To determine if a re-TUR in the presence or absence of muscle at the first TUR in T1-high grade (HG)/G3 bladder cancer patients makes a difference in recurrence, progression, cancer specific (CSS) and overall survival (OS).
In a large retrospective multi-centre cohort of 2451 T1-HG/G3 patients initially treated with BCG, 935 (38%) had a re-TUR. According to the presence or absence of muscle in the specimen of the primary TUR, patients were divided in 4 groups: group 1 (no muscle, no re-TUR), group 2 (no muscle, re-TUR), group 3 (muscle, no re-TUR) and group 4 (muscle, re-TUR). Clinical outcomes were compared across the 4 groups.
Re-TUR had a positive impact on recurrence, progression, CSS and OS only if muscle was not present in the primary specimen. Adjusting for the most important prognostic factors, re-TUR in the absence of muscle had a borderline significant effect on time to recurrence (HR = 0. 67, p = 0. 08), progression (HR = 0. 46, p = 0. 06), CSS (HR = 0. 31; p = 0. 07) and OS (HR = 0. 48, p = 0. 05). Re-TUR in the presence of muscle in the primary specimen did not improve the outcome for any of the endpoints.
Our retrospective analysis suggests that re-TUR may not be necessary in T1-HG/G3 patients if muscle is present in the specimen of the primary TUR. This article is protected by copyright. All rights reserved.
BJU international. 2015 Oct 15 [Epub ahead of print]
Paolo Gontero, Richard Sylvester, Francesca Pisano, Steven Joniau, Marco Oderda, Vincenzo Serretta, Stéphane Larre, Savino Di Stasi, Bas Van Rhijn, Alfred J Witjes, Anne J Grotenhuis, Renzo Colombo, Alberto Briganti, Marek Babjuk, Viktor Soukup, Per-Uno Malmstrom, Jacques Irani, Nuria Malats, Jack Baniel, Roy Mano, Tommaso Cai, Eugene K Cha, Peter Ardelt, John Vakarakis, Riccardo Bartoletti, Guido Dalbagni, Shahrokh F Shariat, Evanguelos Xylinas, R Jeffrey Karnes, Joan Palou
Urology Clinic, Città della Salute e della Scienza di Torino, University of Studies of Turin, Italy. , Formerly Dept of Biostatistics, EORTC Headquarters, Brussels, Belgium. , Urology Clinic, Città della Salute e della Scienza di Torino, University of Studies of Turin, Italy. , Oncologic and Reconstructive Urology, Dept of Urology, University Hospitals Leuven, Belgium. , Urology Clinic, Città della Salute e della Scienza di Torino, University of Studies of Turin, Italy. , Dept of Surgical, Oncological and Stomatological Sciences, University of Palermo, Italy. , Dept of Surgical Science, John Radcliffe Hospital, University of Oxford, UK. , Policlinico Tor Vergata-University of Rome, Italy. , Dept of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. , Dept of Urology, Radboud University Nijmegen Medical Centre, The Netherlands. , Dept of Urology, Radboud University Nijmegen Medical Centre, The Netherlands. , Dipartimento di Urologia, Università Vita-Salute. Ospedale S. Raffaele, Milan, Italy. , Dipartimento di Urologia, Università Vita-Salute. Ospedale S. Raffaele, Milan, Italy. , Dept of Urology, Motol Hospital, University of Praha, Czech Republic. , Dept of Urology, Motol Hospital, University of Praha, Czech Republic. , Dept of Urology, Academic Hospital, Uppsala University, Sweden. , Dept of Urology, Centre Hospitalier Universitaire La Milétrie, University of Poitiers, France. , Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain. , Dept of Urology, Rabin Medical Centre, Tel Aviv, Israel. , Dept of Urology, Rabin Medical Centre, Tel Aviv, Israel. , Department of Urology, Santa Chiara Hospital, Trento, Italy. , Dept of Urology, Weill Medical College of Cornell University in New York City, USA. , Facharzt fur Urologie, Abteilung fur Urologie, Chirurgische Universitats klinik. Freiburg, Germany. , Dept of Urology, Sismanoglio Hospital, University of Athens, Greece. , Dept of Experimental and Clinical Medicine, University of Florence, Italy. , Dept of Urology, Memorial Sloan Kettering, New York, USA. , Dept of Urology, Weill Medical College of Cornell University in New York City, USA. , Dept of Urology, Weill Medical College of Cornell University in New York City, USA. , Dept of Urology, Mayo Clinic, Rochester, USA. , Dept of Urology, Fundacio Puigvert, University of Barcelona, Spain.