Introduction and Objectives
Even experienced urologists have a high percentage of persisting carcinoma after transurethral bladder tumor resection (TURB) for non-muscle invasive bladder tumors (NMIBT). The aim of our study was to quantify the percentage of residual tumors detected by re-TURB.
Material and Methods
Between January 2005 and January 2009, 400 patients with NMIBT underwent re-TURB at 4–6 weeks after the initial resection. The indications were represented by absence of muscle tissue in the specimen from the initial resection, large, multiple, high grade or T1 tumors. After the first TURB, the pathologic stage was pTa in 102 patients (25.5%), pT1 in 288 (72%) and CIS in 10 (2.5%). The pathologic records of the second TUR were reviewed and compared with the findings of the first operation.
Results
Re-TURB was negative in 262 patients (65.5%). Of 102 patients with pTa and 288 patients with pT1 at the first TURB, 71 (69.6%) and 184 (63.9%) had a negative re-TUR, respectively. Three patients with initial CIS had residual tumors. Eighty-eight patients (22%) had residual tumors of the same stage, 28 (7%) had a lower stage and 22 (5.5%), a higher stage. In 85% of the cases, residual tumors were located at the initial site. The protocol treatment was changed in 26 cases (6.5%).
Conclusions
A routine re-TURB should be advised in selected patients with NMIBT in order to achieve a more complete tumor resection and to identify patients in which the treatment protocol should be changed. In addition, removal of residual cancer is achieved early.
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Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
