Efficacy and Safety of Simultaneous Transurethral Resection of Bladder Cancer and Prostate in the Treatment of Bladder Cancer with Benign Prostatic Hyperplasia: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 LISi , XUPeng , SHENPeng-fei ,  WANGJia

Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

WANGJia, Email: Wangjiaa2002@sina.com

Keywords：

Bladder cancer; Benign prostatic hyperplasia; Transurethral resection; Systematic review; Meta-analysis; Randomized controlled trial; Cohort study

DOI：

10.7507/1672-2531.20150155

Video：

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Objective To systematically evaluate the efficacy and safety of simultaneous transurethral resection of bladder cancer and prostate (TURBT+TURP) in the treatment of bladder cancer with benign prostatic hyperplasia (BPH). Methods We searched PubMed, EMbase, The Cochrane Library, Web of Science, CBM, CNKI, WanFang Data and VIP from inception to January 2015, to collect randomized controlled trials (RCTs) and cohort studies investigating the efficacy and safety of TURBT with TURP in the treatment of bladder cancer with BPH. Two reviewers independently screened literature, extracted data, and assessed the risk bias of included studies, and then meta-analysis was performed using RevMan 5.3 software. Results 3 A total of 3 RCTs (n=137) and 10 retrospective cohort studies (n=998) were included. The results of meta-analysis showed that there were no significant differences between the simultaneous resection group and the control group in the overall recurrence rate (RCT:OR=0.55, 95% CI:0.24 to 1.24, P=0.15; retrospective cohort study:OR=0.78, 95% CI:0.60 to 1.01, P=0.06), postoperative recurrence rate in the prostatic fossa/urethra (RCT:OR=1.40, 95% CI:0.28 to 7.60, P=0.68; retrospective cohort study:OR=1.36, 95% CI:0.49 to 3.74, P=0.55), progression rate (OR=0.93, 95% CI:0.53 to 1.61, P=0.79) and overall perioperative complication rate (RCT:OR=0.35, 95% CI:0.08 to 1.55, P=0.17; retrospective cohort study:OR=0.1.75, 95% CI:0.44 to 6.98, P=0.43). Conclusion Compared with only TURBT or sequential TURBT and TURP, simultaneous TURBT and TURP do not increase the overall recurrence rate, postoperative recurrence rate in the prostatic fossa/urethra, progression rate and overall postoperative complication rate. However, due to the limited quality and quantity of included studies, larger sample size and higher quality RCTs are needed to verify the above conclusion.

Citation： LISi, XUPeng, SHENPeng-fei, WANGJia. Efficacy and Safety of Simultaneous Transurethral Resection of Bladder Cancer and Prostate in the Treatment of Bladder Cancer with Benign Prostatic Hyperplasia: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2015, 15(8): 922-929. doi: 10.7507/1672-2531.20150155 Copy

