Efficacy analysis of transurethral en bloc resection for bladder tumors ≥3 cm

Background: En bloc resection of bladder tumors (ERBT) is a surgical treatment for non-muscle-invasive bladder cancer (NMIBC). However, data on the efficacy and safety of ERBT for tumors ≥3 cm are limited. This study aimed to investigate the technical characteristics and clinical application of β-electrode ERBT in the treatment of bladder tumors ≥3 cm and analyze its feasibility and short-term safety. Methods: for pathological examination. The primary endpoints recorded were recurrence-free survival (RFS) and progression-free survival (PFS), with secondary endpoints including detrusor muscle (DM) presence rate (presence of muscularis propria in specimens) and safety (intraoperative and postoperative complications). Results: This study enrolled 102 patients with tumor size ≥3 cm. The median operative time was 50.0 (IQR: 34.5, 90.0) minutes, with 73 (71.6%) cases involving DM. No obturator nerve reflex occurred intraoperatively in any patient. Postoperative complications were observed in 10 patients, among which urinary tract infection was the most common (n=5). During a median follow-up of 22.5 (IQR: 14.0, 29.3) months, 10 recurrences and 4 progressions were recorded. The 2-year RFS and 2-year PFS were 90.2% and 96.9%, respectively. Conclusions: β-electrode ERBT is a selective surgical approach for bladder tumors ≥3 cm, demonstrating favorable short-term efficacy with minimal intraoperative and postoperative complications, and a good short-term oncological prognosis after surgery.