@misc{10481/111879,
year = {2026},
month = {3},
url = {https://hdl.handle.net/10481/111879},
abstract = {Background/Objectives: Non-muscle invasive bladder cancer (NMIBC) is characterized by
high recurrence rates, requiring frequent diagnostic and therapeutic interventions. This
study evaluates the feasibility, safety, oncological outcomes, and economic impact of im
plementing an in-office laser bladder tumor fulguration protocol. Methods: A descriptive,
longitudinal study was conducted between 2020 and 2025 on 65 patients with recurrent
NMIBC. Procedures were performed in an outpatient setting under local anesthesia us
ing a flexible cystoscope and a Holmium:YAG (Ho:YAG) laser. The primary endpoint
was recurrence-free survival. Secondary endpoints included complication rates (Clavien
Dindo) and a cost-analysis comparison with conventional transurethral resection of the
bladder (TURBT). Results: The mean age was 69.4 years, with 89.2% of patients classified
as ASA≥2. After a median follow-up of 20.3 months, the recurrence rate was 33.8%,
with 0% progression. Most procedures (95.4%) had no complications; only 4.6% presented
Clavien–Dindo grade 1 events. Adjuvant mitomycin C was administered in 93.8% of cases.
The cost analysis demonstrated substantial economic advantages, with costs reduced by
89.7% versus the 24 h admission model and 82.1% versus the day-surgery model according
to regional health-system tariffs. Conclusions: In-office laser fulguration is a safe, effective,
and economically sustainable alternative to traditional TURBT for selected low-risk recur
rences. It optimizes hospital resources, minimizes anesthetic risk in comorbid patients, and
maintains favorable oncological control.},
publisher = {MDPI},
keywords = {Bladder cancer},
keywords = {Non-muscle-invasive bladder cancer},
keywords = {Laser therapy},
title = {De-Intensification Strategies in Non-Muscle-Invasive Bladder Cancer: Outcomes and Cost Impact of In-Office Bladder Fulguration},
doi = {10.3390/jcm15051939},
author = {Melgarejo-Segura, Maria Teresa and Herraez Marcos, Miguel and Cano Garcia, Maria Carmen and Zambudio-Munuera, Alberto and Rodríguez Parras, Patricia and Arrabal Polo, Miguel Ángel},
}