En Bloc Radical Cystectomy: Technique and Oncological Results

What is it about?

The study compares the effectiveness of En bloc radical cystectomy (EbRC) and standard radical cystectomy (stdRC) in treating high-grade superficial or muscle invasive bladder cancer. EbRC involves systematic mobilisation of lymphatic tissue and resecting it en bloc with the bladder, while stdRC involves standard bladder removal. The 3-year recurrence-free survival (RFS) was 86% for EbRC versus 67% for stdRC. The improved outcomes persisted in propensity score-matched analyses. The study found no significant differences between the two groups in terms of gender, age, comorbidity, neoadjuvant chemotherapy, or clinical stages. EbRC is safe and the preliminary oncological results are promising.

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Why is it important?

This research is important as it presents a new surgical technique, en bloc radical cystectomy (EbRC), for treating high-grade superficial or muscle invasive bladder cancer. The technique is based on principles used during total mesorectal excision for rectal cancer and aims to improve outcomes by complete excision of the entire lymphatic drainage of the bladder, including all tissue starting at the outer landmarks of the resection. The study shows that EbRC results in improved recurrence-free survival (RFS) compared to the standard radical cystectomy (stdRC) technique. Key Takeaways: 1. EbRC is a new surgical technique for treating high-grade superficial or muscle invasive bladder cancer based on principles used during total mesorectal excision for rectal cancer. 2. EbRC results in improved recurrence-free survival (RFS) compared to standard radical cystectomy (stdRC). 3. The technique focuses on systematic uninterrupted mobilisation of all lymphatic tissue from the circumferential resection margin towards the bladder pedicles, and resecting the tissue en bloc with the bladder.