Retrospective analysis of 1470-/980-nm dual-wavelength laser en bloc resection versus transurethral resection of bladder tumor for primary non-muscle-invasive bladder cancer

To compare the safety and efficacy of en bloc resection of non-muscle-invasive bladder cancer (NMIBC) using a 1470-/980-nm dual-wavelength laser (DwLRBT) compared to the gold standard, transurethral resection (TURBT). The study group included 251 patients with a confirmed diagnosis of NMIBC, 97 in the DwLRBT group and 154 in the TURBT group. Clinical characteristics, complications, and recurrence-free survival were compared between the two groups. There were no differences between the two groups with regard to age, sex, mean tumor size, mean tumor number, tumor location, risk, fever, and reoperation. Compared to TURBT, DwLRBT was associated with a shorter hospitalization time (mean±standard deviation: 5.81±1.48 days vs. 4.96±1.32, respectively, p =0.001), shorter catheterization time (4.98±1.47 vs. 4.20±1.48 days, respectively; p =0.035), and smaller volume of intraoperative bleeding (8.43±6.21 ml vs. 6.15±5.08, respectively; p =0.003). Recurrence-free survival (RFS) was better for DwLRBT than TURBT in the overall cohort (hazard ratio [HR], 0.4323; 95% confidence interval [CI], 0.2852–0.6554; p =0.0004) and for the following subgroups and tumor types: intermediate-risk (HR, 0.2654; 95%CI, 0.1020–0.6904; p =0.0245) and high-risk (HR, 0.4461; 95% CI, 0.2778–0.7162; p =0.0027) groups; and for pedunculate bladder tumors (HR, 0.4158; 95%CI, 0.2401–0.7202; p =0.0063), single bladder tumors (HR, 0.4136; 95%CI, 0.2376–0.7293; p =0.0072), and multiple bladder tumors (HR, 0.2727; 95%CI, 0.1408–0.5282; p =0.0014). DwLRBT is associated with better operative and postoperative outcomes, including, importantly, a longer RFS, compared to TURBT.