Research Article

Value of Repeated Transurethral Resection in Superficial Bladder Cancer

Volume: 16 Number: 1 January 1, 2025
EN

Value of Repeated Transurethral Resection in Superficial Bladder Cancer

Abstract

Background: Bladder cancer is a prevalent malignancy of the urinary system, with superficial tumors representing the majority of cases. Despite initial treatment with transurethral resection (TUR), these tumors have high recurrence rates (70-80%) and can progress to muscle-invasive disease in 20-30% of cases. Repeat transurethral resection (re-TUR) has been proposed as a method to improve staging accuracy and reduce the likelihood of recurrence by detecting residual tumor tissue. Methods: This prospective study included 100 patients with superficial bladder cancer (Ta and T1 stages) treated at the Urology Clinic of Istanbul Fatih Sultan Mehmet Training and Research Hospital between January 2005 and December 2006. Following the initial TUR, all patients underwent re-TUR within 4 to 6 weeks. Pathological findings from both procedures were analyzed to identify residual tumor presence and changes in tumor stage. Patients were followed up for 24 months to monitor recurrence rates and progression to muscle-invasive disease. Results: Re-TUR revealed residual tumor tissue in 40% of patients, with higher detection rates in T1 and Grade II tumors. Patients with residual tumors had a significantly higher recurrence rate (40%) compared to those without residual tumors (15%). Additionally, 20% of patients with residual tumors progressed to muscle-invasive bladder cancer, while no progression was observed in patients without residual tumors. Conclusion: Re-TUR plays a vital role in improving staging accuracy and reducing recurrence in patients with superficial bladder cancer. The presence of residual tumors significantly increases the risk of recurrence and progression, highlighting the importance of re-TUR, especially in high-risk patients. These findings support the routine use of re-TUR in managing superficial bladder cancer.

Keywords

References

  1. 1. Edward M. Messing, MD, Urothelial tumors of the urinary tract In Campbell’s Urology, Eight Edition, 4th volume W.B. Saunders, USA 2002: pp 2723-2784.
  2. 2. Herr, HW: Uncertainty and outcome of invasive bladder tumors. Urol Oncol 1996;2:92.
  3. 3. Herr H: The value of a second transurethral resection in evaluating patients with bladder tumors. J Urol 1999;162: 74–76.
  4. 4. Vögeli TA, Grimm MO, and Ackermann R: Prospective study for quality control of TUR of bladder tumors by routine 2nd TUR. J Urol 1998;159(suppl):143.
  5. 5. Klän R, Loy V, and Huland H: Residual tumor discovered in routine second transurethral resection in patients with stage T1 transitional cell carcinoma of the bladder. J Urol 1991;146:316–318.
  6. 6. Herring JC, Kamat AM. Treatment of muscle-invasive bladder cancer: progress and new challenges. Expert Rev Anticancer Ther. 2004;4(6):1047-1056. doi:10.1586/14737140.4.6.1047.
  7. 7. Köhrmann KU, Woeste M, Rassweiler J, et al: Die transurethrale Nachresektion, notwendig beim oberflächlichen Blasenkarzinom. Urologe A 1992;31(suppl):A59.
  8. 8. Brausi M, Collette L, Kurth K, van dermatoz Meijden AP, Oosterlinck W, Witjes JA, et al. Variability in the recurrence rate at first follow up cystoscopy afterTUR in stage Ta T1 transitional cell carcinoma of the bladder: a combined analysis of seven EORTC studies. Eur Urol 2002;41:523-31.

Details

Primary Language

English

Subjects

Urology

Journal Section

Research Article

Early Pub Date

December 12, 2024

Publication Date

January 1, 2025

Submission Date

October 17, 2024

Acceptance Date

October 21, 2024

Published in Issue

Year 2025 Volume: 16 Number: 1

EndNote
Cakir H, Guner ND, Alp T, Karaman Mİ (January 1, 2025) Value of Repeated Transurethral Resection in Superficial Bladder Cancer. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 16 1 110–115.