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Lasers in Medical Science

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01.10.2020 | Original Article

The value of transurethral thulium laser en bloc resection combined with a single immediate postoperative intravesical instillation of pirarubicin in primary non-muscle-invasive bladder cancer

verfasst von: Sheng Xu, Shaoying Tan, Tingming Wu, Jun Gu, Lei Xu, Xianping Che

Erschienen in: Lasers in Medical Science | Ausgabe 8/2020

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Abstract

The objective of this study was to evaluate which patients might benefit from a single immediate postoperative intravesical instillation (SII) compared to maintenance intravesical instillations (MII) in primary non-muscle-invasive bladder cancer (NMIBC) after transurethral en bloc resection of bladder tumors (ERBT). A total of 141 patients with primary NMIBC who underwent ERBT with thulium laser between January 2012 and May 2016 were retrospectively enrolled. All the patients were categorized into two groups based on the duration of postoperative intravesical instillation of pirarubicin (THP): single intravesical instillation (SII) group, patients received a single immediate postoperative intravesical instillation of THP (30 mg), and maintenance intravesical instillations (MII) group, patients received a 1-year MII of THP (30 mg). Prognosis and recurrence data of each group were analyzed. One hundred and four (73.8%) patients received MII, and other 37 (26.2%) patients received SII. There was no significant difference in recurrence-free survival (RFS) between the two groups (P = 0.105). Following recurrence risk-stratified analysis, patients with high recurrence risk who accepted SII had a significantly lower RFS rate than those who received MII (P = 0.027). However, there were no significant differences in RFS rate between the two groups in patients with low and intermediate recurrence risk. In the multivariate analysis, the number of tumors was found to be an independent prognostic factor for RFS in NMIBC patients [hazard ratio, 5.665; 95% confidence interval (CI), 2.577–12.454; P < 0.001]. SII seems not to be inferior to MII in patients with initial low-risk and intermediate-risk NMIBC after ERBT.

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424CrossRef

Burger M, Catto JW, Dalbagni G, Grossman HB, Herr H, Karakiewicz P et al (2013) Epidemiology and risk factors of urothelial bladder cancer. Eur Urol 63:234–241CrossRef

Sylvester RJ, van der Meijden AP, Oosterlinck W, Witjes JA, Bouffioux C, Denis L et al (2006) Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol 49:466–465 discussion 475-477CrossRef

Babjuk M, Böhle A, Burger M, Capoun O, Cohen D, Compérat EM et al (2017) EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2016. Eur Urol 71:447–461CrossRef

Mariappan P, Zachou A, Grigor KM, Edinburgh Uro-Oncology Group (2010) Detrusor muscle in the first, apparently complete transurethral resection of bladder tumour specimen is a surrogate marker of resection quality, predicts risk of early recurrence, and is dependent on operator experience. Eur Urol 57:843–849CrossRef

Gontero P, Sylvester R, Pisano F, Joniau S, Vander Eeckt K, Serretta V et al (2015) Prognostic factors and risk groups in T1G3 non-muscle-invasive bladder cancer patients initially treated with Bacillus Calmette-Guérin: results of a retrospective multicenter study of 2451 patients. Eur Urol 67:74–82CrossRef

Kramer MW, Bach T, Wolters M, Imkamp F, Gross AJ, Kuczyk MA et al (2011) Current evidence for transurethral laser therapy of non-muscle invasive bladder cancer. World J Urol 29:433–442CrossRef

Kramer MW, Altieri V, Hurle R, Lusuardi L, Merseburger AS, Rassweiler J et al (2017) Current evidence of transurethral en-bloc resection of nonmuscle invasive bladder Cancer. Eur Urol Focus 3:567–576CrossRef

Witjes JA, Hendricksen K (2008) Intravesical pharmacotherapy for non-muscle-invasive bladder cancer: a critical analysis of currently available drugs, treatment schedules, and long-term results. Eur Urol 53:45–52CrossRef

10.

Kikuchi E, Fujimoto H, Mizutani Y, Okajima E, Koga H, Hinotsu S et al (2009) Clinical outcome of tumor recurrence for Ta, T1 non-muscle invasive bladder cancer from the data on registered bladder cancer patients in Japan: 1999-2001 report from the Japanese Urological Association. Int J Urol 16:279–286CrossRef

11.

Kramer MW, Rassweiler JJ, Klein J, Martov A, Baykov N, Lusuardi L et al (2015) En bloc resection of urothelium carcinoma of the bladder (EBRUC): a European multicenter study to compare safety, efficacy, and outcome of laser and electrical en bloc transurethral resection of bladder tumor. World J Urol 33:1937–1943CrossRef

12.

