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Oncological safety and quality of life in men undergoing simultaneous transurethral resection of bladder tumor and prostate: results from a randomized controlled trial

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Abstract

Purpose

To assess oncological safety and quality of life (QL) of men undergoing simultaneous transurethral resection of bladder tumor (TURBT) and transurethral resection of the prostate (TURP) for symptomatic benign prostatic hyperplasia (BPH).

Methods

Ninety-five men with a new diagnosis of bladder cancer (BC) and symptomatic BPH were randomized to receive TURBT + tamsulosin (Group 1) or TURBT + TURP (Group 2). Inclusion criteria were age ≤ 75 years, first diagnosis of BC up to 4 cm, and prostate volume ≤ 80 ml. All patients were evaluated preoperatively with digital rectal examination, PSA, maximal urine flow rate (Qmax), and International Prostate Symptom Score (IPSS). IPSS and Qmax were repeated at 1-year follow-up. QL was evaluated at 1 year using a modified version of the self-report bladder cancer subscale of the Functional Assessment of Cancer Therapy.

Results

Eighty-five men completed the study (43 in Group 1 and 42 in Group 2). Adjuvant instillation therapy was given to 26 patients in Group 1 and to 27 in Group 2. Average time to the first recurrence was 16.64 months in Group 1 and 17.7 in Group 2. Total recurrences were 27 in Group 1 and 22 in Group 2. Bladder neck/prostatic urethra recurrences were 9 in Group 1 vs. 8 in Group 2. QL, IPSS, and Qmax 12 months after surgery were better in Group 2.

Conclusion

Concomitant TURBT and TURP appear to be oncologically safe procedures in terms of total and prostatic urethra recurrence, and improve QL in men with BC who require surgery for symptomatic BPH.

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References

  1. Malats NRF (2015) Epidemiology of bladder cancer. Hematol Oncol Clin North Am 29:177–189

    Article  Google Scholar 

  2. Siegel RL, Miller KD, Jemal A (2017) Cancer statistics, 2017. CA Cancer J Clin 67:7–30. https://doi.org/10.3322/caac.21387

    Article  Google Scholar 

  3. Hollingsworth JM, Wilt TJ (2014) Lower urinary tract symptoms in men. BMJ 349:1–11. https://doi.org/10.1136/bmj.g4474

    Article  Google Scholar 

  4. Burger M, Catto JWF, Dalbagni G et al (2013) Epidemiology and risk factors of urothelial bladder cancer. Eur Urol 63:234–241. https://doi.org/10.1016/j.eururo.2012.07.033

    Article  PubMed  Google Scholar 

  5. Miyazaki J, Nishiyama H (2017) Epidemiology of urothelial carcinoma. Int J Urol 24:730–734. https://doi.org/10.1111/iju.13376

    Article  PubMed  Google Scholar 

  6. Gratzke C, Bachmann A, Descazeaud A et al (2015) EAU guidelines on the assessment of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol 67:1099–1109. https://doi.org/10.1016/j.eururo.2014.12.038

    Article  PubMed  Google Scholar 

  7. Teo JS, Lee YM, Ho HSS (2017) An update on transurethral surgery for benign prostatic obstruction. Asian J Urol 4:195–198. https://doi.org/10.1016/j.ajur.2017.06.006

    Article  PubMed  PubMed Central  Google Scholar 

  8. Braeckman J, Denis L (2017) Management of BPH then 2000 and now 2016—from BPH to BPO. Asian J Urol 4:138–147. https://doi.org/10.1016/j.ajur.2017.02.002

    Article  PubMed  PubMed Central  Google Scholar 

  9. Tsivian A, Shtricker A, Sidi AA (2003) Simultaneous transurethral resection of bladder tumor and benign prostatic hyperplasia: hazardous or a safe timesaver? J Urol 170:2241–2243. https://doi.org/10.1097/01.ju.0000096273.64448.e7

    Article  PubMed  Google Scholar 

  10. Ugurlu O, Gonulalan U, Adsan O et al (2007) Effects of simultaneous transurethral resection of prostate and solitary bladder tumors smaller than 3 cm on oncologic results. Urology 70:55–59. https://doi.org/10.1016/j.urology.2007.03.015

    Article  PubMed  Google Scholar 

  11. Ham WS, Kim WT, Jeon HJ et al (2009) Long-term outcome of simultaneous transurethral resection of bladder tumor and prostate in patients with nonmuscle invasive bladder tumor and bladder outlet obstruction. J Urol 181:1594–1599. https://doi.org/10.1016/j.juro.2008.11.099

    Article  PubMed  Google Scholar 

  12. Jaidane M, Bouicha T, Slama A et al (2010) Tumor recurrence in prostatic urethra following simultaneous resection of bladder tumor and prostate: a comparative retrospective study. Urology 75:1392–1395. https://doi.org/10.1016/j.urology.2009.06.066

    Article  PubMed  Google Scholar 

  13. Babjuk M, Oosterlinck W, Sylvester R et al (2008) EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder. Eur Urol 54:303–314. https://doi.org/10.1016/j.eururo.2008.04.051

