Table 1.

Summary of Studies Evaluating the Impact of Maximal TURBT on Outcomes in Muscle-Invasive Bladder Cancer (MIBC).

Study	Patient Population	TURBT Approach	Outcomes	Key Findings
Efstathiou et al., 2012 [33]	348 patients with MIBC	Complete TURBT	CR: 79% for complete resection vs. 57% for incomplete resection	Complete TURBT associated with better CR and survival rates
James et al., 2012 [21]	360 patients with MIBC	Majority did not undergo maximal debulking	Superior 5-year OS (48% vs. 35%) with chemoradiation vs. radiation alone	Good outcomes despite lack of maximal TURBT in most patients
Mak et al., 2014 [32]	468 patients with MIBC (T2-T4)	Complete vs. Incomplete TURBT	the presence of hydronephrosis, higher clinical stage (T3/T4), and visibly incomplete TURBT are predictors of worse disease-specific survival on univariate analysis.	Only visibly complete TURBT remained a significant predictor of disease-specific survival on multivariable analysis. It is unclear whether a visually complete TURBT before TMT is truly a prognostic factor or a surrogate marker of a lower local tumor stage.
Suer et al., 2016 [36]	90 patients with MIBC	Second TURBT	Higher 5-year DSS (68% vs. 41%) and OS (63.7% vs. 40.1%)	Second TURBT significantly improves 5-year DSS and should be performed in patients with MIBC who are going to be treated with bladder-preserving protocols.
Zamboni et al., 2019 [42]	433 patients with MIBC undergoing RC	Complete TURBT	53% had MIBC at RC; no clear correlation with oncologic outcomes	Complete TURBT not clearly associated with improved outcomes.
Pak et al., 2021 [35]	93 patients with MIBC before neoadjuvant chemotherapy (NAC)	Complete vs. Incomplete TURBT	Superior survival for complete TURBT prior to NAC	Complete TURBT before NAC linked to better survival outcomes