A second transurethral resection could be not necessary in all high grade non-muscle-invasive bladder tumors

J. M. Gaya, J. Palou, M. Cosentino, D. Patiño, O. Rodríguez-Faba, H. Villavicencio

Research output: Contribution to journalArticleResearchpeer-review

15 Citations (Scopus)

Abstract

Objectives: Evaluate the rate of residual tumor, understaging and perioperative complications in patients with high grade non-muscle-invasive bladder cancer who underwent second transurethral resection (re-TUR). Material and methods: A retrospective review of 47 patients with high grade non-muscle-invasive bladder cancer who underwent second TUR from January 2007 to December 2009 at our institution. We evaluated the rate of residual tumor and understaging detected by re-TUR, complications, and the cost of the surgery. Results: Twenty-two patients underwent second TUR because of the absence of muscle in the initial resection specimen (cTx). We observed residual disease in 8/47 patients (17%) and understaging in 2 cases (4.2%), the only 2 patients understaged muscularis propria was not present in the sample of initial TUR. The other 20 cTx (90%) were cT0 in the re-TUR. We did not identify any case of cT1 understaged in the re-TUR (≥ cT2). Six patients (12.6%) reported complications related with the second TUR (one urethral stricture, two patients required reintervention because of bleeding, one febrile urinary infection and two bladder perforations). Conclusions: Our findings show that the absence of muscle in the initial resection specimen is the only risk factor for understaging. Therefore, we consider re-TUR is mandatory in these cases. On the other hand, when complete TUR has been performed and the muscularis propria is present and tumor free (cTa-T1), we consider systematic re-TUR is not necessary and only indicated in selected patients, even more if we consider that re-TUR is not exempt from complications. © 2011 AEU. Published by Elsevier Espaa, S.L. All rights reserved.
Original languageEnglish
Pages (from-to)539-544
JournalActas Urologicas Espanolas
Volume36
Issue number9
DOIs
Publication statusPublished - 1 Oct 2012

Keywords

  • High grade
  • Non-muscle-invasive bladder cancer
  • Recurrence
  • Restaging
  • Second transurethral resection
  • Understaging

Fingerprint Dive into the research topics of 'A second transurethral resection could be not necessary in all high grade non-muscle-invasive bladder tumors'. Together they form a unique fingerprint.

  • Cite this