THE CRITERIA OF PATIENT SELECTION FOR REPEAT TRANSURETHRAL RESECTION OF NON-MUSCLE INVASIVE BLADDER CANCER


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Aim: To evaluate in a prospective study the results of transurethral resection (TUR) for non-muscle invasive bladder cancer (NMIBC) and analyze the prognostic factors for the detection of residual tumor to develop indications for this intervention. Materials and methods: The study included 111 patients with primary or recurrent NMIBC and intermediate or poor prognosis after visually radical TUR of the bladder. All patients underwent repeat TUR, which included a thorough cystoscopy, biopsy or TUR of all suspicious areas of the bladder, a deep biopsy of the area of the previous resection including the muscular layer. All prognostic tumor characteristics for assessing risk factors were available in 81 patients. Results: In total, repeat TUR resulted in the detection of 29/111 (26.1%) malignant tumors, while muscle-invasive cancer was diagnosed in 4/29 cases (3.6% of all included patients). The analysis of the relationship of residual tumor detection with various factors showed that the results of repeat TUR correlated with cystoscopic data at the repeat intervention and the degree of the tumor differentiation. Stratification of data depending on these factors revealed that in the absence of a visible tumor and G1, residual tumor was detected in 3.5% of cases, compared with 28.1% for the negative cystoscopy and G2-G3, and 52.6% for the positive cystoscopy regardless of G. Conclusions: Cystoscopy may be applied for selecting NMIBC patients with G1 differentiation for repeat TUR. In the absence of cystoscopic confirmation of tumor, the repeat TUR can be avoided.

Full Text

Restricted Access

About the authors

A. I. Rolevich

Email: alexander.rolevich@gmail.com
Laboratory of Urologic Oncology of the Department of Surgery, N.N. Alexandrov Republican National Centre for Oncology and Medical Radiology Minsk, Republic of Belarus

References

  1. Okeanov A.E., Moiseev P.I., Levin L.F. Statistics of oncological diseases in the Republic of Belarus (2004-2013) / Ed. O.G. Sukonko. Minsk N.N., Alexandrov RNC OMR, 2014. 382 p. Russian (Океанов А.Е., Моисеев П.И., Левин Л.Ф. Статистика онкологических заболеваний в Республике Беларусь (2004-2013) / Под ред. О.Г. Суконко. Минск: РНПЦ ОМР им. Н.Н. Александрова, 2014. 382 с.).
  2. van Rhijn B. W., Burger M., Lotan Y., Solsona E., Stief C. G., Sylvester R.J., Witjes J.A., Zlotta A.R. Recurrence and progression of disease in non-muscle-invasive bladder cancer: from epidemiology to treatment strategy. Eur Urol. 2009;56:430-442.
  3. Ramwez-Backhaus M., Domhguez-Escrig J., Collado A., Rubio-Briones J., Solsona E. Restaging transurethral resection of bladder tumor for high-risk stage Ta and T1 bladder cancer. Curr Urol Rep. 2012;13:109-114.
  4. Brausi M., Collette L., Kurth K., van der Meijden A.P., Oosterlinck W., Witjes J.A., Newling D., Bouffioux C., Sylvester R.J. EORTC Genito-Urinary Tract Cancer Collaborative Group. Variability in the recurrence rate at first follow-up cystoscopy after TUR in stage Ta T1 transitional cell carcinoma of the bladder: a combined analysis of seven EORTC studies. Eur Urol. 2002;41:523-531.
  5. Mowatt G., N'Dow J., Vale L., Nabi G., Boachie C., Cook J.A., Fraser C., Griffiths T.R.; Aberdeen Technology Assessment Review (TAR) Group. Photodynamic diagnosis of bladder cancer compared with white light cystoscopy: Systematic review and meta-analysis. Int J Technol Assess Health Care. 2011; 27: 3-10.
  6. Klän R., Loy V., Huland H. Residual tumor discovered in routine second transurethral resection in patients with stage T1 transitional cell carcinoma of the bladder. J Urol. 1991;146: 316-318.
  7. Herr H.W. The value of a second transurethral resection in evaluating patients with bladder tumors. J Urol. 1999;162:74-76.
  8. Brauers A., Buettner R., Jakse G. Second resection and prognosis of primary high risk superficial bladder cancer: is cystectomy often too early? J Urol. 2001;165:808-810.
  9. Rigaud J., Karam G., Braud G., Glemain P., Buzelin J.M., Bouchot O. Tumeurs de vessie T1: intérêt d'une deuxième résection endoscopique. Prog Urol. 2002;12:27-30.
  10. Schips L., Augustin H., Zigeuner R.E., Gallé G., Habermann H., Trummer H., Pummer K., Hubmer G. Is repeated transurethral resection justified in patients with newly diagnosed superficial bladder cancer? Urology. 2002;59:220-223.
  11. Grimm M.O., Steinhoff C., Simon X., Spiegelhalder P., Ackermann R., Vogeli T.A. Effect of routine repeat transurethral resection for superficial bladder cancer: a long-term observational study. J Urol. 2003;170:433-437.
  12. Divrik T., Yildirim U., Eroglu A.S., Zorlu F., Ozen H. Is a second transurethral resection necessary for newly diagnosed pT1 bladder cancer? J Urol. 2006;175:1258-1261.
  13. Schwaibold H.E., Sivalingam S., May F., Hartung R. The value of a second transurethral resection for T1 bladder cancer. BJU Int. 2006;97:1199-1201.
  14. Hall M.C., Chang S.S., Dalbagni G., Pruthi R.S., Seigne J.D., Skinner E.C., Wolf J.S. Jr, Schellhammer P.F. Guideline for the management of nonmuscle invasive bladder cancer (stages Ta, T1, andTis): 2007 update. J Urol. 2007;178:2314-2330.
  15. Babjuk M., Burger M., Zigeuner R., Shariat S.F., van Rhijn B.W., Compérat E., Sylvester R.J., Kaasinen E., Böhle A., Palou Redorta J, Rouprêt M; European Association of Urology. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2013. Eur Urol. 2013;64:639-653.
  16. National Comprehensive Cancer Network. Bladder Cancer (Version 2.2015). http://www.nccn.org/professionals/physician_gls/pdf/bladder.pdf, Доступ 02.11.2015.
  17. Burger M., Oosterlinck W., Konety B., Chang S., Gudjonsson S., Pruthi R., Soloway M., Solsona E., Sved P., Babjuk M., Brausi M.A., Cheng C., Comperat E., Dinney C., Otto W., Shah J., Thürof J., Witjes J.A. International Consultation on Urologic Disease-European Association of Urology Consultation on Bladder Cancer 2012. ICUD-EAU International Consultation on Bladder Cancer 2012: Non-muscle-invasive urothelial carcinoma of the bladder. Eur Urol. 2013;63:36-44.
  18. Brausi M., Witjes J.A., Lamm D., Persad R., Palou J., Colombel M., Buckley R., Soloway M., Akaza H., Böhle A. A review of current guidelines and best practice recommendations for the management of nonmuscle invasivebladder cancer by the International Bladder Cancer Group. J Urol. 2011;186:2158-2167.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies