In this study, 94 patients were found to have high-grade disease on their first resection between January 2014 and July 2016. Retrospective data was collected on initial resection, re-resection, and treatment.
Forty three patients (46%) had muscle in their first resection. Twenty two patients (23%) had concomitant carcinoma-in-situ. Seventy seven patients (82%) had an early re-resection. Four patients (4.3%) were upstaged to muscle invasive bladder cancer; 2 had concomitant carcinoma-in-situ and lacked muscle in the first resection, 1 lacked muscle, and 1 had an incomplete resection. Forty patients (52%) had residual tumour on re-resection. Eight out of seventeen patients had no residual disease when muscle was in the primary resection and re-resection was completed within 8 weeks compared with 11/22 when muscle was present and re-resection was delayed beyond 8 weeks.
The authors conclude that in their center under-staging was rare. Therefore, the authors suggest that not all patients require an early re-resection. Further sub-classification of high-grade disease based upon multi-disciplinary discussion of operative and histological findings would enable optimisation of treatment in this group of patients.
Presented by: Brophy T.
Affiliation: Royal Preston Hospital, Preston, United Kingdom
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre.Twitter: @GoldbergHanan at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal