Efficiency of transurethral en-bloc resection vs. conventional transurethral resection for non-muscle-invasive bladder cancer: An umbrella review.

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  • Additional Information
    • Source:
      Publisher: John Wiley & Sons Ltd Country of Publication: United States NLM ID: 101595310 Publication Model: Print Cited Medium: Internet ISSN: 2045-7634 (Electronic) Linking ISSN: 20457634 NLM ISO Abbreviation: Cancer Med Subsets: MEDLINE
    • Publication Information:
      Original Publication: [Malden, MA] : John Wiley & Sons Ltd., c2012-
    • Subject Terms:
      Urinary Bladder Neoplasms*/surgery ; Urinary Bladder Neoplasms*/pathology ; Cystectomy*/methods; Humans ; Treatment Outcome ; Urethra/surgery ; Neoplasm Invasiveness ; Non-Muscle Invasive Bladder Neoplasms
    • Abstract:
      Background: En-Bloc transurethral resection of bladder tumor (ERBT) was clinically used to resect non-muscle-invasive bladder cancer (NMIBC). However, discrepancies persist regarding the comparisons between ERBT and conventional transurethral resection of bladder tumor (cTURBT).
      Methods: We conducted a comprehensive search in PubMed, Embase, Web of Science, Cochrane Database of Systematic Reviews, and performed manual searches of reference lists to collect and extract data. Data evaluation was carried out using Review Manager 5.4.0, Rx64 4.1.3, and relevant packages.
      Results: There were nine eligible meta-analyses and nine eligible RCTs in our study. NMIBC patients undergoing ERBT were significant associated with a lower rate of bladder perforation and obturator nerve reflex compared to those receiving cTURBT. Our pooled result indicated that ERBT and cTURBT required similar operation time. Regarding postoperative outcomes, ERBT demonstrated superior performance compared to cTURBT in terms of detrusor muscle presence, catheterization time, and residual tumor. ERBT exhibited a higher rate of three-month recurrence-free survival (RFS) compared to those receiving cTURBT (p < 0.05; I 2  = 0%). In bipolar subgroup, ERBT had a significant better 12-month RFS than cTURBT (p < 0.05; I 2  = 0%). Simultaneously, the exclusion of Hybrid Knife data revealed a significant improvement in 12-month RFS associated with ERBT (p < 0.05; I 2  = 50%).
      Conclusion: Using a combination of umbrella review and meta-analysis, we demonstrated that ERBT had better or comparable perioperative outcome and improved 3 and 12 month RFS than cTURBT. We suggest that ERBT maybe a better surgical method for patients with NMIBC compared with cTURBT.
      (© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)
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    • Contributed Indexing:
      Keywords: En bloc resection of bladder tumor; bladder cancer; transurethral resection of bladder tumor; urothelial carcinoma
    • Publication Date:
      Date Created: 20240531 Date Completed: 20240531 Latest Revision: 20241108
    • Publication Date:
      20241108
    • Accession Number:
      PMC11141332
    • Accession Number:
      10.1002/cam4.7323
    • Accession Number:
      38819629