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Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer: impact on prognosis
IJ. Beijert, AE. Hentschel, J. Bründl, EM. Compérat, K. Plass, O. Rodríguez, JD. Subiela Henríquez, V. Hernández, E. de la Peña, I. Alemany, D. Turturica, F. Pisano, F. Soria, O. Čapoun, L. Bauerová, M. Pešl, HM. Bruins, W. Runneboom, S....
Jazyk angličtina Země Nizozemsko
Typ dokumentu časopisecké články
- MeSH
- cystektomie MeSH
- lidé MeSH
- močový měchýř chirurgie patologie MeSH
- nádory močového měchýře neinvadující svalovinu * MeSH
- nádory močového měchýře * chirurgie patologie MeSH
- prognóza MeSH
- staging nádorů MeSH
- urologické chirurgické výkony MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: A re-transurethral resection of the bladder (re-TURB) is a well-established approach in managing non-muscle invasive bladder cancer (NMIBC) for various reasons: repeat-TURB is recommended for a macroscopically incomplete initial resection, restaging-TURB is required if the first resection was macroscopically complete but contained no detrusor muscle (DM) and second-TURB is advised for all completely resected T1-tumors with DM in the resection specimen. This study assessed the long-term outcomes after repeat-, second-, and restaging-TURB in T1-NMIBC patients. METHODS: Individual patient data with tumor characteristics of 1660 primary T1-patients (muscle-invasion at re-TURB omitted) diagnosed from 1990 to 2018 in 17 hospitals were analyzed. Time to recurrence, progression, death due to bladder cancer (BC), and all causes (OS) were visualized with cumulative incidence functions and analyzed by log-rank tests and multivariable Cox-regression models stratified by institution. RESULTS: Median follow-up was 45.3 (IQR 22.7-81.1) months. There were no differences in time to recurrence, progression, or OS between patients undergoing restaging (135 patients), second (644 patients), or repeat-TURB (84 patients), nor between patients who did or who did not undergo second or restaging-TURB. However, patients who underwent repeat-TURB had a shorter time to BC death compared to those who had second- or restaging-TURB (multivariable HR 3.58, P = 0.004). CONCLUSION: Prognosis did not significantly differ between patients who underwent restaging- or second-TURB. However, a worse prognosis in terms of death due to bladder cancer was found in patients who underwent repeat-TURB compared to second-TURB and restaging-TURB, highlighting the importance of separately evaluating different indications for re-TURB.
European Association of Urology Guidelines Office Board Arnhem The Netherlands
Health Evidence and Urology Radboud University Medical Center Nijmegen The Netherlands
Pathology Città della Salute e della Scienza University of Torino School of Medicine Turin Italy
Pathology Fundacio Puigvert Universitat Autònoma de Barcelona Barcelona Spain
Pathology Fundación Instituto Valenciano de Oncología Valencia Spain
Pathology Hospital Universitario Fundación Alcorcón Madrid Spain
Pathology Medical University of Graz Graz Austria
Pathology Radboud University Medical Center Nijmegen The Netherlands
Pathology Royal Free London NHS Foundation Trust Royal Free Hospital London UK
Pathology Tenon Hospital AP HP Sorbonne University Paris France
Pathology University of Regensburg Regensburg Germany
Urology Amsterdam University Medical Centers Vrije Universiteit Amsterdam The Netherlands
Urology Caritas St Josef Medical Center University of Regensburg Regensburg Germany
Urology Città della Salute e della Scienza University of Torino School of Medicine Turin Italy
Urology Comprehensive Cancer Center Medical University Vienna Vienna General Hospital Vienna Austria
Urology Fundacio Puigvert Universitat Autònoma de Barcelona Barcelona Spain
Urology Fundación Instituto Valenciano de Oncología Valencia Spain
Urology Hospital Universitario Fundación Alcorcón Madrid Spain
Urology Medical University of Graz Graz Austria
Urology Radboud University Medical Center Nijmegen The Netherlands
Urology Royal Free London NHS Foundation Trust Royal Free Hospital London UK
Urology Tenon Hospital AP HP Sorbonne University Paris France
Urology The Stokes Centre for Urology Royal Surrey Hospital Guildford UK
Urology Zuyderland Medical Center Sittard Heerlen The Netherlands
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- $a Beijert, Irene J $u Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands $u Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands $1 https://orcid.org/0000000205102300
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- $a Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer: impact on prognosis / $c IJ. Beijert, AE. Hentschel, J. Bründl, EM. Compérat, K. Plass, O. Rodríguez, JD. Subiela Henríquez, V. Hernández, E. de la Peña, I. Alemany, D. Turturica, F. Pisano, F. Soria, O. Čapoun, L. Bauerová, M. Pešl, HM. Bruins, W. Runneboom, S. Herdegen, J. Breyer, A. Brisuda, A. Calatrava, J. Rubio-Briones, M. Seles, S. Mannweiler, J. Bosschieter, VRM. Kusuma, D. Ashabere, N. Huebner, J. Cotte, R. Contieri, LS. Mertens, F. Claps, A. Masson-Lecomte, F. Liedberg, D. Cohen, L. Lunelli, O. Cussenot, S. El Sheikh, D. Volanis, JF. Côté, M. Rouprêt, A. Haitel, SF. Shariat, AH. Mostafid, JA. Nieuwenhuijzen, R. Zigeuner, JL. Dominguez-Escrig, J. Hacek, AR. Zlotta, M. Burger, M. Evert, CA. Hulsbergen-van de Kaa, AG. van der Heijden, LALM. Kiemeney, V. Soukup, L. Molinaro, P. Gontero, C. Llorente, F. Algaba, J. Palou, J. N'Dow, MJ. Ribal, TH. van der Kwast, M. Babjuk, RJ. Sylvester, BWG. van Rhijn
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- $a PURPOSE: A re-transurethral resection of the bladder (re-TURB) is a well-established approach in managing non-muscle invasive bladder cancer (NMIBC) for various reasons: repeat-TURB is recommended for a macroscopically incomplete initial resection, restaging-TURB is required if the first resection was macroscopically complete but contained no detrusor muscle (DM) and second-TURB is advised for all completely resected T1-tumors with DM in the resection specimen. This study assessed the long-term outcomes after repeat-, second-, and restaging-TURB in T1-NMIBC patients. METHODS: Individual patient data with tumor characteristics of 1660 primary T1-patients (muscle-invasion at re-TURB omitted) diagnosed from 1990 to 2018 in 17 hospitals were analyzed. Time to recurrence, progression, death due to bladder cancer (BC), and all causes (OS) were visualized with cumulative incidence functions and analyzed by log-rank tests and multivariable Cox-regression models stratified by institution. RESULTS: Median follow-up was 45.3 (IQR 22.7-81.1) months. There were no differences in time to recurrence, progression, or OS between patients undergoing restaging (135 patients), second (644 patients), or repeat-TURB (84 patients), nor between patients who did or who did not undergo second or restaging-TURB. However, patients who underwent repeat-TURB had a shorter time to BC death compared to those who had second- or restaging-TURB (multivariable HR 3.58, P = 0.004). CONCLUSION: Prognosis did not significantly differ between patients who underwent restaging- or second-TURB. However, a worse prognosis in terms of death due to bladder cancer was found in patients who underwent repeat-TURB compared to second-TURB and restaging-TURB, highlighting the importance of separately evaluating different indications for re-TURB.
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