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Therapeutic benefit of second-look transurethral resection of bladder tumors for newly diagnosed T1 bladder cancer: a single-center experience

  • Urology - Original Paper
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Abstract

Purpose

In recent years, second-look transurethral resection of bladder tumors (TURBT) has been recommended for patients with stage T1 bladder cancer after the initial TURBT for restaging and deciding the subsequent treatment. However, we believe that second-look TURBT has therapeutic benefits, such as low incidence of recurrence and progression. Therefore, we compare the differences in long-term outcome between patients who did and did not accept second-look TURBT for stage T1 bladder cancer.

Methods

We assessed 504 patients diagnosed with urothelial carcinoma who underwent initial TURBT between January 2012 and December 2016 at a single medical center; of these patients, 177 were diagnosed with T1 bladder cancer during the initial TURBT, and we excluded no muscle from the specimen in the initial TURBT. The patients were categorized into groups 1 and 2 based on the acceptance of second-look TURBT, which was performed within 4–14 weeks after the initial TURBT. Group 1 underwent second-look TURBT, but group 2 did not. Both groups were followed-up for recurrence-free survival (RFS) and progression-free survival (PFS), and the risk factors for recurrence and progression were analyzed.

Results

In total, 93 (52.5%) patients in group 1 underwent second-look TURBT, and 84 (47.5%) in group 2 did not. The 2-year RFS rates were 74.6% and 60.0% and the PFS rates were 91.2% and 87.5% in groups 1 and 2, respectively.

Conclusion

This study demonstrated higher recurrence-free and progression-free survival rates for patients who underwent second-look TURBT. This result emphasizes the importance of second-look TURBT in stage T1 bladder cancer not only for restaging but also for therapeutic benefit.

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Acknowledgements

The author wishes to acknowledge to Dr. Tseng, Chien-Chang, Ying-Hsia, Shen, Yu-Ping, Huang for guidance.

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Authors and Affiliations

  1. Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan

    Wen-Hsin Tseng, Chien-Liang Liu, Steven K. Huang, Alex Chien-Hwa Liao, Chun-Hao Chen, Chia-Cheng Su, Jhih-Cheng Wang, Kau-Han Lee & Kun-Hung Shen

  2. Division of Uro-Oncology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan

    Chien-Liang Liu

  3. Division of Neurosurgery, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan

    Jinn-Rung Kuo

  4. Division of Urology, Department of Surgery, Chi Mei Hospital, Chiali, Tainan, Taiwan

    Shun-Hsing Hun

  5. Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan

    Chien-Feng Li

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  1. Wen-Hsin Tseng
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  2. Chien-Liang Liu
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Correspondence to Chien-Liang Liu.

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All procedures involving human participants were performed in accordance with the ethical standards of the institutional research committee and the 1964 Declaration of Helsinki.

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Tseng, WH., Liu, CL., Huang, S.K. et al. Therapeutic benefit of second-look transurethral resection of bladder tumors for newly diagnosed T1 bladder cancer: a single-center experience. Int Urol Nephrol 51, 1335–1342 (2019). https://doi.org/10.1007/s11255-019-02172-8

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