Does Simultaneous Transurethral Resection of Bladder Tumor and Prostate Affect the Recurrence of Bladder Tumor? A Meta-Analysis

Abstract

To evaluate the efficacy and safety of simultaneous resection in the treatment of nonmuscle invasive bladder cancer (NMIBC) with benign prostatic hyperplasia (BPH). Combined published data from comparative studies on simultaneous transurethral resection of bladder tumor/transurethral resection of the prostate (TURBT/TURP) vs TURBT alone in NMIBC were analyzed, considering possible confounding factors. Odds ratios (ORs) and 95% confidence intervals (CIs) were used as the primary effect size to estimate the outcome of overall tumor recurrence, recurrence in bladder neck/prostatic fossa. In six eligible clinical trials, 483 patients were treated with simultaneous resection and 500 with TURBT alone. Within the follow-up period, tumor recurrence developed in 203 (42%) patients in the simultaneous resection group and 256 (51.2%) patients in the control group. The combined analysis indicated that the recurrence rate in the simultaneous resection group was statistically significantly lower than in the control group in the overall pooled data (combined OR = 0.67; 95% CI 0.52 to 0.88, P = 0.003). Tumor recurrence of bladder neck/prostatic fossa developed in 37(7.7%) patients in the simultaneous resection group and 42 (8.4%) patients in the control group. No statistically significant difference was found between the two groups (combined OR = 0.92; 95% CI 0.57 to 1.49, P = 0.74). Potential confounders, such as mean age, mean follow-up duration, multiplicity of tumor, and year of publication did not significantly influence the results. There was at least the evidence that simultaneous TURBT/TURP did not increase the overall recurrence rate and recurrence rate in bladder neck/prostatic fossa. Simultaneous TURBT/TURP might be preferable for patients with NMIBC and BPH.