Transurethral en bloc resection versus standard resection of bladder tumor: a multi-center randomized trial (eb-star study)

You have accessJournal of UrologyCME1 Apr 2023PD13-11 TRANSURETHRAL EN BLOC RESECTION VERSUS STANDARD RESECTION OF BLADDER TUMOR: A MULTI-CENTER RANDOMIZED TRIAL (EB-STAR STUDY) Jeremy Teoh, Tsz-Yeung Chan, Ivan Tsang, Joseph Li, Bryan Cheng, Chak-Lam Cho, Wilson Chan, Yi Chiu, Brian Ho, Trevor Li, Man-Chung Law, Chris Lee, Cheung-Hing Cheng, Ka-Lun Lo, Kin-Man Lam, Wayne Chan, Hing-Shing So, Clarence Leung, Chun-Ki Chan, Ming-Kwong Yiu, Chi-Man Ng, Vincent Poon, Chi-Ho Leung, and Chi-Fai Ng Jeremy TeohJeremy Teoh More articles by this author , Tsz-Yeung ChanTsz-Yeung Chan More articles by this author , Ivan TsangIvan Tsang More articles by this author , Joseph LiJoseph Li More articles by this author , Bryan ChengBryan Cheng More articles by this author , Chak-Lam ChoChak-Lam Cho More articles by this author , Wilson ChanWilson Chan More articles by this author , Yi ChiuYi Chiu More articles by this author , Brian HoBrian Ho More articles by this author , Trevor LiTrevor Li More articles by this author , Man-Chung LawMan-Chung Law More articles by this author , Chris LeeChris Lee More articles by this author , Cheung-Hing ChengCheung-Hing Cheng More articles by this author , Ka-Lun LoKa-Lun Lo More articles by this author , Kin-Man LamKin-Man Lam More articles by this author , Wayne ChanWayne Chan More articles by this author , Hing-Shing SoHing-Shing So More articles by this author , Clarence LeungClarence Leung More articles by this author , Chun-Ki ChanChun-Ki Chan More articles by this author , Ming-Kwong YiuMing-Kwong Yiu More articles by this author , Chi-Man NgChi-Man Ng More articles by this author , Vincent PoonVincent Poon More articles by this author , Chi-Ho LeungChi-Ho Leung More articles by this author , and Chi-Fai NgChi-Fai Ng More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003260.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Conventionally, standard resection (SR) is performed by resecting the bladder tumor in a piecemeal manner. En bloc resection of bladder tumor (ERBT) has been proposed as a potentially superior technique in treating non-muscle-invasive bladder cancer (NMIBC). METHODS: The EB-StaR study is a multi-centre, randomized, phase 3 trial comparing between ERBT and SR. In this study, we randomly assigned patients with bladder tumor(s) of ≤3cm to receive ERBT or SR. The primary outcome was 1-year recurrence rate. A modified intention-to-treat analysis on patients with histologically confirmed NMIBC was performed for the study outcomes. This trial is registered with ClinicalTrials.gov (NCT02993211). RESULTS: From April 2017 to Dec 2020, a total of 350 patients were recruited and randomized to receive ERBT or SR. Among the 350 patients, 276 patients were histologically confirmed to have NMIBC, with 143 patients in the ERBT group and 133 patients in the SR group. Regarding the primary outcome, the 1-year recurrence rates were 28.5% (95% confidence interval, 18.4-37.4%) in the ERBT group, and 38.1% (95% confidence interval, 28.4-46.5%) in the SR group (p=0.007). The 1-year progression rates were 0% in the ERBT group, and 2.6% (95% confidence interval, 0-5.5%) in the SR group (p=0.065). The ERBT group had a longer operative time (33.4±18.5 vs 24.7±12.9 minutes, p<0.001) than the SR group. All other secondary outcomes including the detrusor muscle sampling rates, occurrence of obturator reflex, rates of post-operative mitomycin C instillation, hospital stay, 30-day complications, residual disease and upstaging of disease upon second-look transurethral resection were similar between the two groups. CONCLUSIONS: In patients with NMIBC of ≤3cm, ERBT resulted in a significant reduction in 1-year recurrence rate when compared to SR. Source of Funding: Funded by GRF/ECS, Research Grants Council of Hong Kong, Reference no: 14117421, 14120620 and 24116518 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e409 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jeremy Teoh More articles by this author Tsz-Yeung Chan More articles by this author Ivan Tsang More articles by this author Joseph Li More articles by this author Bryan Cheng More articles by this author Chak-Lam Cho More articles by this author Wilson Chan More articles by this author Yi Chiu More articles by this author Brian Ho More articles by this author Trevor Li More articles by this author Man-Chung Law More articles by this author Chris Lee More articles by this author Cheung-Hing Cheng More articles by this author Ka-Lun Lo More articles by this author Kin-Man Lam More articles by this author Wayne Chan More articles by this author Hing-Shing So More articles by this author Clarence Leung More articles by this author Chun-Ki Chan More articles by this author Ming-Kwong Yiu More articles by this author Chi-Man Ng More articles by this author Vincent Poon More articles by this author Chi-Ho Leung More articles by this author Chi-Fai Ng More articles by this author Expand All Advertisement PDF downloadLoading ...