1.	Babjuk M, Burger M, Zigeuner R, et al. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder:update 2013. Eur Urol, 2013, 64(4):639-653.
2.	Sylvester RJ1, van der Meijden AP, Lamm DL. Intravesical bacillus calmette-guerin reduces the risk of progression in patients with superficial bladder cancer:a meta-analysis of the published results of randomized clinical trials. J Urol, 2002, 168(5):1964-1970.
3.	McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA Guideline on the Management of Benign Prostatic Hyperplasia. J Urology, 2011, 185(5):1793-1803.
4.	Kouriefs C, Loizides S, Mufti G. Simultaneous transurethral resection of bladder tumour and prostate:is it safe?. Urol Int, 2008, 81(2):125-128.
5.	Ham WS, Kim WT, Jeon HJ, et al. Long-term outcome of simultaneous transurethral resection of bladder tumor and prostate in patients with nonmuscle invasive bladder tumor and bladder outlet obstruction. J Urology, 2009, 181(4):1594-1599.
6.	Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). Available at:http://handbook.cochrane.org/.
7.	Singh V, Sinha RJ, Sankhwar SN. Outcome of simultaneous transurethral resection of bladder tumor and transurethral resection of the prostate in comparison with the procedures in two separate sittings in patients with bladder tumor and urodynamically proven bladder outflow obstruction. J Endourol, 2009, 23(12):2007-2011.
8.	汤祺. TUR-BT联合TUPKP治疗表浅性膀胱癌合并良性前列腺增生的疗效及安全性. 山东医药, 2013, 53(21):81-83.
9.	吴汉潮, 陈强文, 张雄伟, 等. 膀胱肿瘤并发BPH患者同期性经尿道膀胱肿瘤电切术及前列腺电切术的可行性. 临床和实验医学杂志, 2014, (13):1093-1096.
10.	Jaidane M, Bouicha T, Slama A, et al. Tumor recurrence in prostatic urethra following simultaneous resection of bladder tumor and prostate:a comparative retrospective study. Urology, 2010, 75(6):1392-1395.
11.	Ugurlu O, Gonulalan U, Adsan O, et al. Effects of simultaneous transurethral resection of prostate and solitary bladder tumors smaller than 3 cm on oncologic results. Urology, 2007, 70(1):55-59.
12.	陈海昕. 非肌层浸润性膀胱癌合并良性前列腺增生患者同期行经尿道电切手术的疗效和安全性分析. 中华泌尿外科杂志, 2011, 32(10):679-681.
13.	高瑞辉. 经尿道同期电切膀胱移行细胞癌合并前列腺增生的回顾性分析. 临床外科杂志, 2008, 16(9):624-626.
14.	黄茂林, 汤华章. 表浅膀胱癌合并前列腺增生经尿道同期电切术的临床观察. 中国现代手术学杂志, 2008, 12(1):64-66.
15.	罗松涛, 王应洪, 李绪鲲, 等. 同期经尿道电切术治疗浅表性膀胱癌合并前列腺增生的临床研究. 河南外科学杂志, 2013, 19(2):68-70.
16.	莫金水. 合并前列腺增生的NMIBC患者同期行TURBT及TURP的效果及其安全性分析. 医学综述, 2014, 20(18):3439-3441.
17.	皮明毅. 经尿道同期电切非肌层浸润性膀胱癌合并前列腺增生. 医学临床研究, 2008, 25(6):1002-1004.
18.	余昆. 经尿道电切术治疗表浅性膀胱癌合并良性前列腺增生的临床分析. 局解手术学杂志, 2012, 21(5):556-558.
19.	Lutzeyer W, Rubben H, Dahm H. Prognostic parameters in superficial bladder cancer:an analysis of 315 cases. J Urology, 1982, 127(2):250-252.
20.	Pode D, Alon Y, Horowitz AT, et al. The mechanism of human bladder tumor implantation in an in vitro model. J Urology, 1986, 136(2):482-486.
21.	Soloway MS, Masters S. Urothelial susceptibility to tumor cell implantation:influence of cauterization. Cancer, 1980, 46(5):1158-1163.
22.	El-Abbady AA, Shoukry MS, Hanno AG, et al. Repeated transurethral resection of recurrent superficial bladder tumors--does it affect the spread and stage of the tumor?. Scand J Urol Nephrol, 2002, 36(1):60-64.
23.	Tsivian A, Shtricker A, Sidi AA. Simultaneous transurethral resection of bladder tumor and benign prostatic hyperplasia:hazardous or a safe timesaver?. J Urology, 2003, 170(6 Pt 1):2241-2243.
24.	Mommsen S, Sell A. Prostatic hypertrophy and venereal disease as possible risk factors in the development of bladder cancer. Urol Res, 1983, 11(2):49-52.
25.	Karaguzhin SG, Merinov DS, Martov AG. One-stage transurethral resection of the urinary bladder and the prostate in patients with superficial cancer of the urinary bladder combined with benign prostatic hyperplasia. Urologiia, 2005, (5):17-21.
26.	Wade M, Seigne JD. Surgical management of bladder cancer in 2003. Expert Rev Anticancer Ther, 2003, 3(6):781-792.
27.	范晋海, 曹建伟. 非肌层浸润性膀胱癌合并良性前列腺增生患者可同期行经尿道膀胱肿瘤电切术+经尿道前列腺电切术. 现代泌尿外科杂志, 2014, 32(8):547-549.
28.	郦俊生. 下尿路梗阻对膀胱肿瘤术后复发的影响. 临床泌尿外科杂志, 2009, 24(4):283-284.
29.	Mynderse LA, Roehrborn CG, Partin AW, et al. Results of a 5-year multicenter trial of a new generation cooled high energy transurethral microwave thermal therapy catheter for benign prostatic hyperplasia. J Urology, 2011, 185(5):1804-1810.
30.	Toren P, Margel D, Kulkarni G, et al. Effect of dutasteride on clinical progression of benign prostatic hyperplasia in asymptomatic men with enlarged prostate:a post hoc analysis of the REDUCE study. BMJ, 2013, 346:f2109.

