Safety and efficacy of outpatient Holmium-YAG laser ablation of non‐muscle invasive bladder cancer: following up a large retrospective UK case series
BAUS ePoster online library. Gowda A. 11/10/20; 304208; P12-8
Mr. Arjun Gowda
Mr. Arjun Gowda
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Safety and efficacy of outpatient Holmium-YAG laser ablation of non‐muscle invasive bladder cancer: following up a large retrospective UK case series

A Gowda, AE Bazo, H Yao, P Goodall, B Sherwood
Nottingham City Hospital, Nottingham, United Kingdom

Introduction:
Flexible cystoscopy and Holmium-YAG laser ablation (HoLAT) under local anaesthesia for treatment of low-grade bladder tumour recurrences has been demonstrated to be a safe, well-tolerated procedure with economic advantages. The outcomes for high grade recurrences for patients unfit for regional or general anaesthesia is less clear. This study aims to assess the long-term oncological outcome of a large single institution series of patients with low-grade and high-grade bladder tumour recurrences treated with HoLAT.

Patients and Methods: Patients were offered HoLAT if the tumour recurrence was small and/or they were unfit for regional or general anaesthesia. Patients who had their first episode of HoLAT between June 2006 and September 2013 were included. Data was extracted from patient's medical records. The primary outcomes were overall survival (OS), cancer specific survival (CSS), progression free survival (PFS) and recurrence free survival (RFS).

Results:
232 patients with 522 HoLAT procedures were included. Median age was 74. At initial diagnosis 24.1% had G1pTa, 47% G2pTa, 9.9% G3pTa, 19% T1 and 4.3% CIS. The median follow-up was 74.8 months. 18% were discharged after a recurrence free follow up duration. 52.2% had 1 HoLAT, 19.8% had 2 HoLATs, 11.2% had 3 HoLATs and 16.8% had 4 or more. At 10 years, OS was 47.4%, CSS was 94.1%, PFS was 82.1%, RFS was 15.8% (see Table 1 for subgroup analysis).

Conclusions:
HoLAT for bladder tumour recurrences has an acceptable CSS and PFS for patients with small low grade tumours or those unfit for regional or general anaesthesia.

Safety and efficacy of outpatient Holmium-YAG laser ablation of non‐muscle invasive bladder cancer: following up a large retrospective UK case series

A Gowda, AE Bazo, H Yao, P Goodall, B Sherwood
Nottingham City Hospital, Nottingham, United Kingdom

Introduction:
Flexible cystoscopy and Holmium-YAG laser ablation (HoLAT) under local anaesthesia for treatment of low-grade bladder tumour recurrences has been demonstrated to be a safe, well-tolerated procedure with economic advantages. The outcomes for high grade recurrences for patients unfit for regional or general anaesthesia is less clear. This study aims to assess the long-term oncological outcome of a large single institution series of patients with low-grade and high-grade bladder tumour recurrences treated with HoLAT.

Patients and Methods: Patients were offered HoLAT if the tumour recurrence was small and/or they were unfit for regional or general anaesthesia. Patients who had their first episode of HoLAT between June 2006 and September 2013 were included. Data was extracted from patient's medical records. The primary outcomes were overall survival (OS), cancer specific survival (CSS), progression free survival (PFS) and recurrence free survival (RFS).

Results:
232 patients with 522 HoLAT procedures were included. Median age was 74. At initial diagnosis 24.1% had G1pTa, 47% G2pTa, 9.9% G3pTa, 19% T1 and 4.3% CIS. The median follow-up was 74.8 months. 18% were discharged after a recurrence free follow up duration. 52.2% had 1 HoLAT, 19.8% had 2 HoLATs, 11.2% had 3 HoLATs and 16.8% had 4 or more. At 10 years, OS was 47.4%, CSS was 94.1%, PFS was 82.1%, RFS was 15.8% (see Table 1 for subgroup analysis).

Conclusions:
HoLAT for bladder tumour recurrences has an acceptable CSS and PFS for patients with small low grade tumours or those unfit for regional or general anaesthesia.

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