Comparison of Pathological Outcome and Recurrence Rate between En Bloc Transurethral Resection of Bladder Tumor and Conventional Transurethral Resection: A Meta-Analysis

Abstract

Current treatment for non-muscle invasive bladder cancer (NMIBC) is the conventional transurethral resection of bladder tumor (CTURBT), but the en bloc transurethral resection of bladder tumor (ERBT) has been gaining more attraction in recent years considering better specimen integrity. Thus, we conducted this meta-analysis to compare the safety and efficacy of ERBT versus CTURBT. Trials were collected from an online database. The primary outcomes included identification of detrusor muscle in specimen, residual tumor, 3, 12, and 24-month recurrence rates and same-site recurrence rate. A total of 31 trials were included. The ERBT group had a higher rate of identification of detrusor muscle in specimens (p = 0.003) and lower residual tumor (p < 0.001). Other than that, lower rates of 3-month (p = 0.005) and 24-month recurrence rate (p < 0.001), same-site recurrence rate (p < 0.001) and complications were also observed. For perioperative outcomes, shorter hospitalization time (HT) (p < 0.001), and catheterization time (CT) (p < 0.001) were also revealed in the ERBT group. No significant difference was found in operative time (OT) (p = 0.93). The use of ERBT showed better pathological outcomes and fewer complications, so it could be considered a more effective treatment option for NMIBC.

Efficiency of transurethral en‐bloc resection vs. conventional transurethral resection for non‐muscle‐invasive bladder cancer: An umbrella review

“…When compared to cTURBT, ERBT has shown a notable association with reduced rates of bladder perforation and ONR, suggesting that it may offer a safer surgical alternative for NMIBC patients. 16,[18][19][20][21][22] The pooled ORT result reported by Teoh et al 16 exhibited disparities from the findings of other five meta-analyses. [18][19][20][21][22] In our metaanalysis, comprised of five studies, ERBT and cTURBT required a similar amount of time to complete the surgery.…”

“…Recently, these problems are discussed in several studies (including meta-analysis and RCT). 17,22,31 Using a combination of umbrella review and meta-analysis, we demonstrated that ERBT had a better or comparable perioperative outcome than cTURBT. Furthermore, NMIBC patients undergoing ERBT exhibited improved 3 and 12 month RFS compared to those receiving cTURBT.…”

“…Furthermore, surrounding perioperative outcomes, there are still some controversies between ERBT and cTURBT. For instance, most meta-analyses [18][19][20][21][22] indicated that ERBT and cTURBT required similar operation times. However, one metaanalysis reported that ERBT would require more time for tumor resection.…”

Comparative Analysis of En-Bloc and Conventional Transurethral Resection of Bladder Tumor (TURBT) for Non-Muscle Invasive Bladder Cancer: A Systematic Review and Meta-Analysis

“…However, the standard TURBT is thought to have some problems, such as the fact that it removes tumor cells partially and doesn't include the detrusor muscle in the specimen. This removal method doesn't follow the basic rules of oncological surgery, which means it can't effectively find and treat bladder cancer (Kim & Patel, 2020a;Wang et al, 2023). In the past few years, improvements in medical tools like surgical techniques and instruments, as well as micro or small tumor imaging, have made it possible for more than one way to be used instead of conventional TURBT (Kramer et al, 2017).…”

Rotatable Bi-Channel En Bloc Resection of Bladder Tumor for Non-Muscle-Invasive Bladder Cancer in an Ex Vivo Porcine Model

“…En bloc resection of bladder tumor (ERBT) has emerged as a promising alternative. This technique offers several potential advantages, such as the ability to resect the tumor and its base as a single piece and improved specimen collection for accurate pathological assessment with increased DM sampling [6,7]. Additionally, ERBT may lead to reduced perioperative complications, a decreased risk of tumor shedding and implantation, and potentially lower recurrence rates [8][9][10].…”