1017 Transurethral Laser Ablation for Non-Muscle Invasive Bladder Cancer: A Service Validation

Abstract

Abstract Aim Transurethral laser ablation (TULA) for non-muscle invasive bladder cancer (NMIBC) allows outpatient treatment of suspected bladder cancer re-occurrence whilst avoiding the risks of the general anaesthetic. The COVID pandemic limited operating capacity was therefore TULA was adopted in a tertiary centre hospital in the UK in order to continue treatment for appropriate cases. We aimed to assess remission free period, the laser energy usage and waiting time for patients since the service started. Method A retrospective service evaluation since December 2020 till May 2022. All patients who were listed for TULA were eligible. Exclusion criteria was incomplete data and patients who did not have NMIBC. Demographic data, listing time, remission free period and lasering usage were all recorded. Patients were risk stratified as per the EAU guidelines; patients were upstaged to the higher category if there was incomplete data to stage accurately. Statistical analysis was conducting using a one-way ANOVA. Results 183 patients underwent TULA; 165 patients were included. The mean age was 79 years. The mean time was listing to procedure was 77 days. 72 patients had not had a flexible cystoscope post TULA. There was no significant difference between remission rates and re-occurrence rates (p = 0.544) between risk categories (p = 0.96). Conclusions The re-occurrence rates following TULA did not vary depending on the risk of NIMBC, nor did the energy usage. Longer collection periods are required to ascertain if this alters with time. Further research is required to assess if earlier treatment of more aggressive forms of NMIBC allows for lower reoccurrence rates.