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. 2024 Apr;56(4):1323-1333.
doi: 10.1007/s11255-023-03867-9. Epub 2023 Nov 19.

Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer: impact on prognosis?

Irene J Beijert  1   2 , Anouk E Hentschel  1   2 , Johannes Bründl  3 , Eva M Compérat  4   5 , Karin Plass  6 , Oscar Rodríguez  7 , Jose D Subiela Henríquez  7 , Virginia Hernández  4   8 , Enrique de la Peña  8 , Isabel Alemany  9 , Diana Turturica  10 , Francesca Pisano  7   10 , Francesco Soria  10 , Otakar Čapoun  4   11 , Lenka Bauerová  12 , Michael Pešl  11 , H Maxim Bruins  4   13   14 , Willemien Runneboom  15 , Sonja Herdegen  3 , Johannes Breyer  3 , Antonin Brisuda  16 , Ana Calatrava  17 , José Rubio-Briones  18 , Maximilian Seles  19 , Sebastian Mannweiler  20 , Judith Bosschieter  2 , Venkata R M Kusuma  21 , David Ashabere  21 , Nicolai Huebner  22 , Juliette Cotte  23 , Roberto Contieri  1 , Laura S Mertens  1 , Francesco Claps  1 , Alexandra Masson-Lecomte  4 , Fredrik Liedberg  4 , Daniel Cohen  4   24 , Luca Lunelli  25 , Olivier Cussenot  25 , Soha El Sheikh  26 , Dimitrios Volanis  24 , Jean-François Côté  27 , Morgan Rouprêt  4   23 , Andrea Haitel  28 , Shahrokh F Shariat  4   16   22 , A Hugh Mostafid  4   21 , Jakko A Nieuwenhuijzen  2 , Richard Zigeuner  4   19 , Jose L Dominguez-Escrig  4   18 , Jaromir Hacek  29 , Alexandre R Zlotta  30 , Maximilian Burger  3   4 , Matthias Evert  31 , Christina A Hulsbergen-van de Kaa  15 , Antoine G van der Heijden  13 , Lambertus A L M Kiemeney  32 , Viktor Soukup  4   11 , Luca Molinaro  33 , Paolo Gontero  4   10 , Carlos Llorente  8 , Ferran Algaba  34 , Joan Palou  4   7 , James N'Dow  6 , Maria J Ribal  6 , Theo H van der Kwast  35 , Marko Babjuk  4   16   22 , Richard J Sylvester #  4 , Bas W G van Rhijn #  36   37   38   39
Affiliations
Free article

Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer: impact on prognosis?

Irene J Beijert et al. Int Urol Nephrol. 2024 Apr.
Free article

Abstract

Purpose: A re-transurethral resection of the bladder (re-TURB) is a well-established approach in managing non-muscle invasive bladder cancer (NMIBC) for various reasons: repeat-TURB is recommended for a macroscopically incomplete initial resection, restaging-TURB is required if the first resection was macroscopically complete but contained no detrusor muscle (DM) and second-TURB is advised for all completely resected T1-tumors with DM in the resection specimen. This study assessed the long-term outcomes after repeat-, second-, and restaging-TURB in T1-NMIBC patients.

Methods: Individual patient data with tumor characteristics of 1660 primary T1-patients (muscle-invasion at re-TURB omitted) diagnosed from 1990 to 2018 in 17 hospitals were analyzed. Time to recurrence, progression, death due to bladder cancer (BC), and all causes (OS) were visualized with cumulative incidence functions and analyzed by log-rank tests and multivariable Cox-regression models stratified by institution.

Results: Median follow-up was 45.3 (IQR 22.7-81.1) months. There were no differences in time to recurrence, progression, or OS between patients undergoing restaging (135 patients), second (644 patients), or repeat-TURB (84 patients), nor between patients who did or who did not undergo second or restaging-TURB. However, patients who underwent repeat-TURB had a shorter time to BC death compared to those who had second- or restaging-TURB (multivariable HR 3.58, P = 0.004).

Conclusion: Prognosis did not significantly differ between patients who underwent restaging- or second-TURB. However, a worse prognosis in terms of death due to bladder cancer was found in patients who underwent repeat-TURB compared to second-TURB and restaging-TURB, highlighting the importance of separately evaluating different indications for re-TURB.

Keywords: Non-muscle invasive bladder cancer; Prognosis; Re-TURB; Repeat TURB; Restaging TURB; Second TURB.

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References

    1. Babjuk M, Burger M, Capoun O et al (2022) European association of urology guidelines on non-muscle-invasive bladder cancer (Ta, T1, and Carcinoma in Situ). Eur Urol 81(1):75–94. https://doi.org/10.1016/j.eururo.2021.08.010[publishedOnlineFirst:2021/0... - DOI - PubMed
    1. Divrik RT, Sahin AF, Yildirim U, Altok M, Zorlu F (2010) Impact of routine second transurethral resection on the long-term outcome of patients with newly diagnosed pT1 urothelial carcinoma with respect to recurrence, progression rate, and disease-specific survival: a prospective randomised clinical trial. Eur Urol 58(2):185–190. https://doi.org/10.1016/j.eururo.2010.03.007[publishedOnlineFirst:2010/0... - DOI - PubMed
    1. Naselli A, Hurle R, Paparella S et al (2018) Role of restaging transurethral resection for T1 non-muscle invasive bladder cancer: a systematic review and meta-analysis. Eur Urol Focus 4(4):558–567. https://doi.org/10.1016/j.euf.2016.12.011[publishedOnlineFirst:2017/07/30] - DOI - PubMed
    1. Eroglu A, Ekin RG, Koc G, Divrik RT (2020) The prognostic value of routine second transurethral resection in patients with newly diagnosed stage pT1 non-muscle-invasive bladder cancer: results from randomized 10-year extension trial. Int J Clin Oncol 25(4):698–704. https://doi.org/10.1007/s10147-019-01581-0[publishedOnlineFirst:2019/11/25] - DOI - PubMed
    1. Grimm MO, Steinhoff C, Simon X, Spiegelhalder P, Ackermann R, Vogeli TA (2003) Effect of routine repeat transurethral resection for superficial bladder cancer: a long-term observational study. J Urol 170(2 Pt 1):433–437. https://doi.org/10.1097/01.ju.0000070437.14275.e0 - DOI - PubMed