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The value of extensive transurethral resection in the diagnosis and treatment of nonmuscle invasive bladder cancer with respect to recurrence at the first follow-up cystoscopy

Authors Qie Y, Hu H, Tian D, Zhang Y, Xie L, Xu Y, Wu C

Received 6 January 2016

Accepted for publication 9 February 2016

Published 5 April 2016 Volume 2016:9 Pages 2019—2025


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Venktesh Shirure

Peer reviewer comments 2

Editor who approved publication: Professor Min Li

Yunkai Qie,* Hailong Hu,* Dawei Tian, Yu Zhang, Linguo Xie, Yong Xu, Changli Wu

Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin, People’s Republic of China

*These authors contributed equally to this work

Objective: To evaluate the value of extensive transurethral resection (TUR) in the diagnosis and treatment of nonmuscle invasive bladder cancer (NMIBC) and its further impact on the recurrence rate at the first follow-up cystoscopy (RR-FFC).
Patients and methods: A retrospective review of consecutive series of 523 patients with NMIBCs who underwent TUR from June 2009 to July 2015 at the Second Hospital of Tianjin Medical University was conducted. Extensive TURs were performed by taking additional tumor base and marginal specimens for 317 patients (group 1). Extensive TURs were not done in the other 206 patients (group 2). Urine cytology and follow-up cystoscopy were performed at 3 months after the initial TUR. The positive findings of additional specimens were noted and it was found whether or not the diagnosis and treatment plan had changed in group 1. Also, a comparison was made of the RR-FFC between group 1 and 2.
Results: There were 51/317 (16.1%) patients whose additional specimens revealed pathological findings such as Ta, T1, and carcinoma in situ diseases. Of these positive findings, 6/51 (11.8%) were Ta stage, 16/51 (31.4%) were T1 stage, 18/51 (35.3%) were T2 stage, and 11/51 (21.5%) were carcinoma in situ. Due to the positive findings, 29/317 (9.1%) patients had their final diagnosis changed and 45/317 (14.2%) had their post-TUR treatment plans adjusted. The RR-FFC of group 1 and 2 were 4.7% (14/297) and 13.1% (27/206), respectively (P=0.001).
Conclusion: Routine extensive TUR is helpful for the pathological diagnosis and the post-TUR treatment of NMIBC. Furthermore, it can significantly reduce the RR-FFC of NMIBC, especially in patients with T1 stage or high-grade disease.

Keywords: bladder cancer, urothelial carcinoma, transurethral resection, specimens, recurrence

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