The Impact of Transurethral Resection of Bladder Tumor: Clinicopathologic Analysis of Cystectomy Specimen to Evaluate Residual Tumor

Jeong, In Gab; Kwak, Cheol; Jeong, Hyeon; Lee, Eunsik; Lee, Chongwook; Lee, Sang Eun

Abstract

PURPOSE: We analyzed the impact of transurethral resection of the bladder (TUR-B) in patients with bladder cancer, in whom a subsequent cystectomy was performed.
MATERIALS AND METHODS
We reviewed the records of 93 patients, with clinical stage T2 or less transitional cell carcinomas of the bladder that underwent a radical cystectomy at our institute. Before the radical cystectomy, TUR-B was performed for diagnostic and therapeutic purposes in all patients. We used the term "complete TUR" for the following procedures. No residual tumors were found after the TUR endoscopically, also, muscle layer should be present in the TUR specimens and no gross residual tumors were found in the cystectomy specimens by the pathologist.
RESULTS
Eleven (26.8%) of the 41 patients with superficial bladder cancer had no evidence of residual tumors. Of the 19 patients with superficial bladder cancer that underwent complete TUR-B, 10 (52.6%) had no residual tumors. For the invasive tumors, 10 (19.2%) of the 52 patients that had a T2 stage disease had no residual tumors, and 10 (29.4%) of the 34 patients with a T2 stage disease, who underwent complete TUR-B, had no residual tumors. In the 38 patients with superficial bladder cancer, 17 (44.7%) changed to a higher stage. Of the 17 patients who underwent complete TUR-B, 3 (17.7%) changed to a higher stage. Among the patients with a T2 stage disease, those with the pT0 stage had a better survival than those with the pT2 stage with residual tumors (p=0.04).
CONCLUSIONS
The completeness of TUR-B is important in evaluating residual tumors after a previous TUR-B in those patients with both superficial and invasive bladder cancers.