The clinical significance of a second transurethral resection for T1 high-grade bladder cancer: Results of a prospective study
- Authors
- Shim, Ji Sung; Choi, Hoon; Noh, Tae Il; Tae, Jong Hyun; Yoon, Sung Goo; Kang, Seok Ho; Bae, Jae Hyun; Park, Hong Seok; Park, Jae Young
- Issue Date
- 6월-2015
- Publisher
- KOREAN UROLOGICAL ASSOC
- Keywords
- Neoplasm invasiveness; Recurrence; Urinary bladder neoplasms
- Citation
- KOREAN JOURNAL OF UROLOGY, v.56, no.6, pp.429 - 434
- Indexed
- SCOPUS
KCI
- Journal Title
- KOREAN JOURNAL OF UROLOGY
- Volume
- 56
- Number
- 6
- Start Page
- 429
- End Page
- 434
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/93336
- DOI
- 10.4111/kju.2015.56.6.429
- ISSN
- 2005-6737
- Abstract
- Purpose: This study was designed to estimate the value of a second transurethral resection of bladder tumor (TURBT) procedure in patients with initially diagnosed T1 high-grade bladder cancer. Materials and Methods: Between August 2009 and January 2013, a total of 29 patients with T1 high-grade bladder cancer prospectively underwent a second TURBT procedure. Evaluation included the presence of previously undetected residual tumor, changes to histopathological staging or grading, and tumor location. Recurrence-free and progression-free survival curves were generated to compare the prognosis between the groups with and without residual lesions by use of the Kaplan-Meier method. Results: Of 29 patients, 22 patients (75.9%) had residual disease after the second TURBT. Staging was as follows: no tumor, 7 (24.1%); Ta, 5 (17.2%); T1, 6 (20.7%); Tis, 6 (20.7%); Ta+Tis, 1 (3.4%); T1+Tis, 1 (3.4%); and >= T2, 3 (10.3%). The muscle layer was included in the surgical specimen after the initial TURBT in 24 patients (82.7%). In three patients whose cancer was upstaged to pT2 after the second TURBT, the initial surgical specimen contained the muscle layer. In the group with residual lesions, the 3-year recurrence-free survival and 3-year progression-free survival rates were 50% and 66.9%, respectively, whereas these rates were 68.6% and 68.6%, respectively, in the group without residual lesions. This difference was not statistically significant. Conclusions: Initial TURBT does not seem to be enough to control T1 high-grade bladder cancer. Therefore, a routine second TURBT procedure should be recommended in patients with T1 high-grade bladder cancer to accomplish adequate tumor resection and to identify patients who may need to undergo prompt cystectomy.
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