Influences of Different Operative Methods on the Recurrence Rate of Non-Muscle-Invasive BladderCancer

Purpose: To compare the influence of three operative approaches [transurethral en bloc resection of bladder tumor by pin-shaped electrode (pin-ERBT), transurethral resection of bladder tumor (TURBT), and transurethral holmium laser resection of bladder tumor (HoLRBT)] on the recurrence rate of non-muscle-invasive bladder cancer (NMIBC) with low dimensions (i.e. diameter below 3 cm). Materials and Methods: A retrospective analysis was conducted for a total of 115 patients affected by solitary NMIBC, with a diameter 3 cm, who were submitted to operation between March 2013 to May 2017. The patients were divided according to the operative method applied (pin-ERBT, TURBT, and HoLRBT groups, respectively). The 2-year recurrence rate was compared among the three groups, and multivariate Cox hazard model analysis was applied to analyze the influencing factor(s) for postoperative recurrence. Results: The 2-year recurrence rate was 10.0% in ERBT, 38.5% in TURBT and 40.0% in HoLRBT group, with a significant difference (P = 0.014). According to the Cox hazard model analysis, age (HR = 1.058, 95% CI: 1.019~1.098, P = 0.003), operative method (HR = 2.974,6.508, 95% CI: 0.862~10.255,1.657~25.566, P = 0.023), smoking (HR=2.399, 95% CI: 1.147~5.017, P = 0.020), and pathological grade (HR = 2.012,95% CI: 1.279~3.165, P = 0.002) were risk factors for postoperative recurrence of bladder cancer. Conclusion: Pin-ERBT can prominently decrease the postoperative recurrence rate of solitary NMIBC with a diameter 3 cm.