Premium
Repeat transurethral resection for non‐muscle‐invasive bladder cancer: a contemporary series
Author(s) -
Gendy Rasha,
Delprado Warick,
Brenner Phillip,
Brooks Andrew,
Coombes Graham,
Cozzi Paul,
Nash Peter,
Patel Manish I.
Publication year - 2016
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13265
Subject(s) - medicine , bladder cancer , cystoscopy , resection , urology , cancer , surgery , urinary system
Objectives To evaluate the depth of transurethral resections of bladder tumour ( TURBT ), residual cancer rates and up‐staging rates in a contemporary Australian series. Materials and Methods Specimen reports from a single, major reporting pathology centre, servicing a group of urological oncologists in Sydney were obtained for TURBT s 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. Results 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. Conclusion 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.