En-bloc Resection of Bladder Tumor Versus Conventional Transurethral Resection of Bladder Tumor: Long-term Oncological Outcomes from a Single-center Prospective Trial
In brief
En bloc removal yields similar 60-month recurrence (10% vs 8%) to standard TURBT
In a prospective single-center trial of 219 patients, en bloc transurethral resection did not lower urothelial recurrence, overall survival or cancer-specific survival compared with conventional TURBT after a median five-year follow-up. Recurrence rates were 10% versus 8%, and survival outcomes were virtually identical, suggesting no clear oncologic benefit of the newer technique.
- Journal
- European urology focus (Q1)
- Published
- 1 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Francesco Di Bello, Pietro Diana, Andrea Gallioli, Angelo Territo, Óscar Rodriguez-Faba, Josep M Gaya, et al.
- PMID
- 42542426
- DOI
- 10.1016/j.euf.2026.07.008
Why clinicians should know about it
- Picked for Urology (top studies of the week, 25 October 2026): Randomized comparison of bladder tumor resection techniques and outcomes
Abstract
Prior randomized trials have shown that en bloc transurethral resection of bladder tumor (ERBT) is noninferior to conventional transurethral resection of bladder tumor (cTURBT) for pathological staging. To address gaps in long-term oncologic outcomes, we conducted a post hoc analysis of a single-center randomized trial including 219 of the 248 patients treated between 2018 and 2021, evaluating overall survival (OS), cancer-specific survival (CSS), and cumulative incidence of urothelial recurrence with a median follow-up of 60 mo (interquartile range = 53-79). ERBT was performed in 124 patients (57%) and cTURBT in 95 (43%). Overall, 77 patients experienced recurrence. With updated follow-up, 60-mo cumulative urothelial recurrence rates ranged from 8% (95% confidence interval [CI] = 2-14) for cTURBT to 10% (95% CI = 5-18) for ERBT. Even after competing-risk multivariable adjustment for overall mortality, as well as age, sex, tumor stage and grade, comorbidities (hypertension and diabetes mellitus), prior bladder tumor, and adjuvant therapy, recurrence rates did not differ between ERBT and cTURBT. Rates of upgrading (low grade to high grade) and upstaging (Tx/Ta/T1-T2) were also similar between groups. During follow-up, 41 patients died, including 5 bladder cancer-related deaths; 60-month OS was 76% (95% CI = 68-86) for cTURBT and 83% (95% CI = 76-90) for ERBT, with no difference in 60-mo CSS (97% vs 97%).
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.