Clinical rationale and safety of restaging transurethral resection in indication-stratified patients with high-risk non-muscle-invasive bladder cancer
Abstract Background Indications for restaging transurethral resection of the bladder tumor (reTURBT) in patients with non-muscle-invasive bladder cancer (NMIBC) remain controversial. This study was aimed at evaluation of clinical value and safety of reTURBT in different clinical indications. Methods...
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| Format: | Article |
| Language: | English |
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BMC
2018-01-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | http://link.springer.com/article/10.1186/s12957-018-1310-0 |
| _version_ | 1818507172113285120 |
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| author | Piotr Zapała Bartosz Dybowski Sławomir Poletajew Łukasz Białek Andrzej Niewczas Piotr Radziszewski |
| author_facet | Piotr Zapała Bartosz Dybowski Sławomir Poletajew Łukasz Białek Andrzej Niewczas Piotr Radziszewski |
| author_sort | Piotr Zapała |
| collection | DOAJ |
| description | Abstract Background Indications for restaging transurethral resection of the bladder tumor (reTURBT) in patients with non-muscle-invasive bladder cancer (NMIBC) remain controversial. This study was aimed at evaluation of clinical value and safety of reTURBT in different clinical indications. Methods This is a retrospective analysis of consecutive 141 patients who underwent TURBT followed by reTURBT in years 2011–2015 in a single department. Pathological results and surgical complications were analyzed in the whole study cohort and stratified by clinical stage (Ta, T1, Tx (no muscle in the specimen)) and grade (low-grade (LG), high-grade (HG)) of bladder cancer diagnosed at primary TURBT. Results Full data was available for 132 patients. Residual disease was found in 53 patients (40.2%) with highest rate for Ta-HG cases (57.1%) followed by T1-HG (51.4%), Tx-HG (45.2%), T1-LG (32.1%), and Tx-LG (25.8%). In the multivariate analysis, high grade (p = 0.02) was the only independent predictor of residual disease. Upstaging to muscle-invasive bladder cancer was noticed in 9 patients (6.8%). The rate of grade ≥ 2 Clavien-Dindo complications (1.5 vs. 5.3%) did not differ significantly between TURBT and reTURBT cases. Conclusions ReTURBT is a safe procedure that remains crucial for therapeutic and staging purposes in patients with T1, Tx, or high-grade bladder cancer found in the primary resection. |
| first_indexed | 2024-12-10T22:14:54Z |
| format | Article |
| id | doaj.art-c256f6a51186468a95e223216a3bf106 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-10T22:14:54Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-c256f6a51186468a95e223216a3bf1062022-12-22T01:31:30ZengBMCWorld Journal of Surgical Oncology1477-78192018-01-011611610.1186/s12957-018-1310-0Clinical rationale and safety of restaging transurethral resection in indication-stratified patients with high-risk non-muscle-invasive bladder cancerPiotr Zapała0Bartosz Dybowski1Sławomir Poletajew2Łukasz Białek3Andrzej Niewczas4Piotr Radziszewski5Department of General, Oncological and Functional Urology, Medical University of WarsawDepartment of General, Oncological and Functional Urology, Medical University of WarsawDepartment of General, Oncological and Functional Urology, Medical University of WarsawDepartment of General, Oncological and Functional Urology, Medical University of WarsawDepartment of General, Oncological and Functional Urology, Medical University of WarsawDepartment of General, Oncological and Functional Urology, Medical University of WarsawAbstract Background Indications for restaging transurethral resection of the bladder tumor (reTURBT) in patients with non-muscle-invasive bladder cancer (NMIBC) remain controversial. This study was aimed at evaluation of clinical value and safety of reTURBT in different clinical indications. Methods This is a retrospective analysis of consecutive 141 patients who underwent TURBT followed by reTURBT in years 2011–2015 in a single department. Pathological results and surgical complications were analyzed in the whole study cohort and stratified by clinical stage (Ta, T1, Tx (no muscle in the specimen)) and grade (low-grade (LG), high-grade (HG)) of bladder cancer diagnosed at primary TURBT. Results Full data was available for 132 patients. Residual disease was found in 53 patients (40.2%) with highest rate for Ta-HG cases (57.1%) followed by T1-HG (51.4%), Tx-HG (45.2%), T1-LG (32.1%), and Tx-LG (25.8%). In the multivariate analysis, high grade (p = 0.02) was the only independent predictor of residual disease. Upstaging to muscle-invasive bladder cancer was noticed in 9 patients (6.8%). The rate of grade ≥ 2 Clavien-Dindo complications (1.5 vs. 5.3%) did not differ significantly between TURBT and reTURBT cases. Conclusions ReTURBT is a safe procedure that remains crucial for therapeutic and staging purposes in patients with T1, Tx, or high-grade bladder cancer found in the primary resection.http://link.springer.com/article/10.1186/s12957-018-1310-0Bladder cancerCancer stagingUrologic surgical procedures |
| spellingShingle | Piotr Zapała Bartosz Dybowski Sławomir Poletajew Łukasz Białek Andrzej Niewczas Piotr Radziszewski Clinical rationale and safety of restaging transurethral resection in indication-stratified patients with high-risk non-muscle-invasive bladder cancer World Journal of Surgical Oncology Bladder cancer Cancer staging Urologic surgical procedures |
| title | Clinical rationale and safety of restaging transurethral resection in indication-stratified patients with high-risk non-muscle-invasive bladder cancer |
| title_full | Clinical rationale and safety of restaging transurethral resection in indication-stratified patients with high-risk non-muscle-invasive bladder cancer |
| title_fullStr | Clinical rationale and safety of restaging transurethral resection in indication-stratified patients with high-risk non-muscle-invasive bladder cancer |
| title_full_unstemmed | Clinical rationale and safety of restaging transurethral resection in indication-stratified patients with high-risk non-muscle-invasive bladder cancer |
| title_short | Clinical rationale and safety of restaging transurethral resection in indication-stratified patients with high-risk non-muscle-invasive bladder cancer |
| title_sort | clinical rationale and safety of restaging transurethral resection in indication stratified patients with high risk non muscle invasive bladder cancer |
| topic | Bladder cancer Cancer staging Urologic surgical procedures |
| url | http://link.springer.com/article/10.1186/s12957-018-1310-0 |
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