Intraoperative control of the effectiveness of transurethral resection of non-muscle-invasive bladder cancer

This paper presents results of 82 patients treated for non-muscle- invasive bladder cancer. 28 patients underwent transurethral resection of bladder cancer (TURB) as a monotherapy, 28 - TURB with photodynamic control, 26 - TURB with dynamic transurethral sonography. Analysis of the 5-year recurrence rate, pattern and timing of recurrence depending on the modality of intraoperative control of TURB effectiveness was performed. The overall recurrence rate in the first group was 60.71%, of them local recurrence in the resection area occurred in 21.43% of cases, outside of the region of resection - in 28.57% of cases, and progression - in 10.71%. In the second group the overall recurrence rate was 25%, recurrence in the resection area was diagnosed in 7.14% of patients, outside of the region of resection - in 14.29% and progression - in 3.57%. In the third group of patients over a 5 -year period local recurrence in the resection area was identified in 3.84% of cases, outside of the region of resection - in 23.07% of cases and no cases of disease progression were observed. The results showed that TURB without additional intraoperative imaging of surgery effectiveness was not a radical treatment for non-muscle- invasive bladder cancer. Photodynamic control increases the surgery effectiveness by preventing recurrences outside the resection region. It allows identifying microscopic modified urothelium clones, but does not affect the rate of disease progression. Intraoperative transurethral ultrasound guidance increases TURB effectiveness by preventing both relapse in the area of resection and disease progression.

non-muscle-invasive bladder cancer, transurethral resection, photodynamic imaging, transurethral sonography