Sionov Ben Valery, Tsivian Matvey, Taha Tarek, Bass Roman, Kheifets Alexander, Sidi Abraham Ami, Tsivian Alexander
Department of Urologic Surgery, Edith Wolfson Medical Center, Holon, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Cent European J Urol. 2020;73(4):440-444. doi: 10.5173/ceju.2020.0073. Epub 2020 Nov 6.
The aim of our study was to evaluate whether a biopsy from the tumor base after transurethral resection of bladder tumor (TURBT) has an impact on subsequent management of patients with bladder tumors. While tumor base biopsy at the completion of TURBT is a common practice, there is no definition of its role within the major international professional guidelines.
We retrospectively reviewed the records of consecutive patients undergoing TURBT between 2015 and 2019 at our institution. We recorded demographic and tumor characteristics of initial TURBT, tumor base biopsy and restaging TURBT pathology outcomes. The pathologic outcomes were correlated to assess the additional value of a separate tumor base biopsy.
A total of 532 patients underwent TURBT. A separate tumor base biopsy after completion of TURBT was performed in 154 patients. The mean patient's age was 72.8 ±11.7 years (range 48-94) and 119 (77.2%) were men. In 40 patients (25.9%) muscle was absent in the pathological specimen of the tumor resection. Muscle was present in all but 6 (3.9%) tumor base biopsies. Of the 33 patients who underwent repeated transurethral resection for pT1 tumors, 2 had residual low-grade pTa, 1 had residual high-grade pT1, and 3 patients were upstaged to pT2.
Although tumor base biopsy at the completion of TURBT is a common practice, our analysis fails to demonstrate any tangible benefit in the staging of bladder tumors. In our experience tumor base biopsy did not change the management in patients with superficial or muscle invasive disease.
我们研究的目的是评估经尿道膀胱肿瘤切除术（TURBT）后取自肿瘤基底部的活检对膀胱肿瘤患者后续治疗的影响。虽然TURBT结束时进行肿瘤基底部活检是一种常见做法，但在主要的国际专业指南中尚未明确其作用。
我们回顾性分析了2015年至2019年在我院连续接受TURBT的患者记录。我们记录了初次TURBT的人口统计学和肿瘤特征、肿瘤基底部活检及再次分期TURBT的病理结果。对病理结果进行相关性分析，以评估单独进行肿瘤基底部活检的附加价值。
共有532例患者接受了TURBT。其中154例患者在TURBT结束后进行了单独的肿瘤基底部活检。患者的平均年龄为72.8±11.7岁（范围48 - 94岁），男性119例（77.2%）。在40例（25.9%）患者的肿瘤切除病理标本中未发现肌肉组织。除6例（3.9%）肿瘤基底部活检外，其余均发现有肌肉组织。在33例因pT1肿瘤接受再次经尿道切除术的患者中，2例残留低级别pTa，1例残留高级别pT1，3例患者分期升至pT2。
虽然TURBT结束时进行肿瘤基底部活检是一种常见做法，但我们的分析未能证明其在膀胱肿瘤分期方面有任何实际益处。根据我们的经验，肿瘤基底部活检并未改变浅表性或肌层浸润性疾病患者的治疗方案。
