The clinical significance of a second transurethral resection for T1 high-grade bladder cancer: Results of a prospective study
Korean Journal of Urology
;
: 429-434, 2015.
Artículo
en Inglés
| WPRIM
| ID: wpr-95911
ABSTRACT
PURPOSE:
This study was designed to estimate the value of a second transurethral resection of bladder tumor (TURBT) procedure in patients with initially diagnosed T1 high-grade bladder cancer. MATERIALS ANDMETHODS:
Between August 2009 and January 2013, a total of 29 patients with T1 high-grade bladder cancer prospectively underwent a second TURBT procedure. Evaluation included the presence of previously undetected residual tumor, changes to histopathological staging or grading, and tumor location. Recurrence-free and progression-free survival curves were generated to compare the prognosis between the groups with and without residual lesions by use of the Kaplan-Meier method.RESULTS:
Of 29 patients, 22 patients (75.9%) had residual disease after the second TURBT. Staging was as follows no tumor, 7 (24.1%); Ta, 5 (17.2%); T1, 6 (20.7%); Tis, 6 (20.7%); Ta+Tis, 1 (3.4%); T1+Tis, 1 (3.4%); and > or =T2, 3 (10.3%). The muscle layer was included in the surgical specimen after the initial TURBT in 24 patients (82.7%). In three patients whose cancer was upstaged to pT2 after the second TURBT, the initial surgical specimen contained the muscle layer. In the group with residual lesions, the 3-year recurrence-free survival and 3-year progression-free survival rates were 50% and 66.9%, respectively, whereas these rates were 68.6% and 68.6%, respectively, in the group without residual lesions. This difference was not statistically significant.CONCLUSIONS:
Initial TURBT does not seem to be enough to control T1 high-grade bladder cancer. Therefore, a routine second TURBT procedure should be recommended in patients with T1 high-grade bladder cancer to accomplish adequate tumor resection and to identify patients who may need to undergo prompt cystectomy.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Pronóstico
/
Reoperación
/
Neoplasias de la Vejiga Urinaria
/
Cistectomía
/
Estudios Prospectivos
/
Resultado del Tratamiento
/
Neoplasia Residual
/
Estimación de Kaplan-Meier
/
Clasificación del Tumor
/
Invasividad Neoplásica
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
Límite:
Anciano
/
Aged80
/
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Korean Journal of Urology
Año:
2015
Tipo del documento:
Artículo
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