SIU 2017: En BIOC Transurethral Resection with Hybrid Knife for Treatment of Primary Non-Muscle-Invasive Bladder Cancer: A Single-Center, Randomized, Controlled Trial

Lisbon, Portugal (  Dr. Hu presented a study attempting to evaluate the safety and effectivity of en bloc transurethral resection with Hybrid Knife as a treatment for primary non-muscle-invasive bladder cancer (NMIBC), and compare it to conventional transurethral resection of bladder tumor (TURBT).

This was a single-center, randomized controlled trial. From March 2016 to September 2016, 86 patients with newly diagnosed NMIBC were enrolled and evaluated with ultrasonography, CT scan and cystoscopy. All patients were randomly assigned in a 1:1 ratio to receive either Hybrid Knife En bloc transurethral resection or conventional TURBT. The baseline clinical characteristics of the patients in each group were similar. The number of low risk NMIBC patients was lower in the Hybrid Knife En bloc resection group (17 vs. 25 P <0.05). However, the number of moderate and high risk NMIBC patients (Tla, Tlb, TaG2, TaC3 Staging) was higher in the Hybrid Knife En bloc resection group. Patients with multifocal disease of more than 5 tumors were excluded. Postoperatively, all patients received intravesical chemotherapy. After 6–12 months follow-up, all patients underwent imaging and cystoscopy examinations. Primary outcome measure was recurrence rate.

No major intraoperative or postoperative complications occurred in both groups. Operation time was longer in the Hybrid Knife En bloc group than in TURBT group when the tumor size was more than 3cm and there were more than 3 tumors. According to Kaplan-Meier survival curves, there was no statistical difference in the rate of recurrence in 6-12 months (P = 0.079).

The authors concluded that en bloc transurethral resection with Hybrid Knife did not decrease tumor recurrence rate in primary NMIBC after a 6-12 months’ time period. Further studies are needed to evaluate the added benefit of this modality, if any.

Presented by:  Hu J
Affiliation: Dept. of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre.Twitter: @GoldbergHanan at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal