A re‐staging transurethral resection predicts early progression of superficial bladder cancer

OBJECTIVE To determine whether pathology on a re‐staging transurethral resection (TUR) predicts the early progression of superficial bladder cancer. PATIENTS AND METHODS In all, 710 patients presenting with multiple superficial bladder cancers were evaluated by re‐staging TUR and followed for 5 years. Tumours were classified by stage as confined to mucosa (Ta) or invading submucosa (T1), and by grade (low‐ or high‐grade). Pathology on re‐staging TUR was correlated with the endpoints of tumour recurrence and stage progression. RESULTS Of the 710 patients, 490 (69%) had a recurrence and 149 (21%) progressed over 5 years. Eighty patients had high‐grade invasive (T1G3) cancer on re‐staging TUR and 61 (76%) progressed to muscle invasion (median time to progression 15 months), compared with 88 of 630 (14%) who had no evidence of tumour (T0) or other than T1 tumours detected on re‐staging TUR. CONCLUSION A re‐staging TUR identifies patients with superficial bladder cancer who are at high risk of early tumour progression.