There are differing clinical perspectives on the resection range of transurethral resection of bladder tumor (TURBT) for paraureteral bladder cancer. This study aimed to compare the incidence of ureteral stricture and bladder cancer recurrence after conservative versus aggressive TURBT in the treatment of paraureteral bladder cancer. A retrospective analysis was performed on 164 patients with paraureteral bladder cancer who underwent TURBT between April 2017 and July 2024. Among them, 133 patients had complete clinical and follow-up data. Based on the resection margin of the tumor, patients were divided into the conservative group and the aggressive group. The 2 groups were compared regarding the outcomes of postoperative ureteral stricture and bladder cancer recurrence. The overall incidence of ureteral stricture within 1 year after TURBT was 11.28% (15/133), and the recurrence rate of bladder cancer was 21.80% (29/133). All patients had negative postoperative resection margins and no deaths within 1 year. The incidence of postoperative ureteral stricture was 11.11% (6/54) in the conservative treatment group and 11.39% (9/79) in the aggressive treatment group, with no statistically significant difference between the 2 groups ( P = .960). The postoperative recurrence of bladder cancer was 31.48% (17/54) in the conservative treatment group and 15.19% (12/79) in the aggressive treatment group, and there was a statistically significant difference between the 2 groups ( P = .025). Aggressive TURBT for paraureteral bladder cancer showed no significant difference in the incidence of postoperative ureteral stricture compared with conservative TURBT but significantly reduced the recurrence rate of bladder cancer. Therefore, we believe that during TURBT for paraureteral bladder cancer, maximizing the resection range, including a wider safety margin (>1 cm) around the main tumor – may be more appropriate.
Fan et al. (Fri,) studied this question.