    Article  PubMed  Google Scholar 

  14. Eble JN, Sauter G, Epstein JISIA (eds) (2004) World Health Organization classification of tumours. pathology and genetics of tumours of the urinary system and male genital organs. IARC Press, Lyon

  15. Cella DF, Tulsky DS, Gray G et al (1993) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11:570–579. https://doi.org/10.1200/JCO.1993.11.3.570

    Article  CAS  PubMed  Google Scholar 

  16. Dindo D, Demartines N, Clavien P-A (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  Google Scholar 

  17. Schulz KF, Altman DG, Moher D, CONSORT Group (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol 63:834–840. https://doi.org/10.1016/j.jclinepi.2010.02.005

    Article  PubMed  Google Scholar 

  18. American Cancer Society (2017) Cancer facts and figures 2017. Genes Dev 21:2525–2538. https://doi.org/10.1101/gad.1593107

    Article  CAS  Google Scholar 

  19. Albarran J, Imbert L (1903) Les Tumeurs du rein. Mason, Paris

    Google Scholar 

  20. Hinman F (1956) Recurrence of bladder tumors by surgical implantation. J Urol 75:695–696

    Article  Google Scholar 

  21. Kiefer J (1953) Bladder tumor recurrence in the urethra: a warning. J Urol 69:652–656

    Article  CAS  Google Scholar 

  22. Pode D, Alon Y, Horowitz AT et al (1986) The mechanism of human bladder tumor implantation in an in vitro model. J Urol 136:482–486

    Article  CAS  Google Scholar 

  23. Li S, Zeng X-T, Ruan XL et al (2012) Simultaneous transurethral resection of bladder cancer and prostate may reduce recurrence rates: a systematic review and meta-analysis. Exp Ther Med 4:685–692. https://doi.org/10.3892/etm.2012.660

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Luo S, Lin Y, Zhang W (2011) Does simultaneous transurethral resection of bladder tumor and prostate affect the recurrence of bladder tumor? A meta-analysis. J Endourol 25:291–296. https://doi.org/10.1089/end.2010.0314

    Article  PubMed  Google Scholar 

  25. Picozzi SCM, Ricci C, Gaeta M et al (2012) Is it oncologically safe performing simultaneous transurethral resection of the bladder and prostate? A meta-analysis on 1,234 patients. Int Urol Nephrol 44:1325–1333. https://doi.org/10.1007/s11255-012-0183-3

    Article  PubMed  Google Scholar 

  26. Kang D, Chokkalingam AP, Gridley G et al (2007) Benign prostatic hyperplasia and subsequent risk of bladder cancer. Br J Cancer 96:1475–1479. https://doi.org/10.1038/sj.bjc.6603730

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Matsumoto S, Shimizu N, Hanai T et al (2009) Bladder outlet obstruction accelerates bladder carcinogenesis. BJU Int 103:1436–1439. https://doi.org/10.1111/j.1464-410X.2008.08261.x

    Article  PubMed  Google Scholar 

  28. Kadlubar FF, Dooley KL, Teitel CH et al (1991) Frequency of urination and its effects on metabolism, pharmacokinetics, blood hemoglobin adduct formation, and liver and urinary bladder DNA adduct levels in beagle dogs given the carcinogen 4-aminobiphenyl. Cancer Res 51:4371–4377

    CAS  PubMed  Google Scholar 

  29. Michaud DS, Spiegelman D, Clinton SK et al (1999) Fluid intake and the risk of bladder cancer in men. N Engl J Med 340:1390–1397. https://doi.org/10.1056/NEJM199905063401803

    Article  CAS  PubMed  Google Scholar 

  30. Yoshimura K, Utsunomiya N, Ichioka K et al (2005) Impact of superficial bladder cancer and transurethral resection on general health-related quality of life: an SF-36 survey. Urology 65:290–294. https://doi.org/10.1016/j.urology.2004.09.050

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Urology Unit, Department of Geriatric Surgery, National Institute of Health and Science on Aging - I.N.R.C.A., Via della Montagnola 81, 60127, Ancona, Italy

    Marco Dellabella, Alessandro Branchi, Luca Gasparri, Redi Claudini & Daniele Castellani

Authors
  1. Marco Dellabella
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  2. Alessandro Branchi
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  3. Luca Gasparri
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  4. Redi Claudini
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  5. Daniele Castellani
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Contributions

MD: project development, data analysis, supervision; AB, RC, and LG: data collection and analysis. DC: data analysis, manuscript writing and editing.

Corresponding author

Correspondence to Daniele Castellani.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study. All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Financial disclosure

The authors declare that they have no relevant financial interest.

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Dellabella, M., Branchi, A., Gasparri, L. et al. Oncological safety and quality of life in men undergoing simultaneous transurethral resection of bladder tumor and prostate: results from a randomized controlled trial. World J Urol 36, 1629–1634 (2018). https://doi.org/10.1007/s00345-018-2317-4

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  • DOI: https://doi.org/10.1007/s00345-018-2317-4

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