Office fulguration apt for low grade bladder tumors

In selected patients, small recurrent superficial papillary bladder tumors can be safely dealt with by means of in-office cystodiathermy, New York researchers report in the February issue of the Journal of Urology. They say this approach “can potentially improve patient quality of life and have a major economic impact on health care.”

Dr. S. Machele Donat of Memorial Sloan-Kettering Cancer Center and colleagues note that although such tumors are usually treated under anesthesia by means of transurethral resection, flexible cystodiathermy appears to be an appropriate alternative.To investigate, the researchers analyzed data obtained on 267 patients with bladder cancer undergoing routine surveillance at their institution. All patients had completed initial bladder cancer treatment and the median surveillance period before recurrence was 11.57 months.Given patient agreement, criteria for the office procedure were having less than 5 low-grade tumors, a tumor size of less than 0.5 cm and negative urine cytology.In total, 123 patients experienced tumor recurrence over a median follow-up of 2.6 years. Of these, 74 (60%) underwent office cystodiathermy and the remainder received formal transurethral resection.No difference in disease specific survival or in tumor recurrence was seen in patients who underwent the office procedure compared to those who did not. Thus, the researchers conclude that the approach is “safe and efficacious in properly selected patients.” However, they stress that in cases of any doubt, transurethral resection should be employed.](Source: J Urol 2004;171:636-639: Reuters Health: March 2004: Oncolink)