International journal of urology : official journal of the Japanese Urological Association · 2026
Perioperative Safety and Long-Term Oncological Outcomes of En Bloc Resection of Bladder Tumor: A Multicenter Real-World Study of 668 Patients.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Yanagisawa Takafumi, Matsukawa Akihiro, Iwatani Kosuke, Hayashida Yasushi, Okada Yohei, Kubota Risa, Kamikubo Kiichi, Taneda Yuki, Kondo Hirotaka, Ito Kagenori, Miki Jun, Kimura Takahiro, Japanese En bloc TUR (JET) Study Group
Аннотация
OBJECTIVES: To evaluate perioperative safety, pathological outcomes, and oncological outcomes of en bloc resection of bladder tumor (ERBT) in a large multicenter real-world cohort.
METHODS: We retrospectively analyzed 668 patients who underwent ERBT at five institutions. Perioperative and pathological outcomes were assessed in the overall cohort. Recurrence-free survival (RFS) was evaluated in patients with pathologically confirmed non-muscle-invasive bladder cancer (NMIBC) without a history of upper tract urothelial carcinoma (n = 551). Clinicopathological prognosticators of recurrence were identified using Cox proportional hazards regression.
RESULTS: The median age was 73 years, and the median maximum tumor diameter was 15 mm. The median operative time and postoperative catheterization period were 48 min and 3 days, respectively. Perioperative complications occurred in 60 patients (9.0%), including eight (1.2%) with Clavien-Dindo Grade III or higher complications. Detrusor muscle was identified in 77.2% of evaluable specimens. Final pathology showed pTa, pT1, pTis, and pT2 disease in 377 (56.4%), 239 (35.8%), 16 (2.4%), and 25 patients (3.7%), respectively. With a median follow-up of 42 months, the estimated 1-, 2-, and 5-year RFS rates were 80.9%, 73.2%, and 57.1%, respectively. RFS did not differ significantly between pTa and pT1 disease (log-rank p = 0.39). Patients presenting with recurrent tumors had a significantly higher risk of subsequent intravesical recurrence than those with primary tumors (HR 2.06, 95% CI 1.38-3.07; p < 0.001).
CONCLUSIONS: ERBT demonstrated favorable perioperative safety and acceptable oncological outcomes in this large multicenter cohort. Post-ERBT recurrence remained strongly influenced by prior recurrence history, highlighting the importance of risk-adapted postoperative management.
METHODS: We retrospectively analyzed 668 patients who underwent ERBT at five institutions. Perioperative and pathological outcomes were assessed in the overall cohort. Recurrence-free survival (RFS) was evaluated in patients with pathologically confirmed non-muscle-invasive bladder cancer (NMIBC) without a history of upper tract urothelial carcinoma (n = 551). Clinicopathological prognosticators of recurrence were identified using Cox proportional hazards regression.
RESULTS: The median age was 73 years, and the median maximum tumor diameter was 15 mm. The median operative time and postoperative catheterization period were 48 min and 3 days, respectively. Perioperative complications occurred in 60 patients (9.0%), including eight (1.2%) with Clavien-Dindo Grade III or higher complications. Detrusor muscle was identified in 77.2% of evaluable specimens. Final pathology showed pTa, pT1, pTis, and pT2 disease in 377 (56.4%), 239 (35.8%), 16 (2.4%), and 25 patients (3.7%), respectively. With a median follow-up of 42 months, the estimated 1-, 2-, and 5-year RFS rates were 80.9%, 73.2%, and 57.1%, respectively. RFS did not differ significantly between pTa and pT1 disease (log-rank p = 0.39). Patients presenting with recurrent tumors had a significantly higher risk of subsequent intravesical recurrence than those with primary tumors (HR 2.06, 95% CI 1.38-3.07; p < 0.001).
CONCLUSIONS: ERBT demonstrated favorable perioperative safety and acceptable oncological outcomes in this large multicenter cohort. Post-ERBT recurrence remained strongly influenced by prior recurrence history, highlighting the importance of risk-adapted postoperative management.