En-Bloc Resection of Bladder Tumors

Observational data shows that "en bloc" resection of bladder tumor (EBR-BT) may entail advantages when compared with conventional transurethral bladder tumor resection (TURBT). EBR-BT has the potential to increase the rate of correct staging and accurate assignment of risk-classification in non-muscle-invasive bladder cancer (NMIBC) and to avoid re-TURBT in a considerable number of high-grade NMIBC by demonstrating total macro and microscopic eradication of the primary tumor and to provide the basis for a correct treatment based on a correct stage. Following the rules of the IDEAL collaboration evaluation and stages of surgical innovation and considering EBR-BT as a surgical technical innovation, the investigators designed a multi-institutional, stage 2a/b study on feasibility (procedural success), safety (including pathology features), and short-term efficacy of EBR-BT and as proof of concept on the reliability of NMIBC staging. Main objective: to prospectively assess the pathological efficacy of EBR-BT in the staging of bladder cancer and the clinical efficacy at short-term recurrence-free survival. Secondary objectives: To assess the clinical efficacy at short-term (3-months) of EBR-BT, and to compare efficacy in the staging of the EBR-BT with the conventional TURBT.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Age: 18 years old and older (adult, older adult) Sexes: All Accepts healthy volunteers: No

Inclusion criteria:

* Patients aged 18 and older presenting with suspicion of primary or recurrent Non-muscle invasive bladder cancer (NMIBC)
* Tumor size estimated by cystoscopy ≤ 3 cm
* Solitary or multiple tumors (up to 3 in number)

Exclusion Criteria:

* Tumor size \> 3 cm of maximum dimeter
* Patient with severe systemic disease (ASA III+)
* Location on the anterior bladder wall and/ or anterior bladder neck (relative contraindication depending on accessibility)
* Pregnancy
* Histological diagnosis other than NMIBC urothelial bladder cancer
* Presence or history of previous upper-tract urinary cancer (UTUC)
* Presence of positive cytology without macroscopic identifiable bladder tumor
* Life expectancy \< 1 year
* Non-reversible coagulopathy
* Bladder tumor detected during intravesical BCG therapy
* Tumor multiplicity (\> 3 tumors)

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