For which non-muscle invasive bladder cancer is Re-Transurethral Resection more valuable? Which bladder cancer deserves Re-TUR?

Abstract

Aim: In this study, we aimed to evaluate the re-transurethral resection (re-TUR) pathologies and to compare the pathology results between transurethral resection of the bladder (TUR-B) and re-TUR for non-muscle invasive bladder cancer (NMIBC). Additionally, we aimed to assess the factors affecting the re-TUR pathology and try to define more valuable re-TUR patient groups. We also aimed to evaluate the effect of re-TUR on recurrence and progression. Material and Method: We performed re-TUR in intermediate/high-risk NMIBC patients, 4-6 weeks after the index TUR-B. Both TUR-B and re-TUR pathology characteristics, including tumor stage, grade, size, number, lymphovascular invasion (LVI), carcinoma in situ (CIS), variant pathology, and intermediate/high-risk status were analyzed retrospectively. The recurrence and progression rates were also evaluated according to re-TUR. Results: A total of 78 patients with NMIBC were included in the study. The index TUR-B pathologies were Ta-Low: 6 (7,7%), Ta-High: 5 (6,4%), T1-Low: 14 (17,9%), T1-High: 53 (67,9%). Re-TUR positivity was n: 40 (51 %), and upstaging/upgrading at re-TUR was n: 11 (14 %) in all groups. Re-TUR positivity was significantly higher in high-risk compared to intermediate-risk NMIBC (p:0,026). Re-TUR positivity was higher in patients with hydronephrosis, C15. LVI, differentiation, size (>3 cm), and multiple tumor presence (p<0,05). There was no significant relationship between recurrence/progression and re-TUR (p>0,05). Discussion: Residual tumor was common after the index TUR-B, and upstaging after re-TUR was very important Re-TUR is critically important in high-risk NMIBC, presence of hydronephrosis, CIS, LVI, variant pathology, size (>3 cm). and multiple number of tumors.