Differences in oncological benefits from second transurethral resection between white-light initial surgery and photodynamic diagnosis-guided initial surgery for primary high-risk non-muscle invasive bladder cancer.

Autor: Miyake M; Department of Urology, Nara Medical University, Kashihara, Japan., Nishimura N; Department of Urology, Nara Medical University, Kashihara, Japan., Nakahama T; Department of Urology, Nara Medical University, Kashihara, Japan., Nishimoto K; Department of Uro-Oncology, Saitama Medical University International Medical Center, Hidaka, Japan.; Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan., Oyama M; Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan., Matsushita Y; Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan., Miyake H; Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan.; Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan., Fukuhara H; Department of Urology, Kochi Medical School, Nankoku, Japan., Inoue K; Department of Urology, Kochi Medical School, Nankoku, Japan., Kobayashi K; Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, Japan., Matsuyama H; Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, Japan.; Department of Urology, JA Yamaguchi Kouseiren Nagato General Hospital, Nagato, Japan., Fujii T; Department of Diagnostic Pathology, Nara Medical University, Kashihara, Japan.; Division of Fostering Required Medical Human Resources, Center for Infectious Disease Education and Research (CiDER), Osaka University, Osaka, Japan., Hirao Y; Department of Urology, Osaka Gyoumeikan Hospital, Konohana-ku, Japan., Fujimoto K; Department of Urology, Nara Medical University, Kashihara, Japan.
Jazyk: angličtina
Zdroj: International journal of urology : official journal of the Japanese Urological Association [Int J Urol] 2024 Aug; Vol. 31 (8), pp. 876-885. Date of Electronic Publication: 2024 Apr 30.
DOI: 10.1111/iju.15474
Abstrakt: Objectives: The aim of this study was to compare clinical outcomes between patients receiving second TUR after initial white-light transurethral resection of bladder tumor (WL-TURBT) and initial photodynamic diagnosis (PDD)-assisted TURBT.
Methods: A total of 1007 patients were divided into four groups based on the treatment pattern: WL-TURBT with second TUR (161 patients, WL-second group) or without second TUR (540 patients, WL-alone group) and PDD-TURBT with second TUR (112 patients, PDD-second group) or without second TUR (194 patients, PDD-alone group). Oncologic outcomes (bladder cancer recurrence, progression, urothelial cancer-specific mortality) and rates of residual tumor and risk stratification of non-muscle-invasive bladder cancer (NMIBC) after second TUR were evaluated.
Results: After propensity score-matching 121 patients were included each in the WL-alone and WL-second groups, and 63 patients each in the PDD-alone and PDD-second groups. In the WL group, the second TUR was significantly associated with improved progression-free (p = 0.012) and urothelial cancer-specific free survival (p = 0.011), but not with recurrence-free survival (p = 0.93). Patients initially treated with PDD-TURBT, and with a tumor diameter <30 mm and multifocality had a relatively high benefit from second TUR. The rates of residual tumor and risk stratification of NMIBC did not significantly differ between WL-TURBT and PDD-TURBT groups.
Conclusions: Our findings suggested that a second TUR could be omitted after an initial PDD-TURBT in selected patients with high-risk NMIBC.
(© 2024 The Japanese Urological Association.)
Databáze: MEDLINE
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