Simultaneous Transurethral Resection of Bladder Tumour and Prostate: Is It Safe?

Kouriefs, Chryssanthos; Loizides, Sofronis; Mufti, G. R.

doi:10.1159/000144048

Cited by 6 publications

(3 citation statements)

References 11 publications

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“…Kouriefs et al [ 26 ] reviewed retrospective studies with small numbers to quantify the risk of BCa recurrence that could be attributed to TURP. The authors analyzed 424 patients treated with TURB-T and TURP simultaneously and 350 with TURB-T alone; the rates of bladder tumor recurrence were 58% and 63%, respectively.…”

Section: Discussionmentioning

confidence: 99%

The association between postvoid residual and response to standard therapy in male and female patients with non–muscle-invasive bladder cancer

Gianfrancesco¹

2023

Curr Urol

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Background The urinary retention is recognized as a promoting factor for bladder cancer, but its role as prognostic factor of therapeutic response has not yet been widely considered. To correlate bladder outlet characteristics with short-term response to treatment in non–muscle-invasive bladder cancer. Materials and methods We carried out a case-control study on 600 consecutive patients with a first diagnosis of non–muscle-invasive bladder cancer, recruited at the first endoscopic follow-up visit after standard treatment: 200 patients were not tumor-free (cases) and 400 were tumor-free (controls). Patients were compared based on baseline and bladder-outlet characteristics ("functional parameters”: postvoid residual volume [PVR], International Prostatic Symptoms Score, perceived quality of bladder outlet). t Test, χ 2 test, receiver operating characteristic curves, logistic correlations, and multivariate analysis were applied. Results The cases had higher statistically significant PVR values compared with controls. We reported a linear correlation of no–tumor-free status with PVR (R 2 = 0.087, p < 0.005); the receiver operating characteristic curves revealed an area under the curve of 0.824 (95%confidence interval, 0.783–0.865; optimal PVR cutoff, 50 mL). In the multivariate analysis, age, American Society of Anesthesiologists score ≥2, risk category ≥intermediate, and all functional parameters represented independent factors for no–tumor-free status. Conclusions Urinary retention could represent a prognostic factor of treatment response, and its active treatment should be considered as an important therapeutic step into the clinical management of bladder cancer patients.

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Section: Discussionmentioning

confidence: 99%

The association between postvoid residual and response to standard therapy in male and female patients with non–muscle-invasive bladder cancer

Gianfrancesco¹

2023

Curr Urol

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“…On the other hand, there are studies suggesting that resolution of BPO reduces tumor recurrence by limiting the interaction between urine carcinogens with susceptible bladder epithelium [ 37 ], proposing that concomitant surgery does not negatively affect oncological outcomes and may be a safe and feasible option in selected cases [ 3 , 13 , 14 , 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Concomitant Endoscopic Surgery for Bladder Tumors and Prostatic Obstruction: Are We Safely Hitting Two Birds with One Stone? A Systematic Review and Meta-Analysis

Savvides

Pyrgidis

Langas

et al. 2022

JCM

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Background: Lower urinary tract symptoms (LUTS) caused by benign prostatic obstruction (BPO) and bladder tumors may co-exist, especially among elderly patients. Transurethral resection of bladder tumors (TURBT) and endoscopic surgery for benign prostatic obstruction in the same setting are avoided by many surgeons due to concerns for tumor cell seeding and recurrences in the prostatic urethra. Aim: The aim of this study was assess the effect of concomitant TURBT and endoscopic BPO surgery on oncological safety and patient quality of life via systematic review and meta-analysis. Methods: We searched the PubMed, Cochrane Library, EMBASE, Scopus, and Clinicaltrials.gov databases and sources of grey literature published before June 2021 for relevant studies. We performed a random-effects meta-analysis of odds ratios (ORs) or weighted mean differences (WMD) to compare concomitant TURBT and BPO surgery versus TURBT alone in terms of recurrence and progression rates. Accordingly, we undertook multiple subgroups and sensitivity analyses (PROSPERO: CRD42020173363). Results: Three randomized and twelve retrospective observational studies with 2421 participants were included. Across studies with good methodological quality, no statistically significant differences were demonstrated regarding overall bladder tumors recurrence rates between concomitant endoscopic BPO surgery and TURBT versus TURBT alone (OR: 0.81, 95% CI: 0.60–1.09, I2 = 42%). Similarly, no significant differences were observed in recurrences located at the bladder neck and/or prostatic urethra (OR: 1.06, 95% CI: 0.76–1.47, I2 = 0%), time to first recurrence (WMD: −0.2 months, 95% Cl: −2.2–1.8, I2 = 48%), and progression rate (OR: 1.05, 95% CI: 0.67–1.64, I2 = 0%). Subgroup analyses based on tumor grade, number of tumors, and utilization of single-instillation chemotherapy post-TURBT did not detect any significant differences in overall bladder tumor recurrence. The level of evidence was estimated as low for all outcomes. Concomitant surgery improved lower urinary tract symptoms. Conclusion: Concomitant endoscopic BPO surgery and TURBT are oncologically safe and improve LUTS-related quality of life.

