• Wei-Lun Huang, Chao-Yuan Huang, Kuo-How Huang, Yeong-Shiau Pu, Hong-Chiang Chang, and Po-Ming Chow.
• Department of Urology, National Taiwan University Hospital, National Taiwan University, College of Medicine, Taipei, Taiwan.
• J Formos Med Assoc. 2022 Jan 1; 121 (1 Pt 1): 73-80.

Background/PurposeSeveral strategies have been reported for improving the integrity of transurethral resection of bladder tumor (TURBT). However, no standard has been established. Stratified TURBT (SR) is one of protocols for TURBT, wherein exophytic tumors are first resected and retrieved, and tumor bases are then resected. In this study, we aimed to evaluate the outcomes of SR in patients with nonmuscle invasive bladder cancer (NMIBC).MethodsFrom January 2012 to December 2017, patients newly diagnosed as having NMIBC with a follow-up period of more than 2 years were enrolled and categorized into SR and conventional TURBT (CR) groups. Propensity score matching at a 2:1 ratio was performed. Outcomes were the detrusor muscle sampling rate, recurrence-free survival (RFS), and progression-free survival (PFS).ResultsIn total, 205 patients were included in our study. The detrusor muscle sampling rate was higher in the SR group (P = 0.043). After propensity score matching, 162 patients were selected for outcome analysis, with 108 and 54 patients undergoing SR and CR, respectively. Compared with the CR group, the SR group showed a lower recurrence rate (P = 0.015) and better RFS in univariate (P = 0.010) and multivariate (P = 0.006) Cox proportional hazards regression. Progression rate and PFS were not significantly different between the two groups.ConclusionSR results in a higher detrusor muscle sampling rate and better disease outcomes. Our findings suggest that SR is a promising strategy for TURBT in patients with NMIBC.Copyright © 2021 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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