Factors that predict residual tumors in re-TUR patients

Abstract

Introduction: The first and foremost rule in the treatment of superficial bladder cancer is correct and complete resection of the tumor. Histopathological analysis of the resected tumor will help to define the correct tumor stage, thus delaying or, ideally, avoiding tumor recurrence and progression.

Objectives: To examine the prognostic factors for residual tumors in the tumor base or in another area of the bladder in patients subjected to repeat transurethral resection (re-TUR).

Patients and methods: Between September 2009 and August 2014, 188/221 patients advised to undergo re-TUR for stage T1 tumors were subjected to the procedure. The following data were collected for this retrospective study: patients’ age and sex, information on whether initial TUR was carried out for a primary tumor/primary tumors, tumor number, tumor size and tumor grade, as well as information on whether muscularis propria was found in the resected specimens of initial TUR, whether there was carcinoma in situ and whether single dose intracavitary chemotherapy was administered following initial TUR.

Results: On re-TUR, new tumors outside of the previous resection area were found in 34 (18%) and residual tumors in the initial resection area in 48 (25.5%) patients. 61.7% of the patients diagnosed with new tumors outside of the previous tumor area and 62.5% of those with residual tumors in the initial resection area had initially undergone TUR for multifocal tumors. Both univariate and multivariate analysis revealed a significant relationship between male sex, multifocal primary tumors and the detection of residual tumors in the previous resection area during re-TUR.

Keywords: Bladder tumor; Transurethral resection; Complete resection; Multifocal