Prognostic value of transurethral secondary electrotomy in pT1 stage non-muscular invasive bladder cancer

doi:10.3877/cma.j.issn.1674-3253.2022.04.007

Abstract

Abstract:

Objective

To evaluate the effect of routine second transurethral cystectomy (STURBT) on the long-term prognosis of newly diagnosed pT₁ non-muscular invasive bladder cancer (NMIBC).

Methods

This study retrospectively analyzed 256 patients with T₁ stage NMIBC who received treatment in our hospital, including 126 patients who received TURBT and 130 patients who received STURBT. The prognosis of the two surgical methods was evaluated by medical records and following up. Recurrence and death were recorded in both groups. Finally, the total rate of disease recurrence (DRR), disease-specific mortality (DSM), 2-year, 4-year and 6-year recurrence free survival (RFS) and overall survival (OS) were compared and analyzed as indicators of the two groups.

Results

The follow-up time of the two groups was 6 years, and the DRR (42.1% vs 61.9%, P=0.001) and DSM (23.1 vs 35.7%, P=0.026) of the STURBT group were significantly reduced compared with TURBT group. 4-year and 6-year RFS (59.2% vs 44.4%, P=0.018; 55.4% vs 38.1%, P=0.006) significantly increased; 6-year OS (76.2 % vs 64.3%, P=0.038) was also significantly higher. The RFS and OS curves constructed by Kaplan-Meier method showed statistical difference (RFS: P=0.001; OS: P=0.029), RFS and OS in STURBT group were superior to those in TURBT group.

Conclusion

The prognostic value of STURBT in pT₁ NMIBC patients was not only beneficial to patients' RFS, but also to patients' long-term OS.

Key words: Bladder cancer, Secondary electrotomy, Overall survival, Prognosis

Yonglu Zhao, Xingsheng Zhang, Guangzhi Song, Bin Huang, Bin Zhang, Pengshou Gu, Guogan Liu. Prognostic value of transurethral secondary electrotomy in pT₁ stage non-muscular invasive bladder cancer[J]. Chinese Journal of Endourology(Electronic Edition), 2022, 16(04): 316-319.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2022.04.007

https://zhqjmnmwkzz.cma-cmc.com.cn/EN/Y2022/V16/I04/316

Figures/Tables 4

References 17

[1]	Babjuk M, Böhle A, Burger M, et al. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2016 [J]. Eur Urol, 2017, 71(3): 447-461.
[2]	Torre LA, BRAY F, Siegel RL, et al. Global cancer statistics, 2012[J]. CA: a Cancer J Clin, 2015, 65(2): 87-108.
[3]	Ro JY, Staerkel GA, Ayala AG. Cytologic and histologic features of superficial bladder cancer[J]. Urol Clin North Am, 1992, 19(3): 435-453.
[4]	黄健，郭应禄，那彦群, 等. 中国泌尿外科和男科疾病诊断治疗指南手册: 2019版[M]. 科学出版社, 2019.
[5]	Shen Z, Xie L, Chen T, et al. Risk factors predictive of recurrence and progression for patients who suffered initial recurrence after transurethral resection of stage pt1 bladder tumor in chinese population: a retrospective study [J]. Medicine, 2016, 95(5): e2625.
[6]	Divrik RT, Sahin AF, Yildirim U, et al. 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 [J]. Eur Urol, 2010, 58(2): 185-190.
[7]	Divrik T, Yildirim U, Eroğlu AS, et al. Is a second transurethral resection necessary for newly diagnosed pT1 bladder cancer? [J]. J Urol, 2006, 175(4): 1258-1261.
[8]	Rigaud J, Karam G, Braud G, et al. T1 bladder tumors: value of a second endoscopic resection] [J]. Prog Urol，2002, 12(1): 27-30.
[9]	Zurkirchen MA, Sulser T, Gaspert A, et al. Second transurethral resection of superficial transitional cell carcinoma of the bladder: a must even for experienced urologists [J]. Urol Int, 2004, 72(2): 99-102.
[10]	Vögeli TA, Grimm MO, Simon X, et al. Prospective study of effectiveness. Reoperation (re-TUR) in superficial bladder carcinoma[J]. Der Urologe Ausg A, 2002, 41(5): 470-440.
[11]	Schips L, Augustin H, Zigeuner RE, et al. Is repeated transurethral resection justified in patients with newly diagnosed superficial bladder cancer?[J]. Urology, 2002, 59(2): 220-223.
[12]	Jakse G, Algaba F, Malmström PU, et al. A second-look TUR in T1 transitional cell carcinoma: why? [J]. Eur Urol, 2004, 45(5): 539-546.
[13]	Engilbertsson H, Aaltonen KE, Björnsson S, et al. Transurethral bladder tumor resection can cause seeding of cancer cells into the bloodstream[J]. J Urol, 2015, 193(1): 53-57.
[14]	Divrik RT, Yildirim U, Zorlu F, et al. 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]. J Urol, 2006, 175(5): 1641-1644.
[15]	Cumberbatch MGK, Foerster B, Catto JWF, et al. Repeat transurethral resection in non-muscle-invasive bladder cancer: a systematic review [J]. Eur Urol, 2018, 73(6): 925-933.
[16]	Kim W, Song C, Park S, et al. Value of immediate second resection of the tumor bed to improve the effectiveness of transurethral resection of bladder tumor [J]. J Endourol, 2012, 26(8): 1059-1064.
[17]	Herr HW. Restaging transurethral resection of high risk superficial bladder cancer improves the initial response to bacillus Calmette-Guerin therapy [J]. J Urol, 2005, 174(6): 2134-2137.

