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Oncological and safety profiles in patients undergoing simultaneous transurethral resection (TUR) of bladder tumour and TUR of the prostate
E. Laukhtina, M. Moschini, W. Krajewski, JY. Teoh, G. Ploussard, F. Soria, F. Roghmann, MA. Muenker, M. Roumiguie, M. Alvarez-Maestro, V. Misrai, A. Antonelli, A. Tafuri, G. Simone, R. Mastroianni, H. Zhao, RG. Rahota, D. D'Andrea, K. Mori, S....
Language English Country England, Great Britain
Document type Journal Article
NLK
Free Medical Journals
from 1999
Medline Complete (EBSCOhost)
from 1999-01-01 to 1 year ago
PubMed
36134575
DOI
10.1111/bju.15898
Knihovny.cz E-resources
- MeSH
- Prostatic Hyperplasia * complications MeSH
- Humans MeSH
- Neoplasm Recurrence, Local pathology MeSH
- Urinary Bladder Neoplasms * pathology MeSH
- Prostate surgery pathology MeSH
- Retrospective Studies MeSH
- Transurethral Resection of Prostate * adverse effects methods MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
OBJECTIVES: To determine the oncological impact and adverse events of performing simultaneous transurethral resection of bladder tumour (TURB) and transurethral resection of the prostate (TURP), as evidence on the outcomes of simultaneous TURB for bladder cancer and TURP for obstructive benign prostatic hyperplasia is limited and contradictory. PATIENTS AND METHODS: Patients from 12 European hospitals treated with either TURB alone or simultaneous TURB and TURP (TURB+TURP) were retrospectively analysed. A propensity score matching (PSM) 1:1 was performed with patients from the TURB+TURP group matched to TURB-alone patients. Associations between surgery approach with recurrence-free (RFS) and progression-free (PFS) survivals were assessed in Cox regression models before and after PSM. We performed a subgroup analysis in patients with risk factors for recurrence (multifocality and/or tumour size >3 cm). RESULTS: A total of 762 men were included, among whom, 76% (581) underwent a TURB alone and 24% (181) a TURB+TURP. There was no difference in terms of tumour characteristics between the groups. We observed comparable length of stay as well as complication rates including major complications (Clavien-Dindo Grade ≥III) for the TURB-alone vs TURB+TURP groups, while the latest led to longer operative time (P < 0.001). During a median follow-up of 44 months, there were more recurrences in the TURB-alone (47%) compared to the TURB+TURP group (28%; P < 0.001). Interestingly, there were more recurrences at the bladder neck/prostatic fossa in the TURB-alone group (55% vs 3%, P < 0.001). TURB+TURP procedures were associated with improved RFS (hazard ratio [HR] 0.39, 95% confidence interval [CI] 0.29-0.53; P < 0.001), but not PFS (HR 1.63, 95% CI 0.90-2.98; P = 0.11). Within the PSM cohort of 254 patients, the simultaneous TURB+TURP was still associated with improved RFS (HR 0.33, 95% CI 0.22-0.49; P < 0.001). This was also true in the subgroup of 380 patients with recurrence risk factors (HR 0.41, 95% CI 0.28-0.62; P < 0.001). CONCLUSION: In our contemporary cohort, simultaneous TURB and TURP seems to be an oncologically safe option that may, even, improve RFS by potentially preventing disease recurrence at the bladder neck and in the prostatic fossa.
Cancer Prognostics and Health Outcomes Unit University of Montreal Health Centre Montreal Canada
Departement of Urology University of Verona Verona Italy
Department of Surgery Prince of Wales Hospital The Chinese University of Hong Kong Hong Kong China
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology Clinique Pasteur Toulouse France
Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Urology Marien Hospital Herne Herne Germany
Department of Urology The Jikei University School of Medicine Tokyo Japan
Department of Urology University Hospital of Toulouse Rangueil Toulouse France
Department of Urology University of Texas Southwestern Dallas TX USA
Department of Urology Weill Cornell Medical College New York NY USA
Division of Experimental Oncology Unit of Urology Urological Research Institute Milan Italy
Hourani Center for Applied Scientific Research Al Ahliyya Amman University Amman Jordan
IRCCS Regina Elena National Cancer Institute Rome Italy
Karl Landsteiner Institute of Urology and Andrology Vienna Austria
Service d'Urologie Hôpital Erasme Université Libre de Bruxelles Brussels Belgium
Servicio de Urología Hospital Universitario La Paz Madrid Spain
References provided by Crossref.org
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