Neodymium:YAG Laser Treatment of Bladder Tumors

Abstract

Sixty-six patients with primary or recurrent transitional cell carcinoma of the bladder in stage T_A-T₂ N₀ M₀ were randomized to receive either laser or transurethral resection. Some of these patients also received adjuvant mitomycin C. In patients treated by laser resection, the recurrence rates were 0.27 without mitomycin and 0.17 with mitomycin; corresponding figures in patients treated by transurethral resection were 7.89 and 1.82. These results are similar to those reported by the much larger EORTC study. Notably, after laser treatment, there were almost no local recurrences (1%), whereas the recurrence rate after standard transurethral resection is 40%–60%. Our findings indicate that the laser is superior to standard transurethral resection for bladder tumors of no more than cherry size. Additional benefits are greater ease of performance, sealing of blood and lymphatic vessels supplying the tumor, and reduction in cost and morbidity.