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World Journal of Surgical Oncology

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Open Access 01-12-2018 | Research

Clinical rationale and safety of restaging transurethral resection in indication-stratified patients with high-risk non-muscle-invasive bladder cancer

Authors: Piotr Zapała, Bartosz Dybowski, Sławomir Poletajew, Łukasz Białek, Andrzej Niewczas, Piotr Radziszewski

Published in: World Journal of Surgical Oncology | Issue 1/2018

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.

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Title: Clinical rationale and safety of restaging transurethral resection in indication-stratified patients with high-risk non-muscle-invasive bladder cancer
Authors: Piotr Zapała
Bartosz Dybowski
Sławomir Poletajew
Łukasz Białek
Andrzej Niewczas
Piotr Radziszewski
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2018
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/s12957-018-1310-0

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Clinical rationale and safety of restaging transurethral resection in indication-stratified patients with high-risk non-muscle-invasive bladder cancer

Abstract

Background

Methods

Results

Conclusions

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