51–53 Of 29 included studies, 13 RCTs comprising 1,792 patients were eligible for analysis of oncologic and perioperative outcomes, 9–16,36–40 and 5 RCTs and 16 NRCTs/observational studies comprising 3,369 patients were eligible for analysis of pathological and reTUR outcomes. 10–13,24,25,29,40–50,51–53 The demographics of each included study are represented in tables 1 and 2.…”

Section: Resultsmentioning

confidence: 99%

En Bloc Resection for Bladder Tumors: An Updated Systematic Review and Meta-Analysis of Its Differential Effect on Safety, Recurrence and Histopathology

et al. 2022

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Purpose: En bloc resection for bladder tumors has been developed to overcome shortcomings of conventional transurethral resection of bladder tumors with regard to safety, pathological evaluation and oncologic outcomes. However, the potential benefits and utility compared to conventional transurethral resection of bladder tumors have not been conclusively demonstrated. We aimed to update the current evidence with focus on the pathological benefits of en bloc resection for nonmuscle-invasive bladder cancer. Materials and Methods: The PubMedÒ, Web of ScienceÔ and ScopusÒ databases were searched in August 2021 according to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement. Studies were deemed eligible if they compared safety, and pathological and clinical outcomes in patients who underwent en bloc resection with conventional transurethral resection of bladder tumors.

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Section: Resultsmentioning

confidence: 99%

En Bloc Resection for Bladder Tumors: An Updated Systematic Review and Meta-Analysis of Its Differential Effect on Safety, Recurrence and Histopathology

et al. 2022

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“…In order to assess the feasibility of ERBT in routine practice the same authors implemented ERBT as the primary surgical approach in all NMIBC patients with TURBT reserved as a conversion procedure in those patients where ERBT could not be completed for technical reasons. The authors found that ERBT was successfully carried out in 73% of all patients including those with large and multi-focal tumors, and 84% in patients with bladder tumors of ≤3 cm confirming that ERBT could be used as the primary approach for excising bladder tumor in the majority of NMIBC patients (15).…”

Section: Introductionmentioning

confidence: 88%

En Bloc Resection of Bladder Tumor—Is It the Way Forward?

et al. 2021

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Transurethral resection of bladder tumors (TURBT) represents the cornerstone in diagnosis and treatment of bladder cancer but recurrence is observed in up to 80% and over- or understaging with TURBT is common. A more recent development to overcome these limitations represents en-bloc resection of bladder tumors (ERBT) which offers several advantages over TURBT. In this report, we briefly review studies assessing outcomes of bladder cancer patients undergoing ERBT. Most randomized and non-randomized trial demonstrate improvement in clinical outcomes for ERBT over TURBT, however more pathological and translational studies are warranted.

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“…In clinical practice, when stratified by tumor size, the technical success rates of ERBT for bladder tumors ≤3 cm and > 3 cm in size were 84.3% and 29.6%, respectively. Multivariate analysis showed that tumor size was the only significant factor predicting the success of ERBT surgery ( 27 ). Thus, in order to ensure a complete resection, urologists should accept modified approaches of ERBT, such as retrieval of tumor sample in several pieces ( 28 – 30 ), or piecemeal resection of the exophytic part of tumor tissue followed by en bloc resection of the tumor base ( 31 ).…”

Section: The Technique Of Erbtmentioning

confidence: 99%

Precise diagnosis and treatment of non-muscle invasive bladder cancer - A clinical perspective

Yang

Wang

et al. 2023

Front. Oncol.

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According to the guidelines, transurethral resection of bladder tumor (TURBT) followed by intravesical therapy remains the standard strategy for the management of non-muscle invasive bladder cancer (NMIBC). However, even if patients receive standard strategy, the risk of postoperative recurrence and progression is high. From the clinical perspective, the standard strategy needs to be optimized and improved. Compared to conventional TURBT, the technique of en bloc resection of bladder tumor (ERBT) removes the tumor tissue in one piece, thus following the principles of cancer surgery. Meanwhile, the integrity and spatial orientation of tumor tissue is protected during the operation, which is helpful for pathologists to make accurate histopathological analysis. Then, urologists can make a postoperative individualized treatment plan based on the patient’s clinical characteristics and histopathological results. To date, there is no strong evidence that NMIBC patients treated with ERBT achieve better oncological prognosis, which indicates that ERBT alone does not yet improve patient outcomes. With the development of enhanced imaging technology and proteogenomics technology, en bloc resection combined with these technologies will make it possible to achieve precise diagnosis and treatment of bladder cancer. In this review, the authors analyze the current existing shortcomings of en bloc resection and points out its future direction, in order to promote continuous optimization of the management strategy of bladder cancer.

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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

Cited by 16 publications

References 16 publications

En Bloc Resection for Bladder Tumors: An Updated Systematic Review and Meta-Analysis of Its Differential Effect on Safety, Recurrence and Histopathology

En Bloc Resection for Bladder Tumors: An Updated Systematic Review and Meta-Analysis of Its Differential Effect on Safety, Recurrence and Histopathology

En Bloc Resection of Bladder Tumor—Is It the Way Forward?

Precise diagnosis and treatment of non-muscle invasive bladder cancer - A clinical perspective

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