BACKGROUND AND PURPOSE: Transurethral resection of the bladder (TURB), the first step in treatment of patients with urothelial bladder cancers, is limited by technicalities, surgeon skill, and random chance. When high-risk superficial diseases are discovered, a repeated TURB is indicated. We reviewed current literature and performed a meta-analysis of the role of repeated TURB in the management of nonmuscle-invasive bladder cancers. METHODS: PubMed, MEDLINE, ISI Web of Knowledge, EBSCO, EMBASE, and Biomed Central databases were searched for reports in English from 1980 to June 2010. The end point was prevalence of persistent urothelial bladder cancer of any stage and grade at repeated TURB, assessed separately for T(a) and T(1) lesions at TURB. Persistence was presence at repeated TURB of same or lower stage cancer as at TURB; upstaging was presence of higher stage. RESULTS: There were 2327 original articles and 562 reviews retrieved. Data from 15 studies were pooled and analyzed. Prevalence of T(1) was reported in all and of T(a) in 8. Persistence rate prevalence at repeated TURB was 0.39 (95% confidence interval [CI]=0.26 to 0.54) for T(a) and 0.47 (95% CI=0.41 to 0.53) for T(1). Persistence was 19.4% to 56% and 15.2% to 55%, and upstaging occurred in 0% to 14.3% of T(a) and 0% to 24.4% of T(1) at repeated TURB, respectively. CONCLUSION: High percentages of persistence and upstaging confirm a repeated TURB is needed in patients with high-risk nonmuscle-invasive bladder cancer. Further investigation is encouraged taking risk stratification into consideration to evaluate the role of repeated TURB in low- and mid- risk diseases.
BACKGROUND AND PURPOSE: Transurethral resection of the bladder (TURB), the first step in treatment of patients with urothelial bladder cancers, is limited by technicalities, surgeon skill, and random chance. When high-risk superficial diseases are discovered, a repeated TURB is indicated. We reviewed current literature and performed a meta-analysis of the role of repeated TURB in the management of nonmuscle-invasive bladder cancers. METHODS: PubMed, MEDLINE, ISI Web of Knowledge, EBSCO, EMBASE, and Biomed Central databases were searched for reports in English from 1980 to June 2010. The end point was prevalence of persistent urothelial bladder cancer of any stage and grade at repeated TURB, assessed separately for T(a) and T(1) lesions at TURB. Persistence was presence at repeated TURB of same or lower stage cancer as at TURB; upstaging was presence of higher stage. RESULTS: There were 2327 original articles and 562 reviews retrieved. Data from 15 studies were pooled and analyzed. Prevalence of T(1) was reported in all and of T(a) in 8. Persistence rate prevalence at repeated TURB was 0.39 (95% confidence interval [CI]=0.26 to 0.54) for T(a) and 0.47 (95% CI=0.41 to 0.53) for T(1). Persistence was 19.4% to 56% and 15.2% to 55%, and upstaging occurred in 0% to 14.3% of T(a) and 0% to 24.4% of T(1) at repeated TURB, respectively. CONCLUSION: High percentages of persistence and upstaging confirm a repeated TURB is needed in patients with high-risk nonmuscle-invasive bladder cancer. Further investigation is encouraged taking risk stratification into consideration to evaluate the role of repeated TURB in low- and mid- risk diseases.
Authors: Rodolfo Hurle; Paolo Casale; Massimo Lazzeri; Marco Paciotti; Alberto Saita; Piergiuseppe Colombo; Emanuela Morenghi; David Oswald; Daniela Colleselli; Michael Mitterberger; Thomas Kunit; Martina Hager; Thomas R W Herrmann; Lukas Lusuardi Journal: World J Urol Date: 2019-05-21 Impact factor: 4.226
Authors: V Hechler; M Rink; D Beyersdorff; M Beer; A J Beer; V Panebianco; M Pecoraro; C Bolenz; G Salomon Journal: Urologe A Date: 2019-12 Impact factor: 0.639
Authors: François Audenet; Caitlyn Retinger; Christine Chien; Nicole E Benfante; Bernard H Bochner; S Machele Donat; Harry W Herr; Guido Dalbagni Journal: Urol Oncol Date: 2017-07-06 Impact factor: 3.498
Authors: Matteo Ferro; Giuseppe Di Lorenzo; Carlo Buonerba; Giuseppe Lucarelli; Giorgio Ivan Russo; Francesco Cantiello; Abdal Rahman Abu Farhan; Savino Di Stasi; Gennaro Musi; Rodolfo Hurle; Serretta Vincenzo; Gian Maria Busetto; Ettore De Berardinis; Sisto Perdonà; Marco Borghesi; Riccardo Schiavina; Gilberto L Almeida; Pierluigi Bove; Estevao Lima; Giovanni Grimaldi; Deliu Victor Matei; Francesco Alessandro Mistretta; Nicolae Crisan; Daniela Terracciano; Verze Paolo; Michele Battaglia; Giorgