Abstract
You have accessJournal of UrologyBladder Cancer: Invasive IV1 Apr 2018MP47-02 EN BLOC TRANSURETHRAL RESECTION WITH HYBRID KNIFE FOR TREATMENT PRIMARY NON-MUSCLE-INVASIVE BLADDER CANCER: A SINGLE-CENTER, CONTROLLED TRIAL BASED ON PATHOLOGICAL STAGING jia hu jia hujia hu More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1481AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the pathological stage (Primary outcome), clinic safety and annual recurrence rate (Secondary outcome) of en bloc transurethral resection with Hybrid Knife as treatment for primary NMIBC compared to conventional TURBT. METHODS This was a single-center and controlled trial. From March 2016 to October 2016, 93 patients with newly diagnosed NMIBC by ultrasonography, CT scan and cystoscopy that were enrolled. Of all the 93 patients, 71 were males and 22 females. Mean age 57.1years(range 41-80y). All patients were assigned in a 1:1 ratio to receive either Hybrid Knife En bloc transurethral treatment (ERBT) (n=46) or TURBT (n=47). The clinical characteristics of the patients in each group, such as age, gender, BMI index, the number of tumor and tumor size had no significant differences(P>0.05). Patients with tumor number more than 5, diameter of tumor >3cm or <1cm, CIS were ruled out. Specimens for ERBT group were given standardized sampling. All patients received intravesical chemotherapy postoperation. After 12-18 month follow-up, patients underwent imaging and cystoscopy examinations. Primary outcome measure was difference of the pathological stage at the end of study. Secondary outcome measure were clinic safety and annual recurrence rate. RESULTS Number of low risk NMIBC patients (TaG1) was lower in the ERBT group vs. TURBT group (18 vs. 26, P <0.05). However, number of moderate and high risk NMIBC patients (T1a, T1b,TaG2, TaG3 Staging) was higher in the ERBT group vs. TURBT group (29 vs. 20, P <0.05), of which ERBT group detected 8 cases of T1b patients, significantly higher than TURBT group (1 cases). Major intraoperative or postoperative complications did not occur in all of the patients. Operation time was longer in ERBT group than in TURBT group when tumor size more than 3cm and tumor number more than three (45,1 ± 18.7 vs. 39.2 ± 19.1 min, P <0.05). According to Kaplan–Meier survival curves, there was no statistical difference in the annual recurrence rate in 12-18 months (P = 0.079). CONCLUSIONS En bloc transurethral resection with Hybrid Knife for treatment primary NMIBC is a safe, effective. Compared to TURBT, it can reserve tumor margins and basal completely and clearly, then can be accurately detected more NMIBC patients with moderate and high risk of pathological staging, especially T1b staging, which is helpful to judge the prognosis of the patients. Further studies need to be clarify the difference of tumor recurrence rate of two groups. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e615 Advertisement Copyright & Permissions© 2018MetricsAuthor Information jia hu More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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