Potential candidates for en bloc resection among patients with primary and recurrent bladder tumours

Ninna Kjaer Nielsen; Jakob Kristian Jakobsen; Pernille Skjold Kingo; Jørgen Bjerggaard Jensen

doi:10.1080/21681805.2021.1954686

Potential candidates for en bloc resection among patients with primary and recurrent bladder tumours

Ninna Kjaer Nielsen^*, Jakob Kristian Jakobsen, Pernille Skjold Kingo, Jørgen Bjerggaard Jensen

^*Corresponding author for this work

Department of Clinical Medicine - Department of Urology

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

INTRODUCTION: Transurethral resection (TURB) is the gold standard treatment for non-muscle invasive bladder cancer (NMIBC). However, conventional TURB is possibly part of the mechanism leading to the high recurrence rate in NMIBC and the need for repeated procedures, as the method with piecemeal resection of the tumour violates basic oncological principles and compromises pathological examination. En bloc resection (EBR) could potentially overcome these flaws by improving pathological quality and thereby reducing the need for re-resections and could potentially also lower the risk of tumour seeding leading to early recurrences. With this study, we aimed to evaluate tumour characteristics in a consecutive cohort of patients undergoing conventional TURB in order to estimate the proportion of procedures eligible for EBR, findings at re-resection, and early recurrence rate.

METHODS: All TURBs performed at a single large University Hospital in a 12 month period were manually reviewed. Based on tumour size and appearance, patients were registered as candidates or non-candidate for EBR.

RESULTS: A total of 600 TURBs were reviewed. Overall, 25% of procedures were found to be eligible for EBR. The most frequent reason for not being a candidate was tumour diameter <1 cm. Re-resections were done after 10.5% of the procedures, where the residual tumour was found in 28.6% of these. Within 6 months, 21.2% had a recurrence.

CONCLUSION: We found approximately 25% of all TURBs to be eligible for EBR. Based on a relatively low recurrence rate, we conclude that future studies on EBR with recurrence rate as the primary endpoint will require large patient cohorts.

Original language	English
Journal	Scandinavian Journal of Urology
Volume	55
Issue	5
Pages (from-to)	366-371
Number of pages	6
ISSN	2168-1805
DOIs	https://doi.org/10.1080/21681805.2021.1954686
Publication status	Published - Oct 2021

Keywords

En bloc resection
TURB
non-muscle invasive bladder cancer
EFFICACY
SAFETY
LASER
CANCER
CARCINOMA
TRANSURETHRAL RESECTION
PROGRESSION

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10.1080/21681805.2021.1954686

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title = "Potential candidates for en bloc resection among patients with primary and recurrent bladder tumours",

abstract = "INTRODUCTION: Transurethral resection (TURB) is the gold standard treatment for non-muscle invasive bladder cancer (NMIBC). However, conventional TURB is possibly part of the mechanism leading to the high recurrence rate in NMIBC and the need for repeated procedures, as the method with piecemeal resection of the tumour violates basic oncological principles and compromises pathological examination. En bloc resection (EBR) could potentially overcome these flaws by improving pathological quality and thereby reducing the need for re-resections and could potentially also lower the risk of tumour seeding leading to early recurrences. With this study, we aimed to evaluate tumour characteristics in a consecutive cohort of patients undergoing conventional TURB in order to estimate the proportion of procedures eligible for EBR, findings at re-resection, and early recurrence rate.METHODS: All TURBs performed at a single large University Hospital in a 12 month period were manually reviewed. Based on tumour size and appearance, patients were registered as candidates or non-candidate for EBR.RESULTS: A total of 600 TURBs were reviewed. Overall, 25% of procedures were found to be eligible for EBR. The most frequent reason for not being a candidate was tumour diameter <1 cm. Re-resections were done after 10.5% of the procedures, where the residual tumour was found in 28.6% of these. Within 6 months, 21.2% had a recurrence.CONCLUSION: We found approximately 25% of all TURBs to be eligible for EBR. Based on a relatively low recurrence rate, we conclude that future studies on EBR with recurrence rate as the primary endpoint will require large patient cohorts.",

keywords = "En bloc resection, TURB, non-muscle invasive bladder cancer, EFFICACY, SAFETY, LASER, CANCER, CARCINOMA, TRANSURETHRAL RESECTION, PROGRESSION",

author = "{Kjaer Nielsen}, Ninna and Jakobsen, {Jakob Kristian} and Kingo, {Pernille Skjold} and Jensen, {J{\o}rgen Bjerggaard}",

year = "2021",

month = oct,

doi = "10.1080/21681805.2021.1954686",

language = "English",

volume = "55",

pages = "366--371",

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Potential candidates for en bloc resection among patients with primary and recurrent bladder tumours. / Kjaer Nielsen, Ninna ; Jakobsen, Jakob Kristian ; Kingo, Pernille Skjold et al.
In: Scandinavian Journal of Urology, Vol. 55, No. 5, 10.2021, p. 366-371.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Potential candidates for en bloc resection among patients with primary and recurrent bladder tumours

