The clinical significance of a second transurethral resection for T1 high-grade bladder cancer: Results of a prospective study
Korean Journal of Urology
; : 429-434, 2015.
Article
in En
| WPRIM
| ID: wpr-95911
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WPRO
ABSTRACT
PURPOSE: This study was designed to estimate the value of a second transurethral resection of bladder tumor (TURBT) procedure in patients with initially diagnosed T1 high-grade bladder cancer. MATERIALS AND METHODS: Between August 2009 and January 2013, a total of 29 patients with T1 high-grade bladder cancer prospectively underwent a second TURBT procedure. Evaluation included the presence of previously undetected residual tumor, changes to histopathological staging or grading, and tumor location. Recurrence-free and progression-free survival curves were generated to compare the prognosis between the groups with and without residual lesions by use of the Kaplan-Meier method. RESULTS: Of 29 patients, 22 patients (75.9%) had residual disease after the second TURBT. Staging was as follows: no tumor, 7 (24.1%); Ta, 5 (17.2%); T1, 6 (20.7%); Tis, 6 (20.7%); Ta+Tis, 1 (3.4%); T1+Tis, 1 (3.4%); and > or =T2, 3 (10.3%). The muscle layer was included in the surgical specimen after the initial TURBT in 24 patients (82.7%). In three patients whose cancer was upstaged to pT2 after the second TURBT, the initial surgical specimen contained the muscle layer. In the group with residual lesions, the 3-year recurrence-free survival and 3-year progression-free survival rates were 50% and 66.9%, respectively, whereas these rates were 68.6% and 68.6%, respectively, in the group without residual lesions. This difference was not statistically significant. CONCLUSIONS: Initial TURBT does not seem to be enough to control T1 high-grade bladder cancer. Therefore, a routine second TURBT procedure should be recommended in patients with T1 high-grade bladder cancer to accomplish adequate tumor resection and to identify patients who may need to undergo prompt cystectomy.
Key words
Full text:
1
Index:
WPRIM
Main subject:
Prognosis
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Reoperation
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Urinary Bladder Neoplasms
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Cystectomy
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Prospective Studies
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Treatment Outcome
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Neoplasm, Residual
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Kaplan-Meier Estimate
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Neoplasm Grading
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Neoplasm Invasiveness
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Aged
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Aged80
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Female
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Humans
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Male
Language:
En
Journal:
Korean Journal of Urology
Year:
2015
Type:
Article