Trans-urethral whole layer core biopsy for detection of residual tumor after neoadjuvant therapy in invasive bladder cancer

The most essential information necessary for the treatment of bladder cance r is to know its exact staging. We have developed a percutaneous whole laye r core biopsy (PC- WLCB) of the bladder tumor and applied it successfully s ince April 1985 for the staging and evaluation of neoadjuvant therapy in lo cally invasive bladder cancer. We report here a modified method, the trans- urethral WLCB (TU-WLCB) and present its clinical results. Methods: A 20 F. rigid nephroscope was introduced trans-urethrally and an 18 gauger 350mm-lo ng biopsy needle or newly developed 450mm-long biopsy needle was advanced t o the tumor through the nephroscope. Biopsy was performed under Irans abdom inal ultrasound guidance. Results: Specimens of all 20 TU-WLCB cases includ ed the muscle layer and adipose tissue, and demonstrated small focus of res idual cancers after neoadjuvant therapy. Serious complications were not obs erved so far. Conclusion: TU-WLCB may prove to be a reliable method to stag e and evaluate neoadjuvant therapy for invasive bladder cancer. (C) 2001 El sevier Science Inc. All rights reserved.