Sylvester RJ, Oosterlinck W, Witjes JA (2008) The schedule and duration of intravesical chemotherapy in patients with non-muscle-invasive bladder cancer: a systematic review of the published results of randomized clinical trials. Eur Urol 53:709–719CrossRef

13.

Sylvester RJ, Oosterlinck W, Holmang S, Sydes MR, Birtle A, Gudjonsson S et al (2016) Systematic review and individual patient data meta-analysis of randomized trials comparing a single immediate instillation of chemotherapy after transurethral resection with transurethral resection alone in patients with stage pTa-pT1 Urothelial carcinoma of the bladder: which patients benefit from the instillation. Eur Urol 69:231–244CrossRef

14.

Lamm DL, Blumenstein BA, Crissman JD, Montie JE, Gottesman JE, Lowe BA et al (2000) Maintenance bacillus Calmette-Guerin immunotherapy for recurrent TA, T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized southwest oncology group study. J Urol 163:1124–1129CrossRef

15.

Nakai Y, Anai S, Tanaka N, Chihara Y, Haramoto M, Otani T et al (2016) Insignificant role of bacillus Calmette-Guérin maintenance therapy after complete transurethral resection of bladder tumor for intermediate- and high-risk non-muscle-invasive bladder cancer: results from a randomized trial. Int J Urol 23:854–860CrossRef

16.

Friedrich MG, Pichlmeier U, Schwaibold H, Conrad S, Huland H (2007) Long-term intravesical adjuvant chemotherapy further reduces recurrence rate compared with short-term intravesical chemotherapy and short-term therapy with Bacillus Calmette-Guérin (BCG) in patients with non-muscle-invasive bladder carcinoma. Eur Urol 52:1123–1129CrossRef

17.

Serretta V, Morgia G, Altieri V, Di Lallo A, Ruggiero G, Salzano L et al (2010) A 1-year maintenance after early adjuvant intravesical chemotherapy has a limited efficacy in preventing recurrence of intermediate risk non-muscle-invasive bladder cancer. BJU Int 106:212–217CrossRef

18.

Naya Y, Mikami K, Takaha N, Inoue Y, Fujihara A, Kanazawa M et al (2018) Randomized study of intravesical pirarubicin chemotherapy with low and intermediate-risk nonmuscle-invasive bladder cancer in Japan: comparison of a single immediate postoperative intravesical instillation with short-term adjuvant intravesical instillations after transurethral resection. Medicine (Baltimore) 97:e12740CrossRef

19.

Divrik RT, Sahin AF, Yildirim U, Altok M, Zorlu F (2010) Impact of routine second transurethral resection on the long-term outcome of patients with newly diagnosed pT1 urothelial carcinoma with respect to recurrence, progression rate, and disease-specific survival: a prospective randomised clinical trial. Eur Urol 58:185–190CrossRef

20.

Divrik RT, Yildirim U, Zorlu F, Ozen H (2006) The effect of repeat transurethral resection on recurrence and progression rates in patients with T1 tumors of the bladder who received intravesical mitomycin: a prospective, randomized clinical trial. J Urol 175:1641–1644CrossRef

21.

Hurle R, Lazzeri M, Colombo P, Buffi N, Morenghi E, Peschechera R et al (2016) "En bloc" resection of nonmuscle invasive bladder Cancer: a prospective single-center study. Urology 90:126–130CrossRef

22.

Acar Ö, Özkurt E, Demir G, Saraç H, Alkan C, Esen T et al (2015) Determining the origin of synchronous multifocal bladder cancer by exome sequencing. BMC Cancer 15:871CrossRef

23.

Cauberg EC, Mamoulakis C, de la Rosette JJ, de Reijke TM (2011) Narrow band imaging-assisted transurethral resection for non-muscle invasive bladder cancer significantly reduces residual tumour rate. World J Urol 29:503–509CrossRef

24.

Chang TC, Liu JJ, Hsiao ST, Pan Y, Mach KE, Leppert JT et al (2013) Interobserver agreement of confocal laser endomicroscopy for bladder cancer. J Endourol 27:598–603CrossRef

Titel: The value of transurethral thulium laser en bloc resection combined with a single immediate postoperative intravesical instillation of pirarubicin in primary non-muscle-invasive bladder cancer
verfasst von: Sheng Xu
Shaoying Tan
Tingming Wu
Jun Gu
Lei Xu
Xianping Che
Publikationsdatum: 01.10.2020
Verlag: Springer London
Erschienen in: Lasers in Medical Science / Ausgabe 8/2020
Print ISSN: 0268-8921
Elektronische ISSN: 1435-604X
DOI: https://doi.org/10.1007/s10103-020-02960-0

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

The value of transurethral thulium laser en bloc resection combined with a single immediate postoperative intravesical instillation of pirarubicin in primary non-muscle-invasive bladder cancer

Abstract

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

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