Reduced recurrence by standardizing the first TURBT

Published: 16 May 2019

Data from a prospective intervention study in non-muscle-invasive bladder cancer (NMIBC) patients show that a systematic, guideline-based approach to the first TURBT improve patient outcomes.

The impact of introducing a standardized treatment for primary bladder tumors was assessed, by comparing retrospective data for a patient cohort at Skåne University Hospital, Malmø, Sweden, from 2010 with prospective data for a cohort from 2013 after the standardization was implemented.

The standardization protocol included a pre-defined set of measures for the peri-and postoperative treatment, including such as reducing the number of responsible surgeons, all patients scheduled for resection with Blue Light Cystoscopy with Hexvix, one dose of prophylactic antibiotics, fractionating tumor specimen with separate specimen from tumor base, bimanual palpation, post-operative continuous irrigation with sterile water, second resection to all patients with high grade tumors (T1, TaG3) without muscle in specimen and where primary resection was considered incomplete.

By implementing this standard protocol the number of recurrences at first cystoscopy after complete treatment was reduced from 22% to 9.6 %, p=0.005 and lowered the recurrence incidence by 35%. This demonstrates the importance of the quality of the first TURBT, including offering BLC to all new patients, on patients' outcomes.

Link to the article in The Scandinavian Journal of Urology:

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