Actas urologicas espanolas · 2025
The oncological impact of complete transurethral resection before neoadjuvant chemotherapy in muscle-invasive bladder cancer.
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Fernandes C, Baptista I, Manso M, Ferreira C, Botelho F, Silva J, Silva C, Vale L
Аннотация
OBJECTIVES: To assess the impact of cTURBT on pathologic response. Secondary endpoints involved survival and oncologic outcomes.
METHODS: Tertiary centre data from patients with MIBC submitted to NAC and radical cystectomy between March 2010 and November 2022 was retrospectively analysed. Patients with complete resection (cTURBT) before NAC were compared to those with incomplete (iTURBT).
RESULTS: Thirty-seven patients were included in this study. NAC regime was identical between groups. cTURBT group demonstrated a higher rate of downstaging than the iTURBT group (50% vs 20%, p = 0.022). During the mean 49-month follow-up period, overall survival (86.4% vs. 40%, p=0.005), relapse-free survival (81.8% vs. 46.7% p=0.036), and cancer-specific survival (90.9% vs 60%, p=0.042) were higher in the cTURBT group. Furthermore, we observed significantly fewer relapses, higher survival rates, and lower oncological-related deaths in patients who exhibited downstaging.
CONCLUSION: cTURBT demonstrated a favourable impact on patients with MIBC undergoing NAC, enhancing pathologic downstaging and improving survival outcomes. Our results can be confounded by cTURBT being a proxy for less aggressive disease.
METHODS: Tertiary centre data from patients with MIBC submitted to NAC and radical cystectomy between March 2010 and November 2022 was retrospectively analysed. Patients with complete resection (cTURBT) before NAC were compared to those with incomplete (iTURBT).
RESULTS: Thirty-seven patients were included in this study. NAC regime was identical between groups. cTURBT group demonstrated a higher rate of downstaging than the iTURBT group (50% vs 20%, p = 0.022). During the mean 49-month follow-up period, overall survival (86.4% vs. 40%, p=0.005), relapse-free survival (81.8% vs. 46.7% p=0.036), and cancer-specific survival (90.9% vs 60%, p=0.042) were higher in the cTURBT group. Furthermore, we observed significantly fewer relapses, higher survival rates, and lower oncological-related deaths in patients who exhibited downstaging.
CONCLUSION: cTURBT demonstrated a favourable impact on patients with MIBC undergoing NAC, enhancing pathologic downstaging and improving survival outcomes. Our results can be confounded by cTURBT being a proxy for less aggressive disease.