ArticleEuropean urology open science2026
Histopathological Advantages of En Bloc Resection in Non-muscle-invasive Bladder Cancer: A Multinational Randomised Controlled Clinical Trial.
Article in European urology open science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and objective: En bloc resection of bladder tumours (ERBT) has been proposed as an alternative to conventional transurethral resection of bladder tumours (cTURBT) for non-muscle-invasive bladder cancer (NMIBC), potentially improving clinical outcomes and pathological specimen quality. This randomised controlled trial (RCT) compared pathological staging and grading consistency, thermal damage, and specimen orientation between ERBT and cTURBT. Methods: In this multinational RCT, patients with suspected NMIBC tumours measuring 1-4 cm were randomised 1:1 to ERBT or cTURBT. A central pathology review was conducted. The primary end point was T-stage concordance between central review and initial pathology assessment. Secondary outcomes included thermal damage and loss of orientation (fragments lacking epithelial cells or detrusor muscle). Surgical outcomes and complications were also evaluated. Key findings and limitations: Across 11 sites in five countries, 220 patients were randomised (110 ERBT, 110 cTURBT). For pathology review, 209 cases (103 ERBT, 106 cTURBT) were available. T-stage concordance was 80% (ERBT) versus 81% (cTURBT), corresponding to a difference of -1.5% (95% confidence interval [CI], -12 to 9.3; Conclusions and clinical implications: T-stage concordance was similar between the ERBT and cTURBT groups. ERBT specimens showed improved orientation and reduced thermal damage. Standardised specimen-handling protocols are essential to fully realise the pathological advantages of ERBT.
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