组别	例数	年龄(岁)	性别(例)		肿瘤大小(例)				肿瘤分级(例)
			男	女	单发		多发		低	高
			男	女	<3 cm	≥3 cm	<3 cm	≥3 cm	低	高
TURBT组	126	64±19	110	16	29	12	52	33	69	57
STURBT组	130	64±17	112	18	32	11	49	38	67	63
统计值		t=0.457	χ²=0.073		χ²=0.143		χ²=0.418		χ²=0.267
P值		0.638	0.787		0.705		0.518		0.605

组别	例数	年龄(岁)	性别(例)		肿瘤大小(例)				肿瘤分级(例)
			男	女	单发		多发		低	高
			男	女	<3 cm	≥3 cm	<3 cm	≥3 cm	低	高
TURBT组	126	64±19	110	16	29	12	52	33	69	57
STURBT组	130	64±17	112	18	32	11	49	38	67	63
统计值		t=0.457	χ²=0.073		χ²=0.143		χ²=0.418		χ²=0.267
P值		0.638	0.787		0.705		0.518		0.605

组别	例数	复发[例(%)]	疾病特异性死亡[例(%)]	无复发生存率(%)			总生存率(%)
组别	例数	复发[例(%)]	疾病特异性死亡[例(%)]	2年	4年	6年	2年	4年	6年
TURBT组	126	78（61.9）	45（35.7）	53.2	44.4	38.1	90.5	77.0	64.3
STURBT组	130	53（42.1）	30（23.1）	64.6	59.2	55.4	90.8	80.8	76.2
χ²值		11.439	4.933	3.462	5.604	7.681	0.006	0.551	4.318
P值		0.001	0.026	0.063	0.018	0.006	0.936	0.458	0.038

组别	例数	复发[例(%)]	疾病特异性死亡[例(%)]	无复发生存率(%)			总生存率(%)
组别	例数	复发[例(%)]	疾病特异性死亡[例(%)]	2年	4年	6年	2年	4年	6年
TURBT组	126	78（61.9）	45（35.7）	53.2	44.4	38.1	90.5	77.0	64.3
STURBT组	130	53（42.1）	30（23.1）	64.6	59.2	55.4	90.8	80.8	76.2
χ²值		11.439	4.933	3.462	5.604	7.681	0.006	0.551	4.318
P值		0.001	0.026	0.063	0.018	0.006	0.936	0.458	0.038