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“…However, Greene and Yalowitz (6) in 1972 studied 100 patients who underwent simultaneous transurethral resection and the authors observed that simultaneous resection was preferable without increasing the risk of tumor recurrence. Since then, numerous studies on this issue have been conducted, however, the results of these studies were different or even contradictory (7). A previous meta-analysis (8), based on five pooled non-randomized concurrent controlled trials (NRCCTs) and one randomized controlled trial (RCT), reported a statistically significant result.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous transurethral resection of bladder cancer and prostate may reduce recurrence rates: A systematic review and meta-analysis

Zeng

Ruan

et al. 2012

Experimental and Therapeutic Medicine

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The aim of this study was to evaluate the recurrence rate of simultaneous transurethral resection of bladder cancer and prostate (TURBT+TURP) in the treatment of non-muscle invasive bladder cancer (NMIBC) with benign prostatic hyperplasia (BPH). We searched PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and the ISI Web of Knowledge databases from their establishment until March 2012, to collect all the original studies on TURBT+TURP vs. TURBT alone in the treatment of NMIBC with BPH. After screening the literature, methodological quality assessment and data extraction was conducted independently by two reviewers and meta-analysis was performed using the RevMan 5.1 software. The quality of data was assessed using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Eight studies, including seven non-randomized concurrent controlled trials (NRCCTs) and one randomized controlled trial (RCT), involving a total of 1,372 patients met the criteria. Meta-analyses of NRCCTs showed that in the TURBT+TURP group, overall recurrence rates were lower [odds ratio (OR), 0.76; 95% confidence interval (CI), 0.60–0.96; P=0.02] and the difference was statistically significant. The postoperative recurrence rate in the prostatic fossa/bladder neck (OR, 0.96; 95% CI, 0.64–1.45; P=0.86) and bladder tumor progression rates (OR, 0.96; 95% CI, 0.49–1.87; P=0.91) were similar between the TURBT+TURP and TURBT groups, but the difference was not significant. According to the GRADE approach, the level of evidence was moderate or low. Only one RCT demonstrated that overall postoperative tumor recurrence rates, recurrence rates at prostate fossa/bladder neck and bladder tumor progression rates between simultaneous groups and control groups were almost equal. There was no significant difference (P>0.05), and the level of evidence was moderate. For patients with NMIBC and BPH, simultaneous resection did not increase the overall recurrence rate of bladder tumors, it also did not cause metastasis and tumor progression, but it may reduce the recurrence rate. However, due to the low quality of investigations included in the present study, careful selection was necessary, and more large-scale and high-quality randomized controlled trials are also required for further confirmation.

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Simultaneous Transurethral Resection of Bladder Tumour and Prostate: Is It Safe?

Cited by 6 publications

References 11 publications

The association between postvoid residual and response to standard therapy in male and female patients with non–muscle-invasive bladder cancer

The association between postvoid residual and response to standard therapy in male and female patients with non–muscle-invasive bladder cancer

Concomitant Endoscopic Surgery for Bladder Tumors and Prostatic Obstruction: Are We Safely Hitting Two Birds with One Stone? A Systematic Review and Meta-Analysis

Simultaneous transurethral resection of bladder cancer and prostate may reduce recurrence rates: A systematic review and meta-analysis

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