1784 “THE IMPACT OF EARLY RE-RESECTION ON UPSTAGING AND UPGRADING IN PATIENTS WITH HIGH GRADE NON-MUSCLE INVASIVE BLADDER CANCER”

Abstract

You have accessJournal of UrologyBladder Cancer: Superficial II1 Apr 20121784 “THE IMPACT OF EARLY RE-RESECTION ON UPSTAGING AND UPGRADING IN PATIENTS WITH HIGH GRADE NON-MUSCLE INVASIVE BLADDER CANCER” Nikhil Vasdev, Jose Domineuz-Escrieg, Mark Johnson, Garret Durkan, and Andrew Thorpe Nikhil VasdevNikhil Vasdev Newcastle upon Tyne, United Kingdom More articles by this author , Jose Domineuz-EscriegJose Domineuz-Escrieg Newcastle upon Tyne, United Kingdom More articles by this author , Mark JohnsonMark Johnson Newcastle upon Tyne, United Kingdom More articles by this author , Garret DurkanGarret Durkan Newcastle upon Tyne, United Kingdom More articles by this author , and Andrew ThorpeAndrew Thorpe Newcastle upon Tyne, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1801AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Our objective is to evaluate the impact of early re-resection on the incidence of recurrence and progression in patients with HG-NMIBC. METHODS From 1998 to 2008, 486 consecutive patients were diagnosed with HG-NMIBC. Retrospective data was collected which included patient demographics,histological parameters including the presence of detrusor muscle at initial TUR and at re-resection, adjuvant intravesical therapy and recurrence and progression rates. Early re-resection was performed within 8 weeks of initial TUR. Patients comprised of those who underwent an early re-resection (Group-A) and those who did not (Group-B). Group A consisted of 172 patients and Group B consisted of 314 patients. RESULTS At initial TUR detrusor muscle was present in 61% of patients in group A and 76% of patients in group B. At early re-resection detrusor muscle was present in 77.9% of cases. The incidence of residual tumour was 54.6% with the incidence of up-grading and up-staging being 20.2% and 12.7%, respectively. The overall incidence of tumour recurrence was 35% in group A and 42% in group B. The rate of upstaging was 3.3% of tumours in group A vs. 14.4% in group B (p<0.05), with a rate of upgrading of 8.3% and 26% in group A and B, respectively (p<0.05). CONCLUSIONS Our results confirm the benefits of this approach and highlight a significant reduction in tumour up-staging in recurrences following re-resection. We hence advocate the implementation of an early re-resection in this subset of patients. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e720 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nikhil Vasdev Newcastle upon Tyne, United Kingdom More articles by this author Jose Domineuz-Escrieg Newcastle upon Tyne, United Kingdom More articles by this author Mark Johnson Newcastle upon Tyne, United Kingdom More articles by this author Garret Durkan Newcastle upon Tyne, United Kingdom More articles by this author Andrew Thorpe Newcastle upon Tyne, United Kingdom More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...