Pd30-12 a Prospective Study on the Impact of Continuous Saline Bladder Irrigation After Transurethral Resection of Bladder Tumor on Tumor Cell Dissemination

You have accessJournal of UrologyBladder Cancer: Non-invasive II (PD30)1 May 2024PD30-12 A PROSPECTIVE STUDY ON THE IMPACT OF CONTINUOUS SALINE BLADDER IRRIGATION AFTER TRANSURETHRAL RESECTION OF BLADDER TUMOR ON TUMOR CELL DISSEMINATION Qi Zhang, Yanhua Du, Xiaomin Yu, Gan Du, Wen Zhang, Kaitai Zhang, and Jianzhong Shou Qi ZhangQi Zhang , Yanhua DuYanhua Du , Xiaomin YuXiaomin Yu , Gan DuGan Du , Wen ZhangWen Zhang , Kaitai ZhangKaitai Zhang , and Jianzhong ShouJianzhong Shou View All Author Informationhttps://doi.org/10.1097/01.JU.0001008848.77629.6f.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Continuous saline bladder irrigation (CSBI) has been used clinically to theoretically flush out tumor cells shed during transurethral resection of bladder tumor (TURBT) and prevent their colonization. However, to date, there have been no relevant studies that can provide conclusive evidence to prove the effect of CSBI. To demonstrate the flushing effect of CSBI, we conducted a prospective study to compare postoperative levels of active urinary exfoliated tumor cell (UETC) in patients who received irrigation or not using a new active UETC detection technology that has been validated for capturing peripheral blood circulating tumor cells (CTCs) in prostate cancer (Yang Z, et al. EClinicalMedicine 2022). METHODS: 170 patients with non-muscle invasive bladder cancer (NMIBC) scheduled to undergo TURBT were randomly assigned to receive CSBI (Median flush time: 6 hours) or not after immediate postoperative intravesical instillation of epirubicin. The patients' first urine after morning urine was collected before surgery and on the 1st & 5th day after surgery to detect UETC. RESULTS: The UETC of 170 enrolled patients increased significantly on the first postoperative day, and decreased significantly on the fifth postoperative day. Although this trend existed in both groups of patients who received CSBI or not, the downward trend of the CSBI group is more significant (Fig. 1A). A subgroup analysis of preoperative baseline UETC levels found that UETC levels were associated with risk stratification, invasiveness, multifocality, and urinary leukocyte, but not with tumor size, and bladder irritation (Fig. 1B). Further analysis within relevant subgroups found that there were similar differences within different subgroups, that is, the postoperative UETC of patients in the irrigation group could decrease significantly in a short period of time, while the postoperative UETC of patients in the non-irrigation group did not obviously decrease (Fig. 1C-F). CONCLUSIONS: The fact that UETC increased instead of falling on the first postoperative day suggests that segmented resection by TURBT does lead to tumor cell spread. As a positive clinical regimen, CSBI can effectively eliminate disseminated tumor cells after surgery, potentially reducing the risk of recurrence. Download PPT Source of Funding: This research was supported by the Clinical and Translational Medicine Research Project of the Chinese Academy of Medical Sciences (Grant no. 2022-I2M-C&T-B-056). Funders only provided funding and had no role in the study design, data collection, data analysis, interpretation, and writing of the report © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e629 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Qi Zhang More articles by this author Yanhua Du More articles by this author Xiaomin Yu More articles by this author Gan Du More articles by this author Wen Zhang More articles by this author Kaitai Zhang More articles by this author Jianzhong Shou More articles by this author Expand All Advertisement PDF downloadLoading ...