Influence of the Presence of Muscularis Propria on Recurrence and the Quality of Transurethral Resection in Low-Grade, Stage pTa Bladder Tumors

Objective\udTransurethral resection (TUR) of the bladder and intravesical\udchemotherapy is the standard treatment option for non-muscle-invasive\udbladder tumors. Inadequate tumor resection results in early recurrence\udand staging inaccuracies, which all will change the course of the disease.\udHigh-quality TUR treatment is therefore an important factor in the\udtreatment of non-muscle-invasive bladder tumors. In this study, we\udinvestigated the significance of detecting the presence of muscularis\udpropria (MP) in pathology specimens of low-grade, stage pTa tumors in\udpatients who were treated with TUR due to primary bladder tumors, with\udregard to recurrence, time to recurrence and progression.\udMaterials and Methods\udInitially, 841 patients who were treated with TUR due to primary bladder\udtumors were enrolled in the study. A total of 597 patients were excluded\udfrom the study because they failed to meet the study criteria. Group\ud1 consisted of patients with MP detected in the pathology specimens;\udwhereas group 2 consisted of patients whose TUR specimens did not\udinclude MP. The patients were evaluated with regard to gender, tumor\udnumber, presence or absence of MP, and recurrence status.\udResults\udMP was observed in only 14 (15.2%) of 92 patients with recurrence, but\udnot in the remaining 78 (84.8%) (p=0.004). Progression occurred in 4 (14.2%) patients of group 1 and 28 (29%) patients of group 2 (p=0.159).\udIn univariate analysis, tumor multiplicity (p=0.003) and the absence of\udMP (p=0.004) were found to have effects on recurrence. In multivariate\udanalysis, these two parameters were also found to be have effects on\udrecurrence (p=0.004).\udConclusion\udIn this study, it was pointed out that MP presence in the pathology\udspecimens of low-grade stage pTa tumors is an indicator of a high quality\udTUR and, a well-done TUR is important for the prevention of recurrence