Long-term Success of Laser Treatment for Recurrent Bladder Cancer in Elderly Patients

What is it about?

The study explores the long-term efficacy of transurethral laser ablation (TULA) as a treatment for recurrent non-muscle invasive bladder cancer (NMIBC) in elderly and comorbid patients, offering a minimally invasive alternative to the traditional transurethral resection of bladder tumor (TURBT). Conducted as a single-center, retrospective cohort study, it analyzes outcomes such as recurrence-free survival (RFS), progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS) among 319 patients. TULA showed a 5-year RFS of 31.8% for intermediate-risk and 29.0% for high-risk NMIBC, with a low complication rate of 4.0%. The findings, although limited by missing data and the study's retrospective nature, indicate that TULA is a safe and effective outpatient procedure for managing recurrent NMIBC, potentially reducing healthcare costs and environmental impact.

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Why is it important?

This research is important because it evaluates the long-term outcomes of transurethral laser ablation (TULA) as a treatment for non-muscle invasive bladder cancer (NMIBC), particularly in elderly and comorbid patients. The study addresses a gap in knowledge regarding the efficacy and safety of TULA, which is a less invasive and potentially more cost-effective alternative to the traditional transurethral resection of bladder tumor (TURBT). By providing insights into the recurrence-free and progression-free survival rates, as well as overall survival and cancer-specific survival, this research contributes valuable data to inform clinical decision-making, potentially impacting treatment protocols and improving patient outcomes. Additionally, it highlights the environmental benefits of TULA, aligning with the need for sustainable healthcare practices. Key Takeaways: 1. Long-Term Efficacy: The study provides evidence on the long-term efficacy of TULA in treating recurrent NMIBC, with specific survival rates stratified by risk groups using the EORTC risk model, thus offering a viable alternative to TURBT. 2. Safety and Complications: TULA is shown to be a safe procedure with a low complication rate of 4.0%, making it a suitable option for elderly and comorbid patients who may not tolerate the risks associated with repeated general anesthesia. 3. Environmental and Economic Impact: By reducing the need for operating room resources and hospital stays, TULA presents an opportunity to decrease healthcare costs and the carbon footprint associated with bladder cancer treatment, addressing both economic and environmental concerns in medical practice.