Results of second transurethral resection for high-grade T1 bladder cancer

• Published in: Urology annals Vol. 8; no. 1; pp. 10 - 15
• Main Authors: Hashine, Katsuyoshi, Ide, Takehiro, Nakashima, Takeshi, Hosokawa, Tadanori, Ninomiya, Iku, Teramoto, Norihiro
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer - Medknow Publications 01.01.2016; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Bacillus Calmette–Guérin; Bladder cancer; Care and treatment; Case studies; Diagnosis; high-grade T1 bladder cancer; Original; Patient outcomes; second transurethral resection; United States; Bacillus Calmette-Guérin; second transurethral resection; high-grade T1 bladder cancer; Bacillus Calmette–Guérin
• ISSN: 0974-7796; 0974-7834
• DOI: 10.4103/0974-7796.163798

Background: The aim of this study was to examine the histological outcome and potential therapeutic benefit of second transurethral resection (TUR) for high-grade T1 bladder cancer. Patients and Methods: The subjects were 171 patients who underwent initial TUR between January 1993 and December 2013, and were diagnosed with high-grade T1 bladder cancer. Second TUR was performed within 4-6 weeks after the initial resection. Intravesical recurrence, invasive intravesical recurrence, and disease-free, progression-free, and overall survival were examined between second TUR group and no second TUR group. Results: Of the 171 patients, 79 (46.2%) underwent second TUR. Histological findings from second TUR were no cancer in 33 (41.8%), carcinoma in situ in 18 (22.9%), Ta in 15 (19.0%), T1 in 12 (15.2%), and muscle invasive bladder cancer (T2) in 1 case (1.3%). The 5- and 10-year intravesical recurrence-free survival rates were 72.0% and 57.4%, respectively, and the disease-free survival rates at these times were 69.7% and 49.6%, respectively. Second TUR had no influence on intravesical recurrence, regardless of the use of Bacillus Calmette-Guerin (BCG) therapy. No BCG therapy and recurrent cancer were significantly associated with intravesical recurrence in multivariate analysis. Recurrent cancer was also a significant risk factor for invasive intravesical recurrence. BCG therapy significantly improved disease-free survival. Second TUR was a significant factor in overall survival. In the histological results for second TUR, no cancer and Tis cases had reduced intravesical recurrence compared to Ta and T1 cases. Conclusion: Second TUR allows more accurate staging and pT0 cases in second TUR have a better outcome, indicating a possible therapeutic benefit of the procedure.