You have accessJournal of UrologyBladder Cancer: Non-invasive I (PD09)1 Sep 2021PD09-06 EN-BLOC VERSUS CONVENTIONAL TRANSURETHRAL RESECTION OF BLADDER TUMORS: INTERIM ANALYSIS OF A SINGLE-CENTER PROSPECTIVE RANDOMIZED TRIAL Pietro Diana, Matteo Fontana, Angelo Territo, Andrea Gallioli, Alberto Piana, Asier Marcadé, Sofia Fontanet, Ferran Algaba, Óscar Rodriguez-Faba, Josep Maria Gaya, Joan Palou, and Alberto Breda Pietro DianaPietro Diana More articles by this author , Matteo FontanaMatteo Fontana More articles by this author , Angelo TerritoAngelo Territo More articles by this author , Andrea GallioliAndrea Gallioli More articles by this author , Alberto PianaAlberto Piana More articles by this author , Asier MarcadéAsier Marcadé More articles by this author , Sofia FontanetSofia Fontanet More articles by this author , Ferran AlgabaFerran Algaba More articles by this author , Óscar Rodriguez-FabaÓscar Rodriguez-Faba More articles by this author , Josep Maria GayaJosep Maria Gaya More articles by this author , Joan PalouJoan Palou More articles by this author , and Alberto BredaAlberto Breda More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001977.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transurethral resection of bladder tumor (TURBT) is considered the gold standard in the diagnosis and risk stratification bladder cancer (BC). En-bloc resection of bladder tumor (ERBT) has been proposed to improve resection quality. Recently, the International Collaborative Consensus Statement on ERBT underlined the lack of high-quality prospective studies precluding the achievement of solid conclusion on ERBT. The aim of this study is to compare TURBT and ERBT in terms of pathological diagnosis, surgical, and oncological outcomes. METHODS: This study is an ongoing, prospective, randomized trial enrolling patients diagnosed with BC and undergoing endoscopic intervention. Inclusion criteria were with tumor size of <3 cm, and ≤3 lesions, and no sign of muscle invasion and/or ureteral involvement. The primary outcome is the staging of BC. Secondary outcomes included T1 substaging (microstaging systems T1a/b/c), intraoperative complications, rate of adjuvant treatment, postoperative complications, oncologic outcomes. A total of 300 subjects will be included in the study with 1:1.5 treatment allocation for ERBT. The trial (NCT04712201) was approved by the Institutional Review Board (2017/09c). RESULTS: From 03/2018 to 01/2020, 180 patients met inclusion criteria and 158 (87.8%) of these were underwent the assigned intervention. 64 (40.5%) and 94 (59.5%) patients were submitted to TURBT and ERBT. Pre-operatively, the populations were comparable. Table 1 shows the pathological results per lesion. The rate of Tx was comparable (3.4% TURBT vs 3.7% ERBT). T1 substaging was feasible in 80% TURBT vs 100% ERBT (p=0.07). The rate of obturator nerve reflex and perforation were comparable (both p=0.3). Adjuvant treatment was planned in 84% and 94% in TURBT and ERBT (p=0.1). Clavien-Dindo >2 complications were 5.3% vs 3.1% for TURBT and ERBT. Surgical, irrigation, and catheterization time were all comparable (all p >0.2). Recurrence at 3 months was 3.1% vs 2.1% in TURBT and ERBT (p=0.7). CONCLUSIONS: According to our interim analysis ERBT and TURBT have comparable results in terms pathological, surgical, and oncological outcomes, while ERBT shows a tendency to significance in T1 substaging feasibility. This is the first randomized study in this setting and it is warranted to define the role of ERBT. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e121-e121 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Pietro Diana More articles by this author Matteo Fontana More articles by this author Angelo Territo More articles by this author Andrea Gallioli More articles by this author Alberto Piana More articles by this author Asier Marcadé More articles by this author Sofia Fontanet More articles by this author Ferran Algaba More articles by this author Óscar Rodriguez-Faba More articles by this author Josep Maria Gaya More articles by this author Joan Palou More articles by this author Alberto Breda More articles by this author Expand All Advertisement Loading ...
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