Do we need a re-TUR after en bloc resection of T1 stage bladder cancer?
Bladder tumor
En bloc resection
High-grade T1
Oncology
Second look
Trans-urethral bladder resection
Urology
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
08 Aug 2024
08 Aug 2024
Historique:
received:
26
03
2024
accepted:
11
07
2024
medline:
8
8
2024
pubmed:
8
8
2024
entrez:
8
8
2024
Statut:
epublish
Résumé
A second look trans-urethral resection of the bladder (re-TUR) is recommended after the diagnosis of T1 high grade (T1HG) bladder cancer. Few studies have evaluated the results of re-TUR after a first en bloc resection (EBR) and none of them have specifically reported the pathological results on the field of previous T1 disease. To report the rate of upstaging and the rate of residual disease (RD) on the field of T1HG lesions resected with EBR. Between 01/2014 and 06/2022, patients from 2 centers who had a re-TUR after an EBR for T1HG urothelial carcinoma were retrospectively included. Primary endpoint was the rate of RD including the rate of upstaging to T2 disease on the scar of the primary resection. Secondary endpoints were the rate of any residual disease outside the field. Seventy-five patients were included. No muscle invasive bladder cancer lesions were found after re-TUR. Among the 16 patients who had a RD, 4 were on the resection scar. All of these lesions were papillary and high grade. RD outside the field of the first EBR was observed in 12 patients. After EBR of T1HG disease, none of our patients had an upstaging to MIBC. However, the rate of RD either on and outside the field of the EBR remains quite significant. We suggested that predictive factors of residual papillary disease (number of tumors at the initial TUR and concomitant CIS) might be suitable to select patient who will benefit of the re-TUR.
Sections du résumé
BACKGROUND
BACKGROUND
A second look trans-urethral resection of the bladder (re-TUR) is recommended after the diagnosis of T1 high grade (T1HG) bladder cancer. Few studies have evaluated the results of re-TUR after a first en bloc resection (EBR) and none of them have specifically reported the pathological results on the field of previous T1 disease.
OBJECTIVE
OBJECTIVE
To report the rate of upstaging and the rate of residual disease (RD) on the field of T1HG lesions resected with EBR.
MATERIALS AND METHODS
METHODS
Between 01/2014 and 06/2022, patients from 2 centers who had a re-TUR after an EBR for T1HG urothelial carcinoma were retrospectively included. Primary endpoint was the rate of RD including the rate of upstaging to T2 disease on the scar of the primary resection. Secondary endpoints were the rate of any residual disease outside the field.
RESULTS
RESULTS
Seventy-five patients were included. No muscle invasive bladder cancer lesions were found after re-TUR. Among the 16 patients who had a RD, 4 were on the resection scar. All of these lesions were papillary and high grade. RD outside the field of the first EBR was observed in 12 patients.
CONCLUSION
CONCLUSIONS
After EBR of T1HG disease, none of our patients had an upstaging to MIBC. However, the rate of RD either on and outside the field of the EBR remains quite significant. We suggested that predictive factors of residual papillary disease (number of tumors at the initial TUR and concomitant CIS) might be suitable to select patient who will benefit of the re-TUR.
Identifiants
pubmed: 39115589
doi: 10.1007/s00345-024-05175-y
pii: 10.1007/s00345-024-05175-y
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
475Informations de copyright
© 2024. The Author(s).
