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Perforation during TUR of bladder tumours influences the natural history of superficial bladder cancer

World Journal of Urology volume 32, pages 1219–1223 (2014)Cite this article

Abstract

Objectives

Bladder perforation is the second most common complication during transurethral resection of bladder tumours. It is unknown whether perforation affects the natural history of the tumour through cell seeding. The aim of this study was to study the impact of perforation on the oncologic outcomes of bladder carcinoma.

Materials and methods

Between 2003 and 2007, 926 consecutive patients underwent transurethral resection of bladder tumours at our institution; 327 cases were staged ≥pT2 and were treated immediately with cystectomy and/or multimodal therapy and therefore excluded from the study. An additional 34 cases without urothelial carcinoma were excluded. Of the remaining 565 patients with non-muscle invasive bladder cancer, 457 (80.8 %) were male and 108 (19.2 %) were female with a mean age of 69.5 years in men and 67.3 years in women. Thirty-seven patients (6.5 %) experienced bladder perforation at the time of tumour resection. This group of patients (Group 1) was compared to the remaining 528 patients (Group 2) who did not experience a bladder perforation.

Results

Patients with bladder wall perforation experienced a shorter disease-free survival in both univariate (p = 0.003) and multivariate analyses (p = 0.006). In addition, subsequent recurrences revealed stage progression of recurrent disease (p = 0.05) and trended to a higher number of cystectomies in the perforated group of patients (p = 0.06). Nevertheless, perforation did not appear to influence overall survival (p = 0.127) or cancer-specific survival (p = 0.141).

Conclusion

The results indicate that bladder perforation during resection of superficial bladder tumours is burdened by a shortened disease-free survival and T-stage progression.

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Affiliations

  1. Department of Urology, Central Hospital of Bolzano, Lorenz Böhler Street 5, 39100, Bolzano, Italy

    Evi Comploj, Christopher B. Dechet, Emanuela Trenti, Salvatore Palermo, Michele Lodde & Armin Pycha

  2. Department of Pathology, Central Hospital of Bolzano, Bolzano, Italy

    Christine Mian & Andrea Ambrosini-Spaltro

  3. Department of Urology, Medical School Innsbruck, Innsbruck, Austria

    Wolfgang Horninger

  4. Department of Hematology, Central Hospital of Bolzano, Bolzano, Italy

    Michael Mian

  5. Division of Urology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT, USA

    Christopher B. Dechet

  6. Department of Hematology and Oncology, Medical School Innsbruck, Innsbruck, Austria

    Michael Mian

Authors
  1. Evi Comploj
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  2. Christopher B. Dechet
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  3. Michael Mian
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  4. Emanuela Trenti
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  5. Salvatore Palermo
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  6. Michele Lodde
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  7. Christine Mian
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  8. Andrea Ambrosini-Spaltro
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  9. Wolfgang Horninger
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  10. Armin Pycha
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Correspondence to Evi Comploj.

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Comploj, E., Dechet, C.B., Mian, M. et al. Perforation during TUR of bladder tumours influences the natural history of superficial bladder cancer. World J Urol 32, 1219–1223 (2014). https://doi.org/10.1007/s00345-013-1197-x

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  • DOI: https://doi.org/10.1007/s00345-013-1197-x

Keywords

  • Transurethral resection
  • Urothelial cancer
  • Perforation
  • Complications
  • Tumour cell seeding