In patients with NMIBC, FC-assisted TUR with 5-ALA results in a substantial recurrence and progression risk reduction as compared to WL-TUR. The single early postoperative instillation of doxorubicin did not have a statistically significant impact on recurrence and progression risks.

IntroductionOne of the factors responsible for the risk of recurrence after complete transurethral resection of the bladder tumor (TURBT) in patients with non-muscle invasive bladder cancer (NMIBC) is the quality of surgery that may vary between individual surgeons. The aim of the study was to evaluate the impact of the surgeon on recurrence-free survival in patients with NMIBC.Material and methodsThe long-term results of a series of consecutive TURBTs performed by five staff urologists at a single institution were retrospectively analyzed. A total of 949 cases of organ-preserving treatment in 784 patients with NMIBC were included in the analysis.ResultsWith the median follow-up of 64.3 months (3–124 months), the 5-year recurrence-free survival rates according to the surgeon were 62.9% (95% CI 56.2–69.7%), 53.6% (95% CI 47.4–59.9%), 51.0% (95% CI 39.6–62.4%), 46.2% (95% CI 36.4–56.0%), and 44.2% (95% CI 36.8–51.7%), respectively (p <0.0001). In the multivariate analysis including all potential risk factors, the individual surgeon was associated with a risk of recurrence with a high degree of statistical significance (p = 0.0013). The between-surgeon differences in the recurrence risk were not that pronounced in less extensive tumors.ConclusionsA surgeon has a significant impact on the risk of recurrence after curative treatment of patients with NMIBC. This effect was observed despite the relatively extensive experience in bladder endoscopic surgery of all of the surgeons and practicing in a setting of one specialized center. These findings should be taken into account while performing and evaluating the results of comparative studies.

urinary bladder neoplasms ‹› chemotherapy ‹› adjuvant ‹› antineoplastic combined chemotherapy protocols ‹› cystectomy ‹› randomized controlled trial ‹› survival analysis Citation: Zhegalik AG, Polyakov SL, Rolevich AI, et al. Long-term results of a single-center prospective randomized trial assessing efficacy of a shortened course of adjuvant chemotherapy after radical cystectomy in patients with locally advanced bladder cancer. Cent European J Urol. 2020; 73: 26-32.in patients with pathologically locally advanced bladder cancer does not exceed 50% [3,4]. Neoadjuvant cisplatin-based combination chemotherapy is a standard strategy to improve treatment outcomes in patients with muscle-invasive bladder cancer undergoing RC with level 1 evidence of survival benefit [5]. However, adjuvant chemotherapy (AC) can be an alternative approach, the advantage of which is a more accurate selection of patients * including one febrile neutropenia case; ** the total exceeds 100% as several adverse events could be observed in one patient; AST -aspartate aminotransferase; ALT -alanine aminotransferase

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