40 En-Bloc Transurethral Resection of Non-Muscle- Invasive Bladder Cancer. Current Evidence and Glimpses into the Future Copyright@ Shahrokh F Shariat --------------------------------------------------------------------------------------------------------------------------------- This work is licensed under Creative Commons Attribution 4.0 License AJBSR.MS.ID.000756 Mini Review David D’Andrea 1 , Francesco Soria 1,2 , Kilian M Gust 1 , Paolo Gontero 2 , Rodolfo Hurle 3 , Thomas RW Herrmann 4 , Dmitry Enikeev 5 , Petr V Glybochko 5 , Sergey Kotov 6 , Maxim Ryabov 6 , Lukas Lusuardi 7 and Shahrokh F Shariat 1,5,8,9,10 * 1 Department of Urology, Medical University of Vienna, Austria 2 Department of Surgical Sciences, AOU Città della Salute e della Scienza di Torino, Italy 3 Department of Urology, Istituto Clinico Humanitas IRCCS, Italy 4 Department of Urology, Kantonspital Frauenfeld, Switzerland 5 Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Russia 6 Department urology and andrology Pirogov Russian National Research Medical University, Russia 7 Department of Urology, Paracelsus Medical University, Austria 8 Department of Urology, University of Texas Southwestern Medical Center, USA 9 Departments of Urology, Weill Cornell Medical College, USA 10 Department of Urology, Charles University, Czechia *Corresponding author: Shahrokh F Shariat, Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. To Cite This Article: Shahrokh F Shariat. En-Bloc Transurethral Resection of Non-Muscle-Invasive Bladder Cancer. Current Evidence and Glimpses into the Future. Am J Biomed Sci & Res. 2019 - 4(1). AJBSR.MS.ID.000756. DOI: 10.34297/AJBSR.2019.04.000756 Received: July 04, 2019 | Published: July 17, 2019 American Journal of Biomedical Science & Research ISSN: 2642-1747 www.biomedgrid.com Abstract Background: The purpose of this review was to summarize the current evidence on en-bloc transurethral resection (eTURB) of non-muscle-in- vasive bladder cancer compared to conventional TURB (cTURB) with a particular emphasis on ongoing randomized trials. Materials and methods: A PubMed/MEDLINE search of the English-language literature from its inception until June 2019 using the following terms in isolation or combination “bladder cancer”, “en bloc”, “TURB” and “resection” was performed. Evidence synthesis: Compared to cTURB, eTURB has been shown to achieve higher rates of detrusor muscle (>95%) and better quality of the specimen for pathological evaluation. Complication rates and perioperative outcomes are comparable between the two techniques. Moreover, eTURB seems to achieve lower recurrence rates. However, the retrospective nature of the studies and underpowered prospective trials limit the interpretation of these results. There are currently two active randomized trials which are evaluating the one-year recurrence rate (EB-StaR) and difference in the rate of detrusor muscle in the specimen between cTURB and eTURB (eBLOC), respectively. Conclusion: eTURB seems to provide a significant improvement in the surgical management of NMIBC with regards to oncology and safety outcomes. Keywords: Bladder cancer; En-bloc; Transurethral resection Abbrevations NMIBC: Non-Muscle-Invasive Bladder Cancer; TURB: Transurethral Resection of the Bladder; MIBC: Muscle-Invasive Bladder Cancer; BCG: Bacillus Calmette Guérin; RFS: Recurrence-Free Survival; PFS: Progression-Free Survival; OS: Overall Survival; eTURB: En-Bloc Tran- surethral Resection of the Bladder; cTURB: Conventional Transurethral Resection of the Bladder