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- Title
The impact of re-transurethral resection on clinical outcomes in a large multicentre cohort of patients with T1 high-grade/Grade 3 bladder cancer treated with bacille Calmette-Guérin.
- Authors
Gontero, Paolo; Sylvester, Richard; Pisano, Francesca; Joniau, Steven; Oderda, Marco; Serretta, Vincenzo; Larré, Stéphane; Di Stasi, Savino; Van Rhijn, Bas; Witjes, Alfred J.; Grotenhuis, Anne J.; Colombo, Renzo; Briganti, Alberto; Babjuk, Marek; Soukup, Viktor; Malmström, Per‐Uno; Irani, Jacques; Malats, Nuria; Baniel, Jack; Mano, Roy
- Abstract
Objectives To determine if a re-transurethral resection (TUR), in the presence or absence of muscle at the first TUR in patients with T1-high grade (HG)/Grade 3 (G3) bladder cancer, makes a difference in recurrence, progression, cancer specific (CSS) and overall survival (OS). Patients and methods In a large retrospective multicentre cohort of 2451 patients with T1-HG/G3 initially treated with bacille Calmette-Guérin, 935 (38%) had a re-TUR. According to the presence or absence of muscle in the specimen of the primary TUR, patients were divided in four groups: group 1 (no muscle, no re-TUR), group 2 (no muscle, re-TUR), group 3 (muscle, no re-TUR) and group 4 (muscle, re-TUR). Clinical outcomes were compared across the four groups. Results Re-TUR had a positive impact on recurrence, progression, CSS and OS only if muscle was not present in the primary TUR specimen. Adjusting for the most important prognostic factors, re-TUR in the absence of muscle had a borderline significant effect on time to recurrence [hazard ratio (HR) 0.67, P = 0.08], progression (HR 0.46, P = 0.06), CSS (HR 0.31, P = 0.07) and OS (HR 0.48, P = 0.05). Re-TUR in the presence of muscle in the primary TUR specimen did not improve the outcome for any of the endpoints. Conclusions Our retrospective analysis suggests that re-TUR may not be necessary in patients with T1-HG/G3, if muscle is present in the specimen of the primary TUR.
- Subjects
TRANSURETHRAL prostatectomy; BLADDER cancer; CANCER invasiveness; DISEASE relapse; MUSCLE diseases
- Publication
BJU International, 2016, Vol 118, Issue 1, p44
- ISSN
1464-4096
- Publication type
Article
- DOI
10.1111/bju.13354