Impact of Time to the Second TURBT on Oncological Outcomes in Non-Muscle Invasive Bladder Cancer Patients Treated with BCG - Expert Commentary

The effect of restaging transurethral resection (Re-TUR) timing after initial transurethral resection of bladder tumor (TURBT) on survival rates is not well studied. A recent study published by Calò et al. in the World Journal of Urology investigated the appropriate time frame for patients with high-grade T1 bladder cancer (BC) to undergo Re-TUR.

The authors compared the recurrence-free survival (RFS), progression-free survival (PFS), and cancer-specific survival (CSS) in BC patients who underwent Re-TUR at different time points before receiving intravesical Bacillus Calmette–Guerin (BCG). The authors included 269 high-grade T1 BC patients from two centers. The median follow-up was 49.3 months (interquartile range 25–65). Patients were grouped into three groups based on time to Re-TUR. The study included 65 patients in group A (≤ 6 weeks), 142 patients in group B (> 6–12 weeks), and 62 patients in group C (> 12–18 weeks). The three groups had no significant differences in age, sex, multifocality, tumor diameter, presence of muscle in the TUR specimen, lymphovascular invasion, or rates of positive pathological results at Re-TUR.

The study did not identify any statistically significant difference in RFS, PFS, and CSS among the three groups. Multivariate Cox regression analysis showed that group B (> 6–12 weeks) had higher RFS. This retrospective study in a homogenous BC population shows no significant effect of time to Re-TUR on oncological outcomes. As the authors discussed, previous studies showed that a shorter time to Re-TUR.

Written by: Bishoy M. Faltas, MD, Director of Bladder Cancer Research, Englander Institute for Precision Medicine, Weill Cornell Medicine, New York City, New York


  1. Calò, Beppe, Ugo Falagario, Francesca Sanguedolce, Alessandro Veccia, Marco Chirico, Emanuel Carvalho-Diaz, Paulo Mota et al. "Impact of time to second transurethral resection on oncological outcomes of patients with high-grade T1 bladder cancer treated with intravesical Bacillus Calmette–Guerin." World Journal of Urology (2020): 1-7.
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