The value of transurethral en-bloc resection of bladder tumor in pathological sub-staging of T1 stage bladder cancer

doi:10.3877/cma.j.issn.1674-3253.2025.03.004

Abstract

Abstract:

Objective

To investigate the significance of en-bloc resection of bladder tumor（ERBT） in the pathological sub-staging of T₁ stage bladder cancer.

Methods

Data of T₁ stage bladder cancer （BC） patients who underwent ERBT or conventional transurethral resection of bladder tumor （cTURBT） done by a same surgeon from January 2017 to January 2019 were collected to make retrospective analysis.All patients were T₁ stage， diagnosed as primary BC with no more than 3 tumors and no more than 3.5 cm in diameter.Tumor sections stained by hematoxylin-eosin （HE） were collected and the T_1m/e sub-staging diagnosis was performed， and postoperative tumor recurrence was followed up.

Results

A total of 120 cases were enrolled， in which 52 cases treated with ERBT and 68 cases with cTURBT.There was no significant difference in gender， mean age， tumor size and number between the two groups.The average follow-up time for the ERBT group and cTURBT group was （22±11） months and （21±12）months， respectively.Kaplan-Meier survival curve found no significant difference in RFS between ERBT and cTURBT group （P＞0.05）， but the ERBT group had significant advantages in muscle layer detection rate and T_1m/e sub-staging success rate （P＜0.05）.There was a statistically significant difference in RFS between T_1m patients and T_1e patients after comparing the T_1m/e sub-staging of patients in the ERBT group（P=0.039）.

Conclusions

ERBT takes smore advantages in providing high quality pathological samples and improving sub-staging accuracy.T_1m/e sub-staging system has certain advantages and application value in evaluating the prognosis of T₁ stage bladder cancer.

Key words: En-bloc resection of bladder tumor, Bladder cancer, Sub-staging, Prognosis

Yunkai Qie, Zhe Zhang, Shan Liang, Zhouliang Wu, Yuzhu Li, Chenghui Fu, Chong Shen, Hailong Hu. The value of transurethral en-bloc resection of bladder tumor in pathological sub-staging of T1 stage bladder cancer[J]. Chinese Journal of Endourology(Electronic Edition), 2025, 19(03): 303-308.

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URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2025.03.004

https://zhqjmnmwkzz.cma-cmc.com.cn/EN/Y2025/V19/I03/303

Figures/Tables 6

组别	例数	性别（例）		年龄［岁，（ $\overset{ˉ}{x}$ ± s ）］	肿瘤长径（例）		肿瘤数目（ $\overset{ˉ}{x}$ ± s ）
组别	例数	男	女	年龄［岁，（ $\overset{ˉ}{x}$ ± s ）］	＜3 cm	3～3.5 cm	肿瘤数目（ $\overset{ˉ}{x}$ ± s ）
ERBT组	52	44	8	68±10	42	10	1.2±0.6
cTURBT组	68	57	11	69±10	54	14	1.3±0.6
统计值		χ ²=0.014		t=0.601	χ ²=0.034		t=1.181
P值		0.906		0.549	0.854		0.240

组别	例数	性别（例）		年龄［岁，（ $\overset{ˉ}{x}$ ± s ）］	肿瘤长径（例）		肿瘤数目（ $\overset{ˉ}{x}$ ± s ）
组别	例数	男	女	年龄［岁，（ $\overset{ˉ}{x}$ ± s ）］	＜3 cm	3～3.5 cm	肿瘤数目（ $\overset{ˉ}{x}$ ± s ）
ERBT组	52	44	8	68±10	42	10	1.2±0.6
cTURBT组	68	57	11	69±10	54	14	1.3±0.6
统计值		χ ²=0.014		t=0.601	χ ²=0.034		t=1.181
P值		0.906		0.549	0.854		0.240

组别	例数	可见肌层［例（%）］	可pT_1m/e亚分期［例（%）］
ERBT组	52	49（94.2）	50（96.2）
cTURBT组	68	51（75.0）	40（58.8）
χ ²值		7.846	21.900
P值		0.005	＜0.001

组别	例数	可见肌层［例（%）］	可pT_1m/e1亚分期［例（%）］	基底焦痂厚度［mm，（ $\overset{ˉ}{x}$ ± s ）］
等离子	40	37（92.5）	38（95.0）	1.01±0.13
激光	12	12（100）	12（100）	1.22±0.16
统计值		χ ²=0.955	χ ²=0.624	t=4.973
P值		0.328	0.430	＜0.001

组别	例数	可见肌层［例（%）］	可pT_1m/e1亚分期［例（%）］	基底焦痂厚度［mm，（ $\overset{ˉ}{x}$ ± s ）］
等离子	40	37（92.5）	38（95.0）	1.01±0.13
激光	12	12（100）	12（100）	1.22±0.16
统计值		χ ²=0.955	χ ²=0.624	t=4.973
P值		0.328	0.430	＜0.001

组别	例数	pT_1m/e亚分期［例（%）］			复发	1年RFS［%(95%CI）］
组别	例数	pT_1m	pT_1e	pT_1m/e不可分	复发	1年RFS［%(95%CI）］
ERBT组	52	27（51.9）	23（44.2）	2（3.8）	14（26.9）	81.5（71.2～93.1）
cTURBT组	68	25（36.8）	15（22.1）	28（41.2）	23（33.8）	80.3（70.8～91.0）
χ ²值			42.568		0.658
P值			＜0.001		0.417	0.761

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