CODE: 8.2 - The role of the second transurethral resection of the bladder tumors in managing and evaluating the patients with superficial bladder tumors
Article published in Urologia Polska 2006/59/Suplement 1.
Janusz Ciechan, Ireneusz Ostrowski, Krzysztof Mazurek
- Oddział Urologii Szpitala Specjalistycznego w Puławach
- Introduction. The aim of transurethral resection of the bladder tumors (TURT) is to remove all the tumors and to assess the local extent of the disease.
- Purpose. The role of routine second transurethral resection (re-TURT) in evaluating and managing the bladder tumors is defined. We evaluated the number of visible residual tumors, their staging (T) and grading (G).
- Materials and methods. From May 2004 to December 2005, 30 patients (24 males and 6 females) with new superficial bladder tumors underwent repeat standard transurethral resection of the scar from initial resection and other suspicious lesions within 4 weeks after the initial resection. In this group there were 16 (53%) patients with a single tumor (4 with Ta, 5 Ta/T1, 7 T1) and 14 (47%) with multiple tumors (2 with Ta, 6 Ta/T1, 6 T1). In the opinion of an experienced urologist the first TURT was complete.
- Results. Of the 30 patients who underwent re-TURT 20 (67%) had no and 10 (33%) had residual tumors, including 1 (3%) of Ta, 2 (6%) of Ta/T1 and 7 (24%) of T1 disease. Among them 5 (17%) had a primary single tumor, 5 multiple primary tumors. 6 (20%) had residual tumors at the initial resection site, 4 (13%) had additional focus. Furthermore, after histopathological assessment of re-TURT specimens, 3 tumors were downgraded and one upstaged to T2.
- Conclusions. Many patients with bladder tumors have tumor present after an initial transurethral resection. In our material residual cancers were found in 33%. Routine re-TURT is effective and helpful in detecting residual cancer and allows verification of the first pathological assessment.