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Role of Maximal Transurethral Resection Preceding Partial Cystectomy for Muscle-Invasive Bladder Cancer

  • Urologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

We aimed to evaluate whether maximal transurethral resection (TUR) affects the oncological outcome of partial cystectomy (PC) performed in patients with muscle-invasive bladder cancer (MIBC), although radical cystectomy (RC) and trimodal therapy (TMT) are regarded as standard treatments for MIBC.

Methods

In this retrospective study, we evaluated the data of 98 patients who underwent PC due to MIBC between January 2006 and December 2018. Of the 98 patients, 71 underwent maximal TUR. We evaluated the recurrence-free survival (PFS), pelvic recurrence-free survival (pPFS), cancer-specific survival (CSS), and overall survival (OS) using the Kaplan–Meier method according to the maximal TUR status. Variables associated with survival were analyzed using Cox regression analyses.

Results

The 5-year PFS (42.5% vs. 20.3%, p = 0.008), pPFS (50.7% vs. 24.1%, p = 0.003), and CSS (74.0% vs. 51.0%, p = 0.016) were also higher in patients who underwent maximal TUR. The multivariable Cox regression analysis showed that maximal TUR was associated with PFS (hazard ratio [HR] = 0.500, p = 0.029), pPFS (HR = 0.353, p = 0.004), and CSS (HR = 0.416, p = 0.027). However, maximal TUR did not affect the OS (HR = 0.618, p = 0.132).

Conclusion

PC resulted in acceptable oncological outcomes in patients with MIBC, while maximal TUR played an important role in improving the oncological outcomes. PC after maximal TUR can be suggested as a treatment option for MIBC patients who are unable to undergo RC and TMT.

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Funding

This work was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea [Grant Number: HI17C1095], the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) [Grant Number: 2019R1A2C1002863 and 2022R1A2C2003831], and a faculty research grant from Yonsei University College of Medicine (6-2021-0106).

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Authors and Affiliations

  1. Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea

    Won Sik Ham MD, PhD, Jee Soo Park MD, PhD, Won Sik Jang MD, PhD & Jongchan Kim MD

  2. Department of Urology, Yongin Severance Hospital, Yonsei University Health System, Yongin-si, Gyeonggi-do, Korea

    Jongchan Kim MD

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  1. Won Sik Ham MD, PhD
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Correspondence to Jongchan Kim MD.

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Ham, W.S., Park, J.S., Jang, W.S. et al. Role of Maximal Transurethral Resection Preceding Partial Cystectomy for Muscle-Invasive Bladder Cancer. Ann Surg Oncol 31, 1384–1392 (2024). https://doi.org/10.1245/s10434-023-14449-5

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