Repeat transurethral resection for non-muscle-invasive bladder cancer: a contemporary series

To evaluate the depth of transurethral resections of bladder tumour (TURBT), residual cancer rates and up-staging rates in a contemporary Australian series.

Specimen reports from a single, major reporting pathology centre, servicing a group of urological oncologists in Sydney were obtained for TURBTs performed between October 2008 and February 2013.

We examined the depth of TURBT, rates of repeat-TURBT (re-TUR) and residual cancer rates at the 3-6 month check cystoscopy.

One thousand and two hundred and nine transurethral resection specimens retrieved during this period were analysed. There were 162 (13. 4%) T1 specimens and 631 (52. 2%) Ta specimens, 218 (34. 5%) of which were high grade. Muscularis propria was present in 506 (41. 9%) specimens in total and in 151 (39. 7%) of 380 high-risk specimens (high grade Ta, T1). Of the 380 high-risk non-muscle-invasive tumours, 85 (22. 4%) proceeded to re-TUR. Of the 48 T1 specimens and 37 Ta high grade specimens that proceeded to re-TUR, 7 (14. 6%) and 1 (2. 7%) respectively were upstaged to muscle-invasive disease. Rates of residual disease/early recurrence at 3-6 months was significantly better for those with re-TUR compared to those without 56. 8% vs 82. 5% (P < 0. 001) for Ta high grade and 39. 6% vs 84% (P = 0. 028) for T1 tumours respectively.

Re-TUR rates in high-risk non-muscle-invasive bladder cancer are low. However in a contemporary series, the upstaging rates are low, but residual cancer rates high, supporting the need for re-TUR in this population.

BJU international. 2015 Oct 21 [Epub ahead of print]

Rasha Gendy, Warick Delprado, Phillip Brenner, Andrew Brooks, Graham Coombes, Paul Cozzi, Peter Nash, Manish I Patel

Department of Urology, St George Hospital, Sydney, NSW, Australia. , Douglas Hanley Moir Pathology Laboratory, Sydney, NSW, Australia. , Department of Urology, St Vincent's Hospital, Sydney, NSW, Australia. , Department of Urology, Westmead Hospital and Discipline of Surgery, University of Sydney, Sydney, NSW, Australia. , Department of Urology, Concord Hospital, Sydney, NSW, Australia. , Department of Urology, St George Hospital, Sydney, NSW, Australia. , Department of Urology, St George Hospital, Sydney, NSW, Australia. , Department of Urology, Westmead Hospital and Discipline of Surgery, University of Sydney, Sydney, NSW, Australia.

PubMed

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