(UroToday.com) The 2024 European Association of Urology (EAU) annual congress held in Paris, France between April 5th and 8th was host to a non-muscle invasive bladder cancer (NMIBC) poster session of studies evaluating the benefits and harms of various treatment options. Dr. Gyrithe Pedersen presented the long-term results of a non-inferiority randomized controlled trial comparing outpatient laser coagulation to transurethral resection of bladder tumor (TURBT) for low-grade, intermediate-risk bladder tumors.
Dr. Pedersen and colleagues have previously demonstrated that outpatient photocoagulation of bladder tumors is non-inferior to TURBT with regards to 4-months recurrence-free survival in patients with intermediate-risk, low-grade Ta bladder tumors.1 In this analysis, they reported the 12-months recurrence-free survival, as well as the long-term recurrence-free and long-term progression-free survivals following both laser photocoagulation and TURBT.
This was a randomized controlled trial conducted between 2016 and 2022 in Denmark that compared OPD 980 diode laser photocoagulation of bladder tumors to gold standard TURBT under general anesthesia. 300 patients with recurrent low-grade Ta bladder tumors were randomized in a 1:1 fashion. The inferiority criteria for recurrence-free survival at 12 months was set at 15%. Conversely, the inferiority limit for long-term progression-free survival was set at 5%.
300 patients were randomized, with median follow-up ranging between 47 and 49 months. The 12-months recurrence-free survival rates were 42.2% and 44.1% following laser photocoagulation and TURBT, respectively (difference: 1.9%, 95% CI for difference: -9.3% to 13.2%). Long-term recurrence free survival was not significantly different between the two groups (p=0.35).
At 60 months, the cumulative incidence of stage progression was 1% following laser coagulation, compared to 0.9% with TURBT (difference: 0.2%, 95% CI for difference: -2.4 to 2.7%).
The investigators concluded that:
- 12-months recurrence-free survival was non-inferior following laser photo coagulation, compared to TURBT.
- Stage progression is rare with both treatment modalities and is not higher with laser photo coagulation.
- Laser photo coagulation appears to be a safe alternative to TURBT when treating intermediate risk, low-grade bladder tumors.
Presented by: Gyrithe Lynghøj Pedersen, Department of Urology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark
Written by: Rashid Sayyid, MD, MSc – Society of Urologic Oncology (SUO) Clinical Fellow at The University of Toronto, @rksayyid on Twitter during the 2024 European Association of Urology (EAU) annual congress, Paris, France, April 5th – April 8th, 2024
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