Evaluating the efficacy of secondary transurethral resection of the bladder for high-grade Ta tumors

Investig Clin Urol. 2022 Jan;63(1):14-20. doi: 10.4111/icu.20210314.

Abstract

Purpose: The need for secondary transurethral resection of the bladder (re-TURB) in patients with high-grade Ta tumors has not been assessed. This study aimed to compare the outcomes of patients with high-grade Ta tumors who did and did not undergo re-TURB.

Materials and methods: This study used data from the Seoul National University Prospectively Enrolled Registry for Urothelial Cancer-Transurethral Bladder Tumor Resection (SUPER-UC-TURB). Patients with high-grade Ta tumors who underwent TURB between March 2016 and December 2019 were included. Following the initial TURB, if the pathology results showed a tumor grade higher than high-grade Ta, re-TURB was performed according to the surgeon's recommendation. The recurrence-free survival rate was assessed by Kaplan-Meier analysis and Cox regression analysis between patients who did and did not undergo re-TURB.

Results: In total, 187 patients with high-grade Ta who underwent initial TURB were included, of whom 115 underwent re-TURB and 72 did not. Patients in the re-TURB group had a significantly higher 2-year recurrence-free survival rate than did those in the no re-TURB group (81.3% vs. 60.1%; p=0.005). Whether patients underwent re-TURB was a significant predictor of the risk of bladder cancer recurrence in both the univariate (HR, 0.52; 95% CI, 0.27-0.98; p=0.044) and multivariate (HR, 0.41; 95% CI, 0.19-0.97; p=0.041) analysis.

Conclusions: The risk for bladder cancer recurrence was increased, and the 2-year recurrence-free survival was significantly decreased, in patients with high-grade Ta tumors who did not undergo re-TURB. Thus, re-TURB is beneficial in patients with high-grade Ta bladder cancer.

Keywords: Recurrence; Survival rate; Urinary bladder neoplasms.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Cystectomy / methods*
  • Female
  • Humans
  • Male
  • Neoplasm Grading
  • Neoplasm Staging
  • Retrospective Studies
  • Treatment Outcome
  • Urethra
  • Urinary Bladder Neoplasms / pathology*
  • Urinary Bladder Neoplasms / surgery*