Loading…
Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer: impact on prognosis?
Purpose A re-transurethral resection of the bladder (re-TURB) is a well-established approach in managing non-muscle invasive bladder cancer (NMIBC) for various reasons: repeat- TURB is recommended for a macroscopically incomplete initial resection, restaging- TURB is required if the first resection...
Saved in:
Published in: | International urology and nephrology 2024-04, Vol.56 (4), p.1323-1333 |
---|---|
Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Summary: | Purpose
A re-transurethral resection of the bladder (re-TURB) is a well-established approach in managing non-muscle invasive bladder cancer (NMIBC) for various reasons:
repeat-
TURB is recommended for a macroscopically incomplete initial resection,
restaging-
TURB is required if the first resection was macroscopically complete but contained no detrusor muscle (DM) and
second-
TURB is advised for all completely resected T1-tumors with DM in the resection specimen. This study assessed the long-term outcomes after
repeat-
,
second-
, and
restaging
-TURB in T1-NMIBC patients.
Methods
Individual patient data with tumor characteristics of 1660 primary T1-patients (muscle-invasion at re-TURB omitted) diagnosed from 1990 to 2018 in 17 hospitals were analyzed. Time to recurrence, progression, death due to bladder cancer (BC), and all causes (OS) were visualized with cumulative incidence functions and analyzed by log-rank tests and multivariable Cox-regression models stratified by institution.
Results
Median follow-up was 45.3 (IQR 22.7–81.1) months. There were no differences in time to recurrence, progression, or OS between patients undergoing
restaging
(135 patients),
second
(644 patients), or
repeat-
TURB (84 patients), nor between patients who did or who did not undergo
second
or
restaging-
TURB. However, patients who underwent
repeat-
TURB had a shorter time to BC death compared to those who had
second-
or
restaging-
TURB (multivariable HR 3.58,
P
= 0.004).
Conclusion
Prognosis did not significantly differ between patients who underwent
restaging-
or
second-
TURB. However, a worse prognosis in terms of death due to bladder cancer was found in patients who underwent
repeat
-TURB compared to
second-
TURB and
restaging-
TURB, highlighting the importance of separately evaluating different indications for re-TURB. |
---|---|
ISSN: | 1573-2584 0301-1623 1573-2584 |
DOI: | 10.1007/s11255-023-03867-9 |