The safety and efficacy of front-firing green-light laser endoscopic en bloc photoselective vapo-enucleation of non-muscle-invasive bladder cancer

Abstract

Purpose: Laser therapy provides an alternative option for treating non-muscle-invasive bladder cancer (NMIBC). However, the clinical evidence for potassium-titanyl-phosphate (KTP) laser en bloc resection is still limited. Here, we investigated the efficacy and safety of the 120-W front-firing KTP laser for the treatment of NMIBC. Methods: A total of 64 patients with NMIBC treated with either a 120-W front-firing KTP-photoselective vapo-enucleation of the bladder tumor (PVEBT, n=34) or transurethral resection of the bladder tumor (TURBT, n=30) were included. En bloc resection was applied to the patients in PVEBT group. Results: There was no significant difference in rinsing time ( P =0.292), indwelling catheter ( P =0.080), pathologic type, and T stage ( P =0.870) between the two groups. Compared with the TURBT group, patients treated with PVEBT had a shorter hospitalization stay ( P =0.044), a shorter operation time ( P =0.008), and a lower muscle miss rate ( P =0.044). PVEBT is superior to TURBT in terms of the rate of 1-year recurrence ( P =0.015) and tumor grade progression rate ( P =0.019). Conclusion: The 120-W front-firing KTP laser en bloc enucleation technique is a safe and feasible procedure for treating patients with NMIBC. Further external validation in larger cohorts with a long follow-up period is warranted. Keywords: bladder cancer, transurethral resection, en bloc, laser surgery, recurrence