SIU 2017: Results of Repeat Transurethral Resection of Bladder Tumor (TURBT) by Institution Performing the Initial TURBT: Comparative Analyses between Referred and Non-Referred Group

Lisbon, Portugal ( Repeat TURBT after an initial diagnosis of NMIBC, specifically high-grade T1 disease, is recommended by most guidelines. Due to moderate ~20-30% rate of understaging on initial TURBT, repeat TURBT is recommended to ensure that MIBC is not missed. However, considering the potential cost implications, patient discomfort, and potential risks of repeat TURBT, there has been renewed interest to reassess the need of repeat TURBT.

In this study, the group for South Korea assess the institutional effect of repeat TURBT efficacy. They retrospectively reviewed the charts of 289 patients who undertwent repeat TURBT within 6 weeks of initial diagnosis, but stratified patients based on the institution where their repeat TURBT was completed. The mean follow-up was 50 months. 

Patients referred (initial TURBT done elsewhere) included 69 patients, while the non-referred group (initial TURBT done in the same institution) included 220 patients. The pathology on repeat TURBT included higher rates of residual disease (82.6% vs. 55.9%), higher rates of upstaging (21% vs. 4.5%), and higher rates of upstaging to T2 disease (15.9% vs. 3.5%). 

Based on this, they indicate that there is clearly a difference between the quality of initial TURBT done at outside institutions vs. referral centers. However, there is an inherent bias in this study – as only difficult cases were likely referred to their center. This is never accounted for. While there may be some basis to this statement, this abstract does not prove it.

Presented by: Min Young Yoon 

Written by: Thenappan Chandrasekar, MD, Clinical Fellow, University of Toronto, twitter: @tchandra_uromd, at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal
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