Evaluation of second-look transurethral resection in the management of superficial bladder tumors

Abstract

Objectives The aim of the present study was to evaluate the role of second-look transurethral resection of bladder tumors (TURBT) in the management of non-muscle-invasive bladder cancer (NMIBC). Background Bladder cancer is the ninth most common cancer diagnosis worldwide. Second-look TURBT ensures adequate evaluation of the muscularis propria while detecting and treating residual tumors. Patients and methods Thirty-one NMIBC patients underwent a second-look TURBT 2 weeks after the initial TURBT. The procedures carried out included reassessment of the bladder for the detection of residual lesions after initial resection, and the resection of the base of the previous resection site for restaging. Results Thirty-one NMIBC patients underwent second-look TURBT 2 weeks after the initial TURBT. Residual tumors were found in 28% of the patients with Ta tumors and 54.2% of the patients with T1 tumors (P = 0.445). The overall percent of residual tumors was 48.4% for all patients. Patients with Ta tumors had no upstaging to a higher stage or grade. On the other hand, in patients with T1 tumors we found that 50% of them were upstaged to T2. Thus, the overall upstaging to T2 was 38.7% of all NMIBC patients (P = 0.413). Conclusion Second-look TURBT is highly desirable in patients with high-grade T1 disease and large tumor size (>2-5 cm), especially if deep muscle is not found in the primary resection because of the significant risk for detecting muscle-invasive disease and missed residual tumors.