TY - JOUR
T1 - Thulium
T2 - yttrium-aluminum-garnet laser for en bloc resection of bladder cancer: Clinical and histopathologic advantages
AU - Muto, Giovanni
AU - Collura, Devis
AU - Giacobbe, Alessandro
AU - D'Urso, Leonardo
AU - Muto, Gian Luca
AU - Demarchi, Andrea
AU - Coverlizza, Sergio
AU - Castelli, Emanuele
PY - 2014
Y1 - 2014
N2 - Objective To determine whether thulium:yttrium-aluminum-garnet laser resection of bladder tumor (TmLRBT) may offer advantages over classic resection. Materials and Methods From April 2011 to September 2012, 55 consecutive patients newly diagnosed with clinical stage ≤T2 bladder cancer were enrolled in a prospective study on TmLRBT. Neoplasm was removed en bloc in all cases. When the tumor size was >3 cm, it was necessary to incise longitudinally and/or across the lesion and the bladder wall at its the base into 2 or more parts. All cases of non-muscle-invasive bladder cancer underwent second look in 30-90 days. Results Pathology reported urothelial carcinoma with Ta low grade in 31 patients (56.4%), T1 high grade in 18 (32.7%), and T2 high grade in 6 (10.9%). Histopathologic evaluation showed that the bladder detrusor was provided in all cases. Hemostasis was excellent, and no postoperative hematuria was reported. In a case of T1 G3, endoscopic re-evaluation showed a focal infiltration of the bladder detrusor, so the patient underwent radical cystectomy. To date, with a mean follow-up of 16 months (range, 8-25), the recurrence rate in patients with superficial disease is 14.5%. All recurrences were outside the site of first resection, and there was no progression in tumor grade. Conclusion TmLRBT is a simple method that seems to overcome the "incise and scatter" problem associated with traditional transurethral resection of bladder tumor. Our initial data on staging accuracy and reduction of the local recurrence rate are encouraging.
AB - Objective To determine whether thulium:yttrium-aluminum-garnet laser resection of bladder tumor (TmLRBT) may offer advantages over classic resection. Materials and Methods From April 2011 to September 2012, 55 consecutive patients newly diagnosed with clinical stage ≤T2 bladder cancer were enrolled in a prospective study on TmLRBT. Neoplasm was removed en bloc in all cases. When the tumor size was >3 cm, it was necessary to incise longitudinally and/or across the lesion and the bladder wall at its the base into 2 or more parts. All cases of non-muscle-invasive bladder cancer underwent second look in 30-90 days. Results Pathology reported urothelial carcinoma with Ta low grade in 31 patients (56.4%), T1 high grade in 18 (32.7%), and T2 high grade in 6 (10.9%). Histopathologic evaluation showed that the bladder detrusor was provided in all cases. Hemostasis was excellent, and no postoperative hematuria was reported. In a case of T1 G3, endoscopic re-evaluation showed a focal infiltration of the bladder detrusor, so the patient underwent radical cystectomy. To date, with a mean follow-up of 16 months (range, 8-25), the recurrence rate in patients with superficial disease is 14.5%. All recurrences were outside the site of first resection, and there was no progression in tumor grade. Conclusion TmLRBT is a simple method that seems to overcome the "incise and scatter" problem associated with traditional transurethral resection of bladder tumor. Our initial data on staging accuracy and reduction of the local recurrence rate are encouraging.
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U2 - 10.1016/j.urology.2013.12.022
DO - 10.1016/j.urology.2013.12.022
M3 - Article
C2 - 24548711
AN - SCOPUS:84897409251
VL - 83
SP - 851
EP - 855
JO - Urology
JF - Urology
SN - 0090-4295
IS - 4
ER -