Office-based fulguration for low-grade bladder cancer: Cost-effective and efficient?

What is it about?

The study included 270 patients who underwent office-based fulguration (OF) for small, recurrent, pathological Ta low-grade (LG) non-muscle-invasive bladder cancer (NMIBC) and compared the outcomes to transurethral resection of bladder tumour (TURBT). The median follow-up was 10.1 years and there were no significant periprocedural complications recorded with OF. At the last date of follow-up, 94.1% of the patients were free of progression to muscle-invasive bladder cancer (MIBC) and 85.6% were alive without disease. The incidence of progression to disease pT ≥2 was 2.0%, 3.1%, and 5.5% at 5, 10, and 15 years, respectively. The incidence of metastasis was 1.5%, 2.2%, and 2.2% at 5, 10, and 15 years, respectively. The cancer-specific survival (CSS) was 100% at 10 years. The study supports the use of OF for the management of selected recurrent TaLG-appearing papillary tumours without compromising oncological outcomes, reducing operative and anaesthetic-associated morbidity, convalescence time, and costs. [Some of the content on this page has been created by AI]

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Why is it important?

This research is important because it assesses the effectiveness of office-based fulguration (OF) under local anesthesia for small, recurrent, pathological Ta low-grade (LG) non-muscle-invasive bladder cancer (NMIBC). OF is an alternative to transurethral resection of bladder tumour (TURBT), which avoids the costs and risks associated with the procedure and anesthesia. This study supports the use of OF for managing selected recurrent TaLG-appearing papillary tumours, without compromising the oncological outcome. Key Takeaways: 1. Office-based fulguration (OF) under local anesthesia is an effective alternative to transurethral resection of bladder tumour (TURBT) for managing small, recurrent, pathological Ta low-grade (LG) non-muscle-invasive bladder cancer (NMIBC). 2. OF reduces operative and anaesthetic-associated morbidity, convalescence time, and is cost-effective. 3. OF for recurrent small LG-appearing tumours after an initial diagnosis of TaLG NMIBC should be more widely used worldwide and be part of the urologist's armamentarium. 4. The study supports the management of selected recurrent TaLG-appearing papillary tumours with OF under local anaesthesia, without compromising the oncological outcome.