A Systematic Review on the Role of Repeat Transurethral Resection after Initial en Bloc Resection for Non-Muscle Invasive Bladder Cancer
Abstract
:1. Introduction
2. Materials and Methods
2.1. Literature Search and Study Selection
2.2. Inclusion and Exclusion Criteria
2.3. Data Extraction and Study Quality Assessment
2.4. Data Processing and Statistical Analysis
3. Results
3.1. Literature Search and Study Selection
3.2. Systematic Reviews of Included Studies
3.3. Residual Tumors and Upstage at reTURB after ERBT
3.4. Recurrence and Progression
3.5. Risk of Bias Assessment, Heterogeneity, and Sensitivity Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Guidelines Body | Version | Recommendation on Suitable reTURB Candidates | Recommendation Strength | ReTURB Period after the Initial Resection |
---|---|---|---|---|
European Association of Urology | 2022 | 1. Incomplete initial TURB, or in case of doubt about the completeness of a TURB; 2. If there is no detrusor muscle in the specimen after initial resection, except for Ta LG/G1 tumors and primary CIS; 3. T1 tumors. | Strong | 2–6 weeks |
National Comprehensive Cancer Network (NCCN) | Version 2.2022 | 1. Visually incomplete resection or high-volume tumor 2. TaHG, particularly if large, and/or no muscle in the specimen 3. T1 tumors | 2A * | 2–6 weeks |
European Society for Medical Oncology (ESMO) | 2021 | 1. The initial TURB was incomplete. 2. If no detrusor muscle exists in the specimen on the initial resection, except for Ta LG and CIS. 3. In all pT1 tumors and all HG tumors, except for patients with primary CIS | Strong | 4–6 weeks |
Canadian Urological Association | 2021 | 1. Incomplete initial TURB 2. TaHG tumors (e.g., large and/or multiple tumors) 3. T1 tumors | 1. Strong 2. Weak 3. Strong | within 6 weeks |
American Urological Association & Society of Urological Oncology | 2020 | 1. Incomplete initial TURB 2. TaHG tumors 3. T1 tumors | 1. Strong 2. Moderate 3. Strong | within 6 weeks |
Chinese Urological Association | 2019 | 1. Incomplete initial TURB 2. No muscle in specimen except for Ta LG/Gl and primary CIS 3. T1 tumors. | Moderate | 2–6 weeks |
SIU & International Consultation on Bladder Cancer (ICUD) 2017 | 2017 | 1. Incomplete initial resection 2. TaHG tumors, particularly for patients with large or multifocal tumors 3. T1 disease | 1. B ** 2. C ** 3. B ** | within 6 weeks |
National Institute for Clinical Excellence (NICE) | 2015 | 1. All high-risk non-muscle invasive bladder cancer | 1. Low | within 6 weeks |
First Author & Year | Country | Study Type | Study Period | Re TURB Time | Participants | Groups | Patient Number | Male/ Female | Age Mean ± SD (Range) /Median (IQR) | Stage Ta/T1/Tis | Grade LG/HG | Residual Tumor (%) | Up Stage (%) | Recurrence (%) | RFS | Progression | PFS |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Zhou 2020 [32] | China | RC | June 2012–June 2018 | Within 2–6 weeks | Primary T1 and HG/G3 tumors, excluding primary CIS. | ReTURB | 108 | 86/22 | 66.12 ± 1.52 | 60/48/0 | 25/83 | 6 (5.6) | 2 (1.85) | 23 (21.3) | 1 year: 92.6 2 year: 88.4 * 3 year: 84.3 5 year: 68.0 * | 4 (3.7) | 1 year: 98.1 3 year: 96.3 |
Control | 143 | 111/32 | 68.59 ± 1.36 | 87/56/0 | 49/94 | 11 (7.69) | 2 (1.40) | 39 (27.2) | 1 year: 90.2 2 year: 84.2 * 3 year: 80.4 5 year: 54.1 * | 7 (4.9) | 1 year: 97.9 3 year: 95.1 | ||||||
Xu 2021 [36] | China | RC | June 2015–June 2019 | Within 6 weeks | Primary T1/TaHG tumors, Tumor number ≤ 4 Diameter ≤ 4 cm | ReTURB | 51 | 41/10 | 67.4 ± 9.5 | 16/35/0 | 13/38 | 3 (5.88) | 0 (0) | 10 (19.6) | 1 year: 92.2 2 year: 87.6 * 3 year: 81.1 * 5 year: 71.5 * | 2 (3.9) | NA |
