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Outcome of simultaneous thulium laser enucleation of bladder tumor and prostate in patients with non-muscle invasive bladder tumor and benign prostatic hyperplasia: a matched-pair comparison with a long-term follow-up
摘要： Objective To access the surgical and oncological outcomes of simultaneous thulium laser enucleation of bladder tumor (ThuLEBT) and thulium laser enucleation of prostate (ThuLEP) in patients with non-muscle invasive bladder tumor (NMIBC) and benign prostatic hyperplasia (BPH). Patients and methods Between June 2009 and June 2017, 118 men with NMIBC who underwent simultaneous ThuLEBT and ThuLEP and fulfilled the inclusion criteria were matched with 118 patients who received ThuLEBT alone. Clinico-pathological parameters, surgical outcome data and oncological outcomes were retrospectively analyzed and compared. Results The patients who underwent simultaneous ThuLEBT and ThuLEP experienced a longer length of operation time (70.4 vs. 25.5 min; p < 0.001), but there were no statistically significant differences in catheterization period, hospital stay and complication between the two groups. At a mean follow-up of 58.7 and 55.8 months in ThuLEBT/ThuLEP group and ThuLEBT group, no significant differences in overall recurrence rates, progression rates, recurrence in the bladder neck/prostatic fossa and mean elapsed time to recurrence were detected. The 5-year recurrence-free probability was 73.2% for ThuLEBT/ThuLEP and 69.2% for ThuLEBT (p = 0.361). Conclusions Our results indicate that simultaneous ThuLEBT and ThuLEP can be safely performed without increasing the surgical risk and the risk of tumor recurrence and progression in patients with NMIBC and BPH, and it may be preferred alternative for select patients.
关键词： Bladder tumor,Tumor recurrence,Benign prostatic hyperplasia,Laser therapy,Thulium laser enucleation of bladder tumor,Thulium laser enucleation of prostate
更新于2025-09-23 15:21:01
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Can a second resection be avoided after initial thulium laser endoscopic en bloc resection for non-muscle invasive bladder cancer? A retrospective single-center study of 251 patients
摘要： Background: This study aimed to evaluate the efficacy of transurethral thulium laser en bloc resection of the bladder tumor (TmLRBT) in patients with non-muscle invasive bladder cancer (NMIBC) and to investigate whether a second resection can be avoided. Methods: From June 2012 to June 2018, 251 newly diagnosed patients with NMIBC were enrolled in this retrospective study; all patients received regular administration of pirarubicin after the initial resection. A second transurethral resection (TUR) was performed in patients within 2–6 weeks after the initial TmLRBT in group 1. Patients in group 2 only underwent cystoscopy at 3 months. Results: Second surgery results indicate that recurrence was detected histopathologically in 6/108 and 11/143 patients in group 1 and 2, respectively (P = 0.52); Progression was observed in 2 patients in each group (P = 0.34). The mean follow-up duration was 40.1 months, with no significant difference between the groups (P = 0.32). Recurrence was observed in 23 (21.3%) and 39 (27.3%) patients in groups 1 and 2 during the follow-up, respectively (P = 0.34); disease progression occurred in 4 (3.8%) patients in group 1 compared with 7 (4.0%) in group 2 (P = 0.20). Conclusion: Complete removal of tumors can be achieved by TmLRBT. This technique may decrease the number of second TURs.
关键词： Intravesical instillation,Transurethral thulium laser en bloc resection of bladder tumor,Second resection,Bladder cancer,Pirarubicin
更新于2025-09-23 15:19:57
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Towards automated in vivo bladder tumor stratifcation using Confocal Laser Endomicroscopy
摘要： Purpose Urothelial carcinoma of the bladder (UCB) is the most common urinary cancer. White-light cystoscopy (WLC) forms the corner stone for the diagnosis of UCB. However, histopathological assessment is required for adjuvant treatment selection. Probe-based confocal laser endomicroscopy (pCLE) enables the visualization of the micro-architecture of bladder lesions during WLC, which allows for real-time tissue differentiation and grading of UCB. To improve the diagnostic process of UCB, computer aided classification of pCLE videos of in vivo bladder lesions were evaluated in this study. Materials and Methods We implemented pre-processing methods to optimize contrast and to reduce striping artifacts in each individual pCLE frame. Subsequently, a semi-automatic frame selection was performed. The selected frames were used to train a feature extractor, based on pre-trained ImageNet networks. A recurrent neural network, in specific long-short term memory (LSTM), was used to predict the grade of the bladder lesions. The differentiation of lesions was performed at two levels, namely (i) healthy and benign versus malignant tissue and (ii) low-grade versus high-grade papillary UCB. A total of 53 patients with 72 lesions were included in this study, resulting in approximately 140.000 pCLE frames. Results The semi-automated frame selection reduced the number of frames to approximately 66.500 informative frames. The accuracy for the differentiation of (i) healthy and benign versus malignant urothelium was 79% and (ii) high-grade and low-grade papillary UCB with 82%. Conclusions A feature extractor in combination with a LSTM results in an proper stratification of pCLE videos of in vivo bladder lesions.
关键词： confocal laser endomicroscopy,deep learning,bladder tumor,long-short term memory,classification
更新于2025-09-12 10:27:22