Abstract
AimTo evaluate the impact of early re-resection on the incidence of tumour recurrence and progression in patients with pT1 high-grade non-muscle invasive bladder cancer (HG-NMIBC).Patients and methodsFrom 2001 to 2008, 486 consecutive patients were diagnosed with pT1 HG-NMIBC. Data were collected retrospectively 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 six weeks of initial TUR. Patients comprised those who underwent an early re-resection (Group A, n = 172) and those who did not (Group B, n = 314).ResultsAt initial TUR, detrusor muscle was present in 61% (n = 105) of patients in Group A and 76% (n = 240) of patients in Group B. At early re-resection, detrusor muscle was present in 77.9% of cases. A residual tumour was present in 54.6% of re-resected cases. The overall incidence of tumour recurrence was 35% and 42% in Groups A and B, respectively. During follow-up, there was a significantly higher rate of tumour stage progression in patients who did not undergo early re-resection (Group B 14.4% vs. Group A 3.3%, P < 0.05).ConclusionsEarly re-resection facilitates accurate staging and clearance of residual disease. Subsequent rates of tumour stage progression are significantly improved. We advocate early re-resection for all patients with HG-NMIBC.
Highlights
Bladder carcinoma is the most common malignancy of the urinary tract
In order to assess the potential impact of early re-resection, we conducted a retrospective subset analysis comparing those patients who underwent an early re-resection (Group A, n = 172) and those who did not (Group B, n = 314) (Table 1)
We evaluate the potential impact of early re-resection in a cohort of 486 consecutive patients with newly diagnosed high-grade pT1 carcinoma of the urinary bladder
Summary
Bladder carcinoma is the most common malignancy of the urinary tract. The worldwide age standardised incidence rate (ASR) is 10.1 per 100,000 for males and 2.5 per 100,000 for females. It is the 7th most common malignancy in men and 17th in women. When diagnosed urothelial carcinoma of the bladder presents as non-muscle invasive papillary tumours in 70–85% of cases [2]. Recurrence is common within this group ranging from 0 to 80%, and, more importantly, 10% of pTa tumours and 35% of pT1 tumours will progress to muscle invasive disease [3, 4]. Disease progression has been demonstrated to correlate with tumour size, multi-focality, tumour stage, grade, and early recurrence [2]
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