Safety and efficacy of holmium laser resection for primary nonmuscle-invasive bladder cancer versus transurethral electroresection: Single-center experience

OBJECTIVES To assess the safety and efficacy of holmium laser resection for primary, clinically nonmuscle-invasive, bladder cancer (HoLRBT) compared with standard transurethral resection of bladder tumor (TURBT). METHODS The data from a total of 212 consecutive patients with primary nonmuscle-invasive bladder cancer were collected in this study. These patients were treated by holmium laser resection (HoLRBT group) or transurethral electroresection (TURBT group) and were divided into 2 groups. The patients in each group were stratified into 3 risk subgroups (low, intermediate, and high risk) according to the prognostic factors for recurrence using the European Association of Urology guidelines. The intraoperative complications and postoperative characteristics of the HoLRBT and TURBT groups were compared. Efficacy, indicated by the recurrence-free survival in the overall group and stratified subgroups, was analyzed and compared using the Kaplan-Meier technique and the log-rank test. RESULTS The patient demographics and tumor characteristics in the 2 groups were comparable. HoLRBT was superior to TURBT in terms of intraoperative complications and postoperative catheterization time (P < .001). Recurrence-free survival after HoLRBT was similar to that after TURBT (P = .283). CONCLUSIONS Our results have indicated that HoLRBT is a feasible, safe, and effective alternative for the management of primary, clinically nonmuscle-invasive, bladder cancer compared with TURBT, with similar recurrence-free survival and fewer perioperative complications. It also can provide sufficient material for the pathologic evaluation.