The role of a re-transurethral resection (TUR) is clearly demonstrated in T1 high-grade nonmuscle invasive bladder cancer. However, its role remains controversial for Ta high-risk tumors and the recent European guidelines stated that the second look procedure could be avoided for these patients despite harboring a high-risk of both disease recurrence and progression. We aimed to evaluate the added benefit on staging, response to bacillus Calmette-Guérin and oncological outcomes of re-TUR in patients with Ta high-grade nonmuscle invasive bladder cancer.
Overall, we identified 15 studies, including 3912 patients from which 743 harbored Ta high-grade disease. Delay between first and second TUR was ranging from 2 to 12 weeks (median 5.6 weeks). The rate of residual disease was 52.8% (range 17-67%). The rate of overall upstaging to T1 and muscle-invasive disease were 10.9 and 4.7%, respectively. Although there was a trend toward improvement of recurrence-free survival outcomes, no definitive conclusions can be drawn due to the retrospective design of the studies included.
Residual tumor is common after initial TUR for Ta high-grade. Re-TUR is useful in reducing the rates of residual disease, may improve staging, response to bacillus Calmette-Guérin and oncological outcomes.
Current opinion in urology. 2021 Nov 22 [Epub ahead of print]
Sophie Regnier, Gianluigi Califano, Vincent Elalouf, Simone Albisinni, Atiqullah Aziz, Ettore Di Trapani, Wojciech Krajewski, Andrea Mari, David D'Andrea, Benjamin Pradère, Francesco Soria, Luca Afferi, Marco Moschini, Idir Ouzaid, Evanguelos Xylinas
Urology Department, Bichat-Claude Bernard Hospital, Assistance-Publique Hôpitaux de Paris, Paris University, Paris, France Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy Urology Department, Hôpital Privé Claude Galien, Ramsay Santé, Quincy-Sous-Sénart, France Urology Department, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium Urology Department, München Klinik Bogenhausen, Munich, Germany Urology Department, European Institute of Oncology, Milan, Italy Department of Urology and Oncological Urology, Wrocław Medical University, Wrocław, Poland Urology Department, Careggi Hospital, University of Florence, Florence, Italy Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Urology Division, Department of Surgical Sciences, University of Studies of Torino, Turin, Italy Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland Department of Medical Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.