Please choose a citation manager

Content to export

Prognostic value of transurethral secondary electrotomy in pT₁ stage non-muscular invasive bladder cancer

RichHTML

PDF (PC)

Knowledge

Cited

Abstract

Cite this article

share this article

Figures/Tables 4

References 17

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	Kang Ying, Canying Yang, Fengzhen Liu, Lili Chen, Yanna Liu. Prognostic value of left ventricular myocardial strain in asymptomatic patients with severe aortic stenosis [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 581-587.
[2]	Yuezhou Li, Kongxi Zhang, Xiaohong Li, Zhonghua Shang. Prognostic significance of PUM in gastric carcinoma based on bioinformatics analysis [J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(06): 426-432.
[3]	Jun Zhang, Zai Luo, Mingyu Duan, Zhengjun Qiu, Chen Huang. Research progress of prognostic prediction models for gastric cancer [J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(06): 456-461.
[4]	Peizhong Shang, Runping Zhang, Wei Zhang, Guohong Jia, Xiaowu Li, Jianjun Miao, Bing Liu. Clinical application of novel techniques for obstructive jaundice prevention and treatment: a single-center study [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 104-107.
[5]	Qian Yang, Cuifang Li, Wanqiu Zhang. Analysis of short-term and long-term prognosis and influencing factors of primary liver cancer with spontaneous ruptured hemorrhage after emergency TACE surgery [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 33-36.
[6]	Yansong Li, Huimin Feng, Mingchao Liu, Zepeng Liu, Qiuxia Jiang. Expression and clinical significance of STIP1 in triple negative breast cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 52-56.
[7]	Zhenjian Jiang, Ming Jiang, Dali Huang. The expression and prognostic value of TK1 and Ki67 proteins in differentiated thyroid carcinoma [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 623-626.
[8]	Qingyan Yan, Xiaomei Yong, Hong Luo, Min Du. Prognostic factors and survival analysis of multicenter elderly patients with metastatic breast cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 636-638.
[9]	Xin Lu, Jiayi Xu, Yang Liu, Qin Yang, Wenwen Ju, Yinglong Xu. Comparison of the effects of early LC and PTCD continuous LC on liver function and prognosis of patients with acute cholecystitis [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 648-650.
[10]	Ming Jiang, Rui Luo, Chengchao Long. Diagnosis and treatment of obturator hernia: An experience of 73 cases over 10 years [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(06): 706-710.
[11]	Bing Pan, Shaocheng Lyu, Xin Zhao, Lixin Li, Ren Lang, Qiang He. Effect of number of dissected lymph nodes on efficacy of pancreaticoduodenectomy for distal cholangiocarcinoma [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(06): 608-612.
[12]	Yongsheng Li, Jiahe Sun, Shuwei Guo, Yikang Lu, Hongzhou Liu. Short-term postoperative complications and their influencing factors in elderly patients with colorectal cancer [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(9): 962-967.
[13]	Jun Wang, Kunpeng Liu, Lan Yao, Hua Zhang, Yue Wei, Libin Suo, Jun Chen, chengli Miao, Chenghua Luo. Retrospective analysis of anesthesia management of massive transfusion patients undergoing retroperitoneal tumor resection [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(08): 844-849.
[14]	Libin Suo, Kunpeng Liu, Lan Yao, Hua Zhang, Yue Wei, Jun Wang, Jun Chen, Chengli Miao, Chenghua Luo. Key points of anesthesia management and prognostic factors in patients undergoing primary retroperitoneal paraganglioma resection [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(07): 771-776.
[15]	Shidong Deng, Lingzhi Liu, Dayong Guo, Chao Wang, Zhongxin Huang, Huihui Zhang. Effects of SNHG1 gene silencing on proliferation, apoptosis, migration, and ferroptosis of bladder cancer cells [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(07): 804-811.

模态框（Modal）标题

Please choose a citation manager

Content to export