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

Reference:

  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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