Abstract
Purpose
To evaluate the efficacy of repeat transurethral resection on restaging, preventing tumor recurrence and progression in high-risk non-muscle invasive bladder cancer patients who received initial en bloc resection.
Methods and patients
We reviewed retrospectively the clinical records of 330 consecutive patients who received en bloc resection for non-muscle invasive bladder cancer. Eligible patients with and without repeat transurethral resection were matched 1:1 by propensity score. Important covariates were balanced between the two groups. We compared the recurrence-free survival, progression-free survival, recurrence rate, and progression rate between groups. And the perioperative results regarding residual tumors and the safety of the repeat resection were also evaluated.
Results
Finally, there are 245 patients included in our analysis with a median follow-up duration of 19 months (range 3–50). Detrusor muscle presented in 244 (99.6%) specimens at initial en bloc resection. And among them, 30 (12.2%) patients had undergone a repeat resection and 215 (87.8%) did not. After 1:1 propensity score matching, 30 pairs were further analyzed.No case of upstaging was identified in repeat resection. During the follow-up, recurrence was observed in 5 (16.7%) and 7 (23.3%) patients in reresection group and non-reresection group, respectively. And progression was found only in 1 (3.3%) patient in each group. The 1-year recurrence-free survival estimates were comparable (86.7% vs 83.3%, p = 0.86) between groups.
Conclusion
Our study demonstrates that repeat resection after initial transurethral en bloc resection for bladder tumor appears not to improve staging accuracy, recurrence, and progression.
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Data availability statement
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
Mengqi Zhou would like to dedicate this work to the memory of his dearest uncle Lixing Zhou (1967-2022), who lost his brave fight against cancer.
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Conceptualization: HH and MZ; methodology: MZ, SZ, BY, and PY; software: MZ; validation: BY, SZ, and FL; formal analysis: MZ; investigation: MZ, BY, SZ, ZL, and HH; data curation: MZ, SZ, BY, and PY; writing—original draft preparation: MZ; writing—review and editing: BY, FL, ZL, and HH; supervision: HH. All authors read and approved the final manuscript.
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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Tongji Hospital (TJ-IRB20200729).
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Zhou, M., Yang, B., Zhou, S. et al. 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, 5861–5869 (2023). https://doi.org/10.1007/s00432-022-04564-3
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DOI: https://doi.org/10.1007/s00432-022-04564-3