Ng Chase Peng Yun, Light Alexander, Eleftheriou Charis, Hug Oliver, Richardson Ellie, Gill-Taylor Tarra, Shamsuddin Altaf, Abboudi Hamid, Agrawal Sachin
Imperial Urology Imperial College Healthcare NHS Trust London UK.
Department of Surgery and Cancer Imperial College London London UK.
BJUI Compass. 2025 Jul 17;6(7):e70052. doi: 10.1002/bco2.70052. eCollection 2025 Jul.
Elderly and comorbid patients with non-muscle invasive bladder cancer (NMIBC) often undergo repeated transurethral resection of bladder tumour (TURBT) under general anaesthesia. Transurethral laser ablation (TULA) is an outpatient-based alternative with lower morbidity, cost and carbon footprint, but its long-term efficacy is not well-established. We report the long-term outcomes of recurrent NMIBC treated with TULA, stratified by European Organisation for Research and Treatment of Cancer (EORTC) risk groups.
We conducted a single-centre, retrospective cohort study, including all consecutive NMIBC patients treated with TULA between 2012 and 2023. The primary outcomes were recurrence-free survival (RFS) and progression-free survival (PFS) and secondary outcomes included cancer-specific survival (CSS), overall survival (OS) and complications, stratified by EORTC risk groups. Data were analysed using Kaplan-Meier survival analysis and Cox regression model.
Three hundred and nineteen patients (1186 TULAs), with a median age of 77 and median Charleson Comorbidity Index of 7, were included. Median follow up was 4.4 years. The 5-year RFS of intermediate-risk and high-risk NMIBC treated with TULA were 31.8% (95%CI:25.6-39.7%) and 29.0% (95%CI: 20.1-42.0%), respectively, with no significant difference (p:0.47). The 5-year PFS were 86.8% (95%CI: 82.1-91.7%) and 93.1% (95%CI: 85.2-100.0%), respectively. Overall, the 10-year OS and CSS were 50.7% (95% CI: 41.8-61.5%) and 96.1% (95%CI: 93.3-98.9%), respectively. The complication rate was 4.0%. Age was the only positive predictor of recurrence. Limitations include missing data (7.9%) and single-centre retrospective design.
TULA is a safe, minimally invasive treatment with long-term efficacy for elderly and comorbid patients with recurrent NMIBC. Although recurrence rate at 5 years were high, progression rate, especially muscle invasion, was low and reassuring. Long-term overall survival and cancer-specific survival remained excellent.
患有非肌肉浸润性膀胱癌（NMIBC）的老年合并症患者通常在全身麻醉下接受多次经尿道膀胱肿瘤切除术（TURBT）。经尿道激光消融术（TULA）是一种门诊治疗的替代方法，具有较低的发病率、成本和碳足迹，但其长期疗效尚未明确。我们报告了根据欧洲癌症研究与治疗组织（EORTC）风险组分层的TULA治疗复发性NMIBC的长期结果。
我们进行了一项单中心回顾性队列研究，纳入了2012年至2023年间所有连续接受TULA治疗的NMIBC患者。主要结局是无复发生存期（RFS）和无进展生存期（PFS），次要结局包括癌症特异性生存期（CSS）、总生存期（OS）和并发症，根据EORTC风险组进行分层。使用Kaplan-Meier生存分析和Cox回归模型分析数据。
纳入319例患者（1186次TULA治疗），中位年龄77岁，中位Charlson合并症指数为7。中位随访时间为4.4年。TULA治疗的中危和高危NMIBC的5年RFS分别为31.8%（95%CI：25.6-39.7%）和29.0%（95%CI：20.1-42.0%），无显著差异（p：0.47）。5年PFS分别为86.8%（95%CI：82.1-91.7%）和93.1%（95%CI：85.2-100.0%）。总体而言，10年OS和CSS分别为50.7%（95%CI：41.8-61.5%）和96.
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