Therapeutic benefit of second-look transurethral resection of bladder tumors for newly diagnosed T1 bladder cancer: a single-center experience

• Published in: International urology and nephrology 2019-08, Vol.51 (8), p.1335-1342
• Main Authors: Tseng, Wen-Hsin, Liu, Chien-Liang, Huang, Steven K., Liao, Alex Chien-Hwa, Kuo, Jinn-Rung, Hun, Shun-Hsing, Chen, Chun-Hao, Su, Chia-Cheng, Wang, Jhih-Cheng, Lee, Kau-Han, Shen, Kun-Hung, Li, Chien-Feng
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Bladder cancer; Carcinoma, Transitional Cell - pathology; Carcinoma, Transitional Cell - surgery; Cystectomy - methods; Female; Health risk assessment; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Nephrology; Patients; Reoperation; Retrospective Studies; Risk factors; Survival; Tumors; Urethra; Urinary Bladder Neoplasms - pathology; Urinary Bladder Neoplasms - surgery; Urology; Urology - Original Paper; Urothelial carcinoma
• ISSN: 0301-1623; 1573-2584
• DOI: 10.1007/s11255-019-02172-8

Purpose In recent years, second-look transurethral resection of bladder tumors (TURBT) has been recommended for patients with stage T1 bladder cancer after the initial TURBT for restaging and deciding the subsequent treatment. However, we believe that second-look TURBT has therapeutic benefits, such as low incidence of recurrence and progression. Therefore, we compare the differences in long-term outcome between patients who did and did not accept second-look TURBT for stage T1 bladder cancer. Methods We assessed 504 patients diagnosed with urothelial carcinoma who underwent initial TURBT between January 2012 and December 2016 at a single medical center; of these patients, 177 were diagnosed with T1 bladder cancer during the initial TURBT, and we excluded no muscle from the specimen in the initial TURBT. The patients were categorized into groups 1 and 2 based on the acceptance of second-look TURBT, which was performed within 4–14 weeks after the initial TURBT. Group 1 underwent second-look TURBT, but group 2 did not. Both groups were followed-up for recurrence-free survival (RFS) and progression-free survival (PFS), and the risk factors for recurrence and progression were analyzed. Results In total, 93 (52.5%) patients in group 1 underwent second-look TURBT, and 84 (47.5%) in group 2 did not. The 2-year RFS rates were 74.6% and 60.0% and the PFS rates were 91.2% and 87.5% in groups 1 and 2, respectively. Conclusion This study demonstrated higher recurrence-free and progression-free survival rates for patients who underwent second-look TURBT. This result emphasizes the importance of second-look TURBT in stage T1 bladder cancer not only for restaging but also for therapeutic benefit.