Investig Clin Urol.  2022 Jan;63(1):14-20. 10.4111/icu.20210314.

Evaluating the efficacy of secondary transurethral resection of the bladder for high-grade Ta tumors

• Lee K
• Jeong Sh
• Yoo SH
• Ku JH

• KMID: 2524265
• DOI: http://doi.org/10.4111/icu.20210314

Abstract

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 reTURB.
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 highgrade Ta bladder cancer.

Keyword

Recurrence; Survival rate; Urinary bladder neoplasms