Implementing a Checklist for Transurethral Resection of Bladder Tumor to Standardize Outcome Reporting: When High-quality Resection Could Influence Oncological Outcomes

Checklist for Transurethral Resection of Bladder Tumor (TURBT): A Step Forward in the Standardization for TURBT Reporting

“…Results are very similar for both the presence of detrusor muscle in the pathological specimen as the most reliable indicator of adequate resection and the risk of recurrence. The paper by Diana et al [3] supports these results.…”

“…The presence of detrusor muscle within TURBT specimens serves as a surrogate for resection quality [5] . In the study by Diana et al [3] , 95% of patients in both the EBR and TURBT arms had detrusor muscle in the specimen. ERB was not superior in this aspect and might only offer the advantage of allowing better detection of muscularis mucosae and detrusor muscle in specimens, thus facilitating accurate T1 substaging.…”

“…In this issue of European Urology Open Science , Diana et al [3] present an updated analysis of a single-center, prospective, noninferiority, randomized controlled trial (RCT) of patients undergoing EBR or TURBT. A total of 248 patients were assessed for eligibility and 201 patients reached at least 1 yr of follow-up; the median follow-up for patients without recurrence was 19 mo.…”

“…Disease recurrence is affected by multiple factors that are very difficult to balance when comparing studies, including tumor biology; host factors; continuous saline or sterile water irrigation [8] ; type of adjuvant therapy and delay in its administration after surgery; restaging TURBT; and technical issues such as enhanced visualization and surgeon experience, judgment, and skill that might impact seeding of tumor cells during resection, incomplete resection rates, and missing of microscopic tumors. The use of checklists in RCTs investigating TURBT might take into account all the factors previously mentioned and facilitate comparison of results between trials in the future [3] . I agree that such a checklist for TURBT would be a step forward in the standardization for TURBT reporting, as has been suggested by some authors, and international collaborative groups such as the International Bladder Cancer Group should work on this issue in future consensus meetings [9] , [10] , [11] .…”