After seeking a committee approval, a Retrospective and prospective non-randomized interventional study was conducted between Jan 2018 to February 2020 Department of Urology and Renal Transplant, Madurai Medical College Madurai T N India.
Methods: It is the first kind study in South India for En Block TURBT. End points of the study, i.e., recurrence and progression rates were compared in two groups. ET and CT was carried out by a single surgeon.
Results: Recurrence rate was 18.2% versus 58.2% (P = 0.03) and progression rate was 14%versus 38% (P = 0.32) in ET versus CT group respectively. In the ET group, the recurrence in non-lamina invasive NMIBC tumors was 12%, where as it was 51% in CT. Similarly in lamina invasive tumor, the recurrence rate was 34% and 68% in ET and CT group. Mean RFS Relapse free Survival was 23 months with ET and 14 months in CT with P value of 0.04. Regarding the site of tumor recurrence, only 1 (12%) patient had recurrence at the same site in ET group while 6 (36%) patients had recurrence at the same site with CT
Conclusion: The technique of TURBT is constantly evolving. It demands meticulous care and attention to achieve adequate cancer control and improve recurrence rates. In our study, though ET did not significantly affect the progression rate, it showed a significant reduction in the recurrence rate for NMIBC in comparison with CT. The concept of removing a bladder tumor by CT should be changed to a technique of en-bloc resection to provide better cancer control and long term outcome in non-muscle invasive bladder cancer.