A Systematic Review on the Role of Repeat Transurethral Resection after Initial en Bloc Resection for Non-Muscle Invasive Bladder Cancer
International guidelines recommend repeat transurethral resection of bladder tumors (reTURB) for selected patients with high-risk non-muscle invasive bladder cancer to remove possible residual tumors, restage tumors and improve the therapeutic outcome. However, most evidence supporting the benefits...
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MDPI AG
2022-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/17/5049 |
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| author | Henglong Hu Mengqi Zhou Binrui Yang Shiwei Zhou Zheng Liu Jiaqiao Zhang |
| author_facet | Henglong Hu Mengqi Zhou Binrui Yang Shiwei Zhou Zheng Liu Jiaqiao Zhang |
| author_sort | Henglong Hu |
| collection | DOAJ |
| description | International guidelines recommend repeat transurethral resection of bladder tumors (reTURB) for selected patients with high-risk non-muscle invasive bladder cancer to remove possible residual tumors, restage tumors and improve the therapeutic outcome. However, most evidence supporting the benefits of reTURB is from conventional TURB. The role of reTURB in patients receiving initial En bloc resection of bladder tumor (ERBT) is still unknown. PubMed, Embase, Web of Science, The Cochrane Library, and China National Knowledge Infrastructure (CNKI) were systematically searched. Finally, this systematic review and meta-analysis included twelve articles, including 539 patients. The rates of residual tumor and tumor upstaging detected by reTURB after ERBT were 5.9% (95%CI, 2.0%–11.1%) and 0.0% (95%CI, 0.0%–0.5%), respectively. Recurrence-free survival, tumor recurrence and progression were comparable between patients with and without reTURB after initial ERBT. The pooled hazard ratios of 1-year, 2-year, 3-year and 5-year recurrence-free survival were 0.74 (95%CI, 0.36–1.51; <i>p</i> = 0.40), 0.76 (95%CI, 0.45–1.26; <i>p</i> = 0.28), 0.83 (95%CI, 0.53–1.32; <i>p</i> = 0.43) and 0.83 (95%CI, 0.56–1.23; <i>p</i> = 0.36), respectively. The pooled relative risks of recurrence and progression were 0.87 (95%CI, 0.64–1.20; <i>p</i> = 0.40) and 1.11 (95%CI, 0.54–2.32; <i>p</i> = 0.77), respectively. Current evidence demonstrates that reTURB after ERBT for bladder cancer can detect relatively low rates of residual tumor and tumor upstaging and appears not to improve either recurrence or progression. |
| first_indexed | 2024-03-10T01:39:06Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T01:39:06Z |
| publishDate | 2022-08-01 |
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| spelling | doaj.art-1e57d9800ccb4a9bb59f5882cae230102023-11-23T13:26:45ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011117504910.3390/jcm11175049A Systematic Review on the Role of Repeat Transurethral Resection after Initial en Bloc Resection for Non-Muscle Invasive Bladder CancerHenglong Hu0Mengqi Zhou1Binrui Yang2Shiwei Zhou3Zheng Liu4Jiaqiao Zhang5Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, ChinaDepartment of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, ChinaDepartment of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, ChinaDepartment of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, ChinaDepartment of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, ChinaDepartment of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, ChinaInternational guidelines recommend repeat transurethral resection of bladder tumors (reTURB) for selected patients with high-risk non-muscle invasive bladder cancer to remove possible residual tumors, restage tumors and improve the therapeutic outcome. However, most evidence supporting the benefits of reTURB is from conventional TURB. The role of reTURB in patients receiving initial En bloc resection of bladder tumor (ERBT) is still unknown. PubMed, Embase, Web of Science, The Cochrane Library, and China National Knowledge Infrastructure (CNKI) were systematically searched. Finally, this systematic review and meta-analysis included twelve articles, including 539 patients. The rates of residual tumor and tumor upstaging detected by reTURB after ERBT were 5.9% (95%CI, 2.0%–11.1%) and 0.0% (95%CI, 0.0%–0.5%), respectively. Recurrence-free survival, tumor recurrence and progression were comparable between patients with and without reTURB after initial ERBT. The pooled hazard ratios of 1-year, 2-year, 3-year and 5-year recurrence-free survival were 0.74 (95%CI, 0.36–1.51; <i>p</i> = 0.40), 0.76 (95%CI, 0.45–1.26; <i>p</i> = 0.28), 0.83 (95%CI, 0.53–1.32; <i>p</i> = 0.43) and 0.83 (95%CI, 0.56–1.23; <i>p</i> = 0.36), respectively. The pooled relative risks of recurrence and progression were 0.87 (95%CI, 0.64–1.20; <i>p</i> = 0.40) and 1.11 (95%CI, 0.54–2.32; <i>p</i> = 0.77), respectively. Current evidence demonstrates that reTURB after ERBT for bladder cancer can detect relatively low rates of residual tumor and tumor upstaging and appears not to improve either recurrence or progression.https://www.mdpi.com/2077-0383/11/17/5049bladder cancerrepeat transurethral resectionre-resectionrestageen bloc resectionsystematic review |
| spellingShingle | Henglong Hu Mengqi Zhou Binrui Yang Shiwei Zhou Zheng Liu Jiaqiao Zhang A Systematic Review on the Role of Repeat Transurethral Resection after Initial en Bloc Resection for Non-Muscle Invasive Bladder Cancer Journal of Clinical Medicine bladder cancer repeat transurethral resection re-resection restage en bloc resection systematic review |
| title | A Systematic Review on the Role of Repeat Transurethral Resection after Initial en Bloc Resection for Non-Muscle Invasive Bladder Cancer |
| title_full | A Systematic Review on the Role of Repeat Transurethral Resection after Initial en Bloc Resection for Non-Muscle Invasive Bladder Cancer |
| title_fullStr | A Systematic Review on the Role of Repeat Transurethral Resection after Initial en Bloc Resection for Non-Muscle Invasive Bladder Cancer |
| title_full_unstemmed | A Systematic Review on the Role of Repeat Transurethral Resection after Initial en Bloc Resection for Non-Muscle Invasive Bladder Cancer |
| title_short | A Systematic Review on the Role of Repeat Transurethral Resection after Initial en Bloc Resection for Non-Muscle Invasive Bladder Cancer |
| title_sort | systematic review on the role of repeat transurethral resection after initial en bloc resection for non muscle invasive bladder cancer |
| topic | bladder cancer repeat transurethral resection re-resection restage en bloc resection systematic review |
| url | https://www.mdpi.com/2077-0383/11/17/5049 |
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