Références
Babjuk M, Burger M, Capoun O, Cohen D, Compérat EM, Dominguez Escrig JL 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
doi: 10.1016/j.eururo.2021.08.010
pubmed: 34511303
Herr HW (1999) The value of a second transurethral resection in evaluating patients with bladder tumors. J Urol 162(1):74–76
doi: 10.1097/00005392-199907000-00018
pubmed: 10379743
Cumberbatch MGK, Foerster B, Catto JWF, Kamat AM, Kassouf W, Jubber I et al (2018) Repeat transurethral resection in non-muscle-invasive bladder cancer: a systematic review. Eur Urol 73(6):925–933
doi: 10.1016/j.eururo.2018.02.014
pubmed: 29523366
Yanagisawa T, Kawada T, von Deimling M, Bekku K, Laukhtina E, Rajwa P et al (2024) Repeat transurethral resection for non-muscle-invasive bladder cancer: an updated systematic review and meta-analysis in the contemporary era. Eur Urol Focus 10(1):41–56
doi: 10.1016/j.euf.2023.07.002
pubmed: 37495458
Gallioli A, Diana P, Fontana M, Territo A, Rodriguez-Faba Ó, Gaya JM et al (2022) En bloc versus conventional transurethral resection of bladder tumors: a single-center prospective randomized noninferiority trial. Eur Urol Oncol 5(4):440–448
doi: 10.1016/j.euo.2022.05.001
pubmed: 35618567
D’Andrea D, Soria F, Hurle R, Enikeev D, Kotov S, Régnier S et al (2023) En bloc versus conventional resection of primary bladder tumor (eBLOC): a prospective, multicenter, open-label, phase 3 randomized controlled trial. Eur Urol Oncol 6(5):508–515
doi: 10.1016/j.euo.2023.07.010
pubmed: 37543464
Gregg JR, McCormick B, Wang L, Cohen P, Sun D, Penson DF et al (2016) Short term complications from transurethral resection of bladder tumor. Can J Urol 23(2):8198–8203
pubmed: 27085823
Sieber FE, Barnett SR (2011) Preventing postoperative complications in the elderly. Anesthesiol Clin 29(1):83–97
doi: 10.1016/j.anclin.2010.11.011
pubmed: 21295754
pmcid: 3073675
Hu H, Zhou M, Yang B, Zhou S, Liu Z, Zhang J (2022) A systematic review on the role of repeat transurethral resection after initial en bloc resection for non-muscle invasive bladder cancer. J Clin Med 11(17):5049
doi: 10.3390/jcm11175049
pubmed: 36078978
pmcid: 9456573
Yanagisawa T, Sato S, Hayashida Y, Okada Y, Iwatani K, Matsukawa A et al (2023) Do we need repeat transurethral resection after en bloc resection for pathological T1 bladder cancer? BJU Int 131(2):190–197
doi: 10.1111/bju.15760
pubmed: 35488409
Zhou M, Yang B, Zhou S, Yu P, Li F, Liu Z et al (2023) Will repeat resection after initial transurethral en bloc resection benefit patients with high-risk non-muscle-invasive bladder cancer? A propensity score matching analysis. J Cancer Res Clin Oncol 149(9):5861–5869
doi: 10.1007/s00432-022-04564-3
pubmed: 36585983
Yuen-Chun Teoh J, Cheng CH, Tsang CF, Kai-Man Li J, Kwun-Chung Cheng B, Hoi-Chak Chan W et al (2024) Transurethral en bloc resection versus standard resection of bladder tumour: a randomised, multicentre, phase 3 trial. Eur Urol. https://doi.org/10.1016/j.eururo.2024.04.015
Bebane S, Denize J, Goujon A, Meria P, Verine J, Mongiat-Artus P et al (2021) Perioperative outcomes of transurethral resection for t1 bladder tumors: quality evaluation based on patient, tumor and surgeon criteria. World J Urol 39(11):4159–4165
doi: 10.1007/s00345-021-03765-8
pubmed: 34160681
Ferro M, Di Lorenzo G, Buonerba C, Lucarelli G, Russo GI, Cantiello F et al (2018) Predictors of residual T1 high grade on re-transurethral resection in a large multi-institutional cohort of patients with primary T1 high-grade/grade 3 bladder cancer. J Cancer 9(22):4250–4254
doi: 10.7150/jca.26129
pubmed: 30519326
pmcid: 6277616
Soria F, D’Andrea D, Moschini M, Giordano A, Mazzoli S, Pizzuto G et al (2020) Predictive factors of the absence of residual disease at repeated transurethral resection of the bladder. Is there a possibility to avoid it in well-selected patients? Urol Oncol 38(3):77.e1-77.e7
doi: 10.1016/j.urolonc.2019.08.010
pubmed: 31526650
Laukhtina E, Shim SR, Mori K, D’Andrea D, Soria F, Rajwa P et al (2021) Diagnostic accuracy of novel urinary biomarker tests in non-muscle-invasive bladder cancer: a systematic review and network meta-analysis. Eur Urol Oncol 4(6):927–942
doi: 10.1016/j.euo.2021.10.003
pubmed: 34753702
Diana P, Baboudjian M, Gallioli A, Territo A, Fontanet S, Izquierdo P et al (2023) Implementing a checklist for transurethral resection of bladder tumor to standardize outcome reporting: when high-quality resection could influence oncological outcomes. Eur Urol Open Sci 48:24–27
doi: 10.1016/j.euros.2022.09.025
pubmed: 36588772
Burger M, Grossman HB, Droller M, Schmidbauer J, Hermann G, Drăgoescu O et al (2013) Photodynamic diagnosis of non-muscle-invasive bladder cancer with hexaminolevulinate cystoscopy: a meta-analysis of detection and recurrence based on raw data. Eur Urol 64(5):846–854
doi: 10.1016/j.eururo.2013.03.059
pubmed: 23602406