Ten-year experience on retransurethral resection of non-muscle-invasive bladder cancer. Are we doing on the right patients?

Abstract

Objective: To examine the outcomes ofre-transurethral resection (re-TUR) inpatients with non-muscle invasive bladdercancer (NMIBC).

Patients and Methods: We retrospectivelyreviewed data from Jan 2004 to Dec 2014in Queen Mary and Tung Wah Hospitals.One-hundred-and-eight patients under-went re-TUR for NMIBC. Exclusion crite-ria included histology other thantransitional cell carcinoma (TCC), historyof upper tract TCC and macroscopicincomplete initial resection.Results: Fifty-five patients (51%) had T1tumor and 93 patients (86.1%) had high-grade (HG) disease on the initial resection.Muscularis propria was included in 38patients (35.2%) on the initial resection.After re-TUR, 8 patients (7.4%) hadupstaged to muscle-invasive disease while6 patients (5.6%) still had T1HG tumor inthe resection specimen. This resulted in achange of management to radical treat-ment in ten percent of patients. Allpatients with upstaged muscle-invasivedisease after re-TUR had HG tumor,87.5% had tumor larger than 3 cm and75% had T1 tumor on the initial resection.All 15 patients with low grade disease onthe initial resection did not show anyupstaging after re-TUR.Conclusion: Re-TUR remains an impor-tant treatment strategy to detect upstagingin bladder cancer especially in thosepatients with T1HG disease and withtumor larger than 3 cm.