1. Babjuk M, Burger M, Zigeuner R, et al. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder:update 2013. Eur Urol, 2013, 64(4):639-653.
2. Sylvester RJ1, van der Meijden AP, Lamm DL. Intravesical bacillus calmette-guerin reduces the risk of progression in patients with superficial bladder cancer:a meta-analysis of the published results of randomized clinical trials. J Urol, 2002, 168(5):1964-1970.
3. McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA Guideline on the Management of Benign Prostatic Hyperplasia. J Urology, 2011, 185(5):1793-1803.
4. Kouriefs C, Loizides S, Mufti G. Simultaneous transurethral resection of bladder tumour and prostate:is it safe?. Urol Int, 2008, 81(2):125-128.
5. Ham WS, Kim WT, Jeon HJ, et al. Long-term outcome of simultaneous transurethral resection of bladder tumor and prostate in patients with nonmuscle invasive bladder tumor and bladder outlet obstruction. J Urology, 2009, 181(4):1594-1599.
6. Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). Available at:http://handbook.cochrane.org/.
7. Singh V, Sinha RJ, Sankhwar SN. Outcome of simultaneous transurethral resection of bladder tumor and transurethral resection of the prostate in comparison with the procedures in two separate sittings in patients with bladder tumor and urodynamically proven bladder outflow obstruction. J Endourol, 2009, 23(12):2007-2011.
8. 汤祺. TUR-BT联合TUPKP治疗表浅性膀胱癌合并良性前列腺增生的疗效及安全性. 山东医药, 2013, 53(21):81-83.
9. 吴汉潮, 陈强文, 张雄伟, 等. 膀胱肿瘤并发BPH患者同期性经尿道膀胱肿瘤电切术及前列腺电切术的可行性. 临床和实验医学杂志, 2014, (13):1093-1096.
10. Jaidane M, Bouicha T, Slama A, et al. Tumor recurrence in prostatic urethra following simultaneous resection of bladder tumor and prostate:a comparative retrospective study. Urology, 2010, 75(6):1392-1395.
11. Ugurlu O, Gonulalan U, Adsan O, et al. Effects of simultaneous transurethral resection of prostate and solitary bladder tumors smaller than 3 cm on oncologic results. Urology, 2007, 70(1):55-59.
12. 陈海昕. 非肌层浸润性膀胱癌合并良性前列腺增生患者同期行经尿道电切手术的疗效和安全性分析. 中华泌尿外科杂志, 2011, 32(10):679-681.
13. 高瑞辉. 经尿道同期电切膀胱移行细胞癌合并前列腺增生的回顾性分析. 临床外科杂志, 2008, 16(9):624-626.
14. 黄茂林, 汤华章. 表浅膀胱癌合并前列腺增生经尿道同期电切术的临床观察. 中国现代手术学杂志, 2008, 12(1):64-66.
15. 罗松涛, 王应洪, 李绪鲲, 等. 同期经尿道电切术治疗浅表性膀胱癌合并前列腺增生的临床研究. 河南外科学杂志, 2013, 19(2):68-70.
16. 莫金水. 合并前列腺增生的NMIBC患者同期行TURBT及TURP的效果及其安全性分析. 医学综述, 2014, 20(18):3439-3441.
17. 皮明毅. 经尿道同期电切非肌层浸润性膀胱癌合并前列腺增生. 医学临床研究, 2008, 25(6):1002-1004.
18. 余昆. 经尿道电切术治疗表浅性膀胱癌合并良性前列腺增生的临床分析. 局解手术学杂志, 2012, 21(5):556-558.
19. Lutzeyer W, Rubben H, Dahm H. Prognostic parameters in superficial bladder cancer:an analysis of 315 cases. J Urology, 1982, 127(2):250-252.
20. Pode D, Alon Y, Horowitz AT, et al. The mechanism of human bladder tumor implantation in an in vitro model. J Urology, 1986, 136(2):482-486.
21. Soloway MS, Masters S. Urothelial susceptibility to tumor cell implantation:influence of cauterization. Cancer, 1980, 46(5):1158-1163.
22. El-Abbady AA, Shoukry MS, Hanno AG, et al. Repeated transurethral resection of recurrent superficial bladder tumors--does it affect the spread and stage of the tumor?. Scand J Urol Nephrol, 2002, 36(1):60-64.
23. Tsivian A, Shtricker A, Sidi AA. Simultaneous transurethral resection of bladder tumor and benign prostatic hyperplasia:hazardous or a safe timesaver?. J Urology, 2003, 170(6 Pt 1):2241-2243.
24. Mommsen S, Sell A. Prostatic hypertrophy and venereal disease as possible risk factors in the development of bladder cancer. Urol Res, 1983, 11(2):49-52.
25. Karaguzhin SG, Merinov DS, Martov AG. One-stage transurethral resection of the urinary bladder and the prostate in patients with superficial cancer of the urinary bladder combined with benign prostatic hyperplasia. Urologiia, 2005, (5):17-21.
26. Wade M, Seigne JD. Surgical management of bladder cancer in 2003. Expert Rev Anticancer Ther, 2003, 3(6):781-792.
27. 范晋海, 曹建伟. 非肌层浸润性膀胱癌合并良性前列腺增生患者可同期行经尿道膀胱肿瘤电切术+经尿道前列腺电切术. 现代泌尿外科杂志, 2014, 32(8):547-549.
28. 郦俊生. 下尿路梗阻对膀胱肿瘤术后复发的影响. 临床泌尿外科杂志, 2009, 24(4):283-284.
29. Mynderse LA, Roehrborn CG, Partin AW, et al. Results of a 5-year multicenter trial of a new generation cooled high energy transurethral microwave thermal therapy catheter for benign prostatic hyperplasia. J Urology, 2011, 185(5):1804-1810.
30. Toren P, Margel D, Kulkarni G, et al. Effect of dutasteride on clinical progression of benign prostatic hyperplasia in asymptomatic men with enlarged prostate:a post hoc analysis of the REDUCE study. BMJ, 2013, 346:f2109.

Chinese Journal of Evidence-Based Medicine

Efficacy and Safety of Simultaneous Transurethral Resection of Bladder Cancer and Prostate in the Treatment of Bladder Cancer with Benign Prostatic Hyperplasia: A Systematic Review

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