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KMID : 1011820220630010014
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Investigative and Clinical Urology
2022 Volume.63 No. 1 p.14 ~ p.20
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Evaluating the efficacy of secondary transurethral resection of the bladder for high-grade Ta tumors
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Lee Kyeong-Chae
Jeong Seung-Hwan
Yoo Sang-Hyun
Ku Ja-Hyeon
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Abstract
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Purpose: The need for secondary transurethral resection of the bladder (re-TURB) in patients with high-grade Ta tumors has not been assessed. This study aimed to compare the outcomes of patients with high-grade Ta tumors who did and did not undergo re-TURB.
Materials and Methods: This study used data from the Seoul National University Prospectively Enrolled Registry for Urothelial Cancer?Transurethral Bladder Tumor Resection (SUPER-UC-TURB). Patients with high-grade Ta tumors who underwent TURB between March 2016 and December 2019 were included. Following the initial TURB, if the pathology results showed a tumor grade higher than high-grade Ta, re-TURB was performed according to the surgeon’s recommendation. The recurrence-free survival rate was assessed by Kaplan?Meier analysis and Cox regression analysis between patients who did and did not undergo re-TURB.
Results: In total, 187 patients with high-grade Ta who underwent initial TURB were included, of whom 115 underwent re-TURB and 72 did not. Patients in the re-TURB group had a significantly higher 2-year recurrence-free survival rate than did those in the no re-TURB group (81.3% vs. 60.1%; p=0.005). Whether patients underwent re-TURB was a significant predictor of the risk of bladder cancer recurrence in both the univariate (HR, 0.52; 95% CI, 0.27?0.98; p=0.044) and multivariate (HR, 0.41; 95% CI, 0.19?0.97; p=0.041) analysis.
Conclusions: The risk for bladder cancer recurrence was increased, and the 2-year recurrence-free survival was significantly decreased, in patients with high-grade Ta tumors who did not undergo re-TURB. Thus, re-TURB is beneficial in patients with high-grade Ta bladder cancer.
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KEYWORD
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Recurrence, Survival rate, Urinary bladder neoplasms
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