Related Experiment Video
Updated: Jul 22, 2026
An Orthotopic Bladder Cancer Model for Gene Delivery Studies
Published on: December 1, 2013
Feasibility and Oncological Outcome of Patients Achieving Noninvasive Downstaging After Transurethral Resection of
Takehisa Onishi1, Takuji Shibahara1, Sho Sekito1
1Department of Urology, Ise Red Cross Hospital, Ise, Japan.
Objective:
To evaluate the oncological outcomes of selective bladder preservation therapy, comprising maximal TURBT plus neoadjuvant chemotherapy (NAC) followed by 2nd-TURBT.
Methods:
From 2012 to 2022, 110 localized muscle-invasive bladder cancer patients who desired bladder preservation (BP) received maximal TURBT plus NAC followed by restaging (CT scan+ 1st-TURBT) and 2nd-TURBT. Sixty-one patients with pure urothelial carcinoma of the urinary bladder (PUCUB) who achieved noninvasive downstaging (NID) after NAC and had no residual tumor at 2nd-TURBT underwent conservative treatment (BP group). Overall survival (OS), cancer-specific survival (CSS), distant metastasis-free survival (DMFS), and cystectomy and distant metastasis-free survival (CDMFS) were estimated using the Kaplan-Meyer method. Propensity score matching was performed to compare the survival outcomes of patients in the BP group with those who underwent NAC + radical cystectomy (RC) and were diagnosed with ypT1 or less (RC group, n = 42). Multivariable Cox regression (MCR) models addressed survivals according to each treatment method.
Results:
In the BP group, 5-year OS, CSS, DMFS, and CDMFS were 87.4%, 93.8%, 83.1%, and 76.8%, respectively. MCR models for survival showed no differences in OS (BP: hazard ratio [HR] 1.24, P = .83), CSS (BP: HR 1.15, P = .74), and DMFS (BP: HR 1.09, P = .91) between the matched cohort.
Conclusions:
BP therapy incorporating maximal TURBT plus NAC followed by 2nd-TURBT may be used as an alternative therapy to RC for selected muscle-invasive PUCUB patients. As this was a retrospective study, further randomized trials with longer follow-up are needed.