Control | 64 | 53/11 | 66.8 ± 9.0 | 15/49/0 | 10/54 | 2 (3.13) | 0 (0) | 18 (28.1) | 1 year: 90.6 2 year: 81.1 * 3 year: 66.4 * 5 year: 63.1 * | 1 (1.5) | NA | ||||||
Yanagisawa 2022 [38] | Japan | RC | April 2013–February 2021 | Within 2–6 weeks | T1 Tumors | ReTURB | 50 | 33/17 | 74 (70.25–78) | 0/50/0 | 0/50 | 9 (18.0) | 0 (0) | 18 (36.0) | 1 year: 66.5 * 2 year: 55.1 3 year: 54.9 * 5 year: 54.9 * | 7 (14.0) | 1 year: 95.7 * 3 year: 80.6 5 year: 64.5 * |
Control | 56 | 43/13 | 76 (69–82.25) | 0/56/0 | 0/56 | NA | NA | 18 (32.1) | 1 year: 71.3 * 2 year: 59.9 3 year: 59.9 * 5 year: 54.0 * | 6 (10.7) | 1 year: 95.7 * 3 year: 82.6 5 year: 82.6 * | ||||||
Wolters 2011 [27] | Germany | CS | June 2010–October 2010 | Within 6 weeks | Solitary papillary lesions, treatment-naive, on the lower bladder wall and trigonum | ReTURB | 5 | 4/1 | 57 (57–80) | 2/3/0 | G1 1 G2 1 G3 3 | NA | NA | NA | NA | NA | NA |
Muto 2014 [28] | Italy | PCS | April 2011–September 2012 | Within 30–90 days | Naïve NMIBC | ReTURB | 48 | NA | NA | 31/17/0 | 31/17/0 | 0 (0) | 0 (0) | 7 (14.6) | 1.5 year: 85.4 | 0 (0) | NA |
Migliari 2015 [29] | Italy | PC | February 2012–September 2013 | Within 90 days | Single papillary bladder tumor, diameter ≥ 1 cm | ReTURB | 53 | NA | NA | 30/23/0 | 30/23 | 0 (0) | 0 (0) | 12 (22.6) | 1.5 year: Ta 90.0 T1 76.0 | 0 (0) | NA |
Hurle 2020 [30] | Italy | RCS | September 2011–April 2017 | Within 40 days | First diagnosis or a primary recurrence of High-risk NMIBC, a single tumor of ≤3 cm and ≤4 lesions | ReTURB | 78 | 51/27 | 68 ± 9 | 17/57/4 | G3 72 | 5 (6.41) | 0 (0) | 11 (14.1) | 1 year: 93.4 * 2 year: 92.0 * 3 year: 85.0 * 5 year: 85.0 * | 1 (1.3) | NA |
Yang 2020 [31] | China | PC | October 2015–June 2017 | Within 2–6 weeks | Primary, HG and/or T1 tumor; diameter between 1.0 to 3.0 cm | ReTURB | 28 | NA | NA | NA | NA | 2 (7.14) | 1 (3.57) | NA | NA | NA | NA |
Hashem 2021 [33] | Egypt | RCT | September 2015–September 2018 | 4 weeks after the primary resection | NMIBC | ReTURB | 44 | NA | NA | 2/42 | 28/16 | 3 (6.82) | 0 (0) | 7 (15.9) | 1 year: 92.6 * 2 year: 80.0 * 3 year: 80.0 * | NA | NA |
Hu 2021 [34] | China | RCS | January 2019–October 2019 | 4–6 weeks | Primary T1 or TaHG | ReTURB | 10 | NA | NA | NA | NA | 0 (0) | 0 (0) | NA | NA | NA | NA |
Poletajew 2021 [35] | Poland | PC | NA | Within 2–6 weeks | 1–4 cm in diameter. | ReTURB | 37 | NA | NA | NA | NA | 11 (29.73) | NA | NA | NA | NA | NA |
Fan 2022 [37] | China | RCS | 2013– 2019 | Within 6 weeks | NA | ReTURB | 27 | NA | NA | NA | NA | 4 (14.81) | NA | NA | NA | NA | NA |
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Hu, H.; Zhou, M.; Yang, B.; Zhou, S.; Liu, Z.; Zhang, J. A Systematic Review on the Role of Repeat Transurethral Resection after Initial en Bloc Resection for Non-Muscle Invasive Bladder Cancer. J. Clin. Med. 2022, 11, 5049. https://doi.org/10.3390/jcm11175049
Hu H, Zhou M, Yang B, Zhou S, Liu Z, Zhang J. 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. 2022; 11(17):5049. https://doi.org/10.3390/jcm11175049
Chicago/Turabian StyleHu, Henglong, Mengqi Zhou, Binrui Yang, Shiwei Zhou, Zheng Liu, and Jiaqiao Zhang. 2022. "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 11, no. 17: 5049. https://doi.org/10.3390/jcm11175049
APA StyleHu, H., Zhou, M., Yang, B., Zhou, S., Liu, Z., & Zhang, J. (2022). 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, 11(17), 5049. https://doi.org/10.3390/jcm11175049