You have accessJournal of UrologyCME1 May 2022MP59-11 EN BLOC RESECTION FOR BLADDER TUMORS: AN UPDATED SYSTEMATIC REVIEW AND META-ANALYSES OF ITS DIFFERENTIAL EFFECT ON ITS SAFETY, HISTOPATHOLOGY AND, RECURRENCE Takafumi Yanagisawa, Keiichiro Mori, Reza Sari Motlagh, Tatsushi Kawada, Hadi Mostafaei, Fahad Quhal, Ekaterina Laukhtina, Pawel Rajwa, Frederik König, Maximilian Pallauf, Benjamin Pradere, David D'Andrea, Eva Compérat, Jun Miki, Takahiro Kimura, Shin Egawa, and Shahrokh F. Shariat Takafumi YanagisawaTakafumi Yanagisawa More articles by this author , Keiichiro MoriKeiichiro Mori More articles by this author , Reza Sari MotlaghReza Sari Motlagh More articles by this author , Tatsushi KawadaTatsushi Kawada More articles by this author , Hadi MostafaeiHadi Mostafaei More articles by this author , Fahad QuhalFahad Quhal More articles by this author , Ekaterina LaukhtinaEkaterina Laukhtina More articles by this author , Pawel RajwaPawel Rajwa More articles by this author , Frederik KönigFrederik König More articles by this author , Maximilian PallaufMaximilian Pallauf More articles by this author , Benjamin PradereBenjamin Pradere More articles by this author , David D'AndreaDavid D'Andrea More articles by this author , Eva CompératEva Compérat More articles by this author , Jun MikiJun Miki More articles by this author , Takahiro KimuraTakahiro Kimura More articles by this author , Shin EgawaShin Egawa More articles by this author , and Shahrokh F. ShariatShahrokh F. Shariat More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002642.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: En bloc resection for bladder tumors (ERBT) has been developed to overcome the shortcomings of conventional transurethral resection of bladder tumors (cTURBT) with regards to safety, pathologic evaluation and oncologic outcomes. However, the potential benefits of utility compared with cTURBT have not been conclusively demonstrated. This systematic review and meta-analysis aimed to update the current evidence with focus on the pathologic benefits of ERBT for non-muscle invasive bladder cancer (NMIBC). METHODS: Multiple databases were searched for articles published before August 2021. Studies were deemed eligible if they compared safety, pathologic and clinical outcomes in patients who underwent ERBT with those who underwent cTURBT. RESULTS: Overall, 13 randomized clinical trials (RCTs) and 16 non-RCTs (NRCTs)/ observational studies comprising 4,484 patients were eligible for this meta-analysis. Among 13 RCTs, the pooled 12- and 24-months recurrence risk ratio (RR) were not different between the two surgical techniques (0.96 [95% Confidence Intervals (CI); 0.74- 1.23] and 0.83 [95% CI; 0.55- 1.23], respectively). The pooled RR for bladder perforation was 0.13 (95% CI; 0.05-0.34) in favor of ERBT. The differential rates of detrusor muscle (DM) presence (Pooled RR: 0.77, 95% CI: 0.70-0.85), of detectable muscularis mucosae (MM) (Pooled RR: 0.44, 95% CI: 0.27-0.71) and of evaluable surgical margins (Pooled RR: 0.28, 95% CI: 0.21-0.38) were all more likely in patients receiving ERBT. Patients who underwent ERBT had a lower rate of residual tumor at repeat TURBT (reTUR) than those treated with cTURBT (RR: 0.47, 95% CI: 0.31- 0.71). CONCLUSIONS: ERBT seems to be safer and to yield superior histopathologic information and performance compared to cTURBT in patients with NMIBC. Despite the failure to improve the recurrence rate, the more accurate histopathologic analysis is likely to improve clinical decision-making and core delivery in NMIBC. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e1005 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Takafumi Yanagisawa More articles by this author Keiichiro Mori More articles by this author Reza Sari Motlagh More articles by this author Tatsushi Kawada More articles by this author Hadi Mostafaei More articles by this author Fahad Quhal More articles by this author Ekaterina Laukhtina More articles by this author Pawel Rajwa More articles by this author Frederik König More articles by this author Maximilian Pallauf More articles by this author Benjamin Pradere More articles by this author David D'Andrea More articles by this author Eva Compérat More articles by this author Jun Miki More articles by this author Takahiro Kimura More articles by this author Shin Egawa More articles by this author Shahrokh F. Shariat More articles by this author Expand All Advertisement PDF DownloadLoading ...