AU - Kjaer Nielsen, Ninna

AU - Jakobsen, Jakob Kristian

AU - Kingo, Pernille Skjold

AU - Jensen, Jørgen Bjerggaard

PY - 2021/10

Y1 - 2021/10

N2 - INTRODUCTION: Transurethral resection (TURB) is the gold standard treatment for non-muscle invasive bladder cancer (NMIBC). However, conventional TURB is possibly part of the mechanism leading to the high recurrence rate in NMIBC and the need for repeated procedures, as the method with piecemeal resection of the tumour violates basic oncological principles and compromises pathological examination. En bloc resection (EBR) could potentially overcome these flaws by improving pathological quality and thereby reducing the need for re-resections and could potentially also lower the risk of tumour seeding leading to early recurrences. With this study, we aimed to evaluate tumour characteristics in a consecutive cohort of patients undergoing conventional TURB in order to estimate the proportion of procedures eligible for EBR, findings at re-resection, and early recurrence rate.METHODS: All TURBs performed at a single large University Hospital in a 12 month period were manually reviewed. Based on tumour size and appearance, patients were registered as candidates or non-candidate for EBR.RESULTS: A total of 600 TURBs were reviewed. Overall, 25% of procedures were found to be eligible for EBR. The most frequent reason for not being a candidate was tumour diameter <1 cm. Re-resections were done after 10.5% of the procedures, where the residual tumour was found in 28.6% of these. Within 6 months, 21.2% had a recurrence.CONCLUSION: We found approximately 25% of all TURBs to be eligible for EBR. Based on a relatively low recurrence rate, we conclude that future studies on EBR with recurrence rate as the primary endpoint will require large patient cohorts.

AB - INTRODUCTION: Transurethral resection (TURB) is the gold standard treatment for non-muscle invasive bladder cancer (NMIBC). However, conventional TURB is possibly part of the mechanism leading to the high recurrence rate in NMIBC and the need for repeated procedures, as the method with piecemeal resection of the tumour violates basic oncological principles and compromises pathological examination. En bloc resection (EBR) could potentially overcome these flaws by improving pathological quality and thereby reducing the need for re-resections and could potentially also lower the risk of tumour seeding leading to early recurrences. With this study, we aimed to evaluate tumour characteristics in a consecutive cohort of patients undergoing conventional TURB in order to estimate the proportion of procedures eligible for EBR, findings at re-resection, and early recurrence rate.METHODS: All TURBs performed at a single large University Hospital in a 12 month period were manually reviewed. Based on tumour size and appearance, patients were registered as candidates or non-candidate for EBR.RESULTS: A total of 600 TURBs were reviewed. Overall, 25% of procedures were found to be eligible for EBR. The most frequent reason for not being a candidate was tumour diameter <1 cm. Re-resections were done after 10.5% of the procedures, where the residual tumour was found in 28.6% of these. Within 6 months, 21.2% had a recurrence.CONCLUSION: We found approximately 25% of all TURBs to be eligible for EBR. Based on a relatively low recurrence rate, we conclude that future studies on EBR with recurrence rate as the primary endpoint will require large patient cohorts.

KW - En bloc resection

KW - TURB

KW - non-muscle invasive bladder cancer

KW - EFFICACY

KW - SAFETY

KW - LASER

KW - CANCER

KW - CARCINOMA

KW - TRANSURETHRAL RESECTION

KW - PROGRESSION

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U2 - 10.1080/21681805.2021.1954686

DO - 10.1080/21681805.2021.1954686

M3 - Journal article

C2 - 34279178

SN - 2168-1805

VL - 55

SP - 366

EP - 371

JO - Scandinavian Journal of Urology

JF - Scandinavian Journal of Urology

IS - 5

ER -

Potential candidates for en bloc resection among patients with primary and recurrent bladder tumours

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Keywords

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