Vesical Imaging-Reporting and Data System (VI-RADS) Followed by Photodynamic Trans-urethral Resection of Bladder Tumours (PDD-TURBT) to Avoid Secondary Resections (Re-TURBT) in Non-Muscle Invasive Bladder Cancers (NMIBCs) (CUT-less)
Non-muscle-invasive Bladder Cancer, Non-Muscle Invasive Bladder Urothelial Carcinoma, High Risk Non-Muscle Invasive Bladder Urothelial Carcinoma
About this trial
This is an interventional treatment trial for Non-muscle-invasive Bladder Cancer
Eligibility Criteria
Inclusion Criteria: Female and Male patients at least 18 years old referred for clinical suspicion of primary or recurrent BCa who have been advised to undergo TURBT. Patients with a TUR-confirmed diagnosis of NMIBC and candidate for second look and resection (Re-TURBT) according to EAU Guidelines [6]. No imaging evidence (i.e., mpMRI/VI-RADS score 1 or 2) of muscle-invasive, locally advanced, or metastatic BCa (i.e., only confirmed CIS, Ta, T1, N0, M0 will be considered eligible). Patients who never received adjuvant Bacillus of Calmette-Guérin (BCG) immunotherapy (i.e., BCG naïve patients) for previous BCa history. Fit to undergo all procedures listed in protocol. Able to provide written informed consent. Exclusion Criteria: Contraindication to TURBT and/or Re-TURBT. Initial TURBT diagnosis of MIBC (i.e., T2) or locally advanced BCa (i.e., T3-T4). Preoperative evidence of metastatic disease (i.e., cN1 - N3 and/or cM1). Visual evidence of low-risk NMIBC (solitary tumor, < 1 cm) before initial TURBT. Visual evidence of MIBC on preliminary cystoscopy (i.e., non-papillary or sessile mass attached directly by its base without a stalk). TURBT diagnosis of NMIBCs not eligible for Re-TURBT according to EAU Guidelines (i.e., Ta-LG; Ta-HG with detrusor muscle in the specimen; primary CIS) [6]. Concomitant Upper tract (kidney or ureteric) tumours on imaging. Contraindication to adjuvant intravesical BCG immunotherapy. Unfit to undergo any procedures listed in protocol.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
PPD-TURBT (no Re-TURBT)
WL TURBT plus Re-TURBT (Standard of Care)
Primary PDD-TURBT, not followed by Re-TURBT
Standard of care consisting in primary WL TURBT followed by WL Re-TURBT within 2 - 6 weeks from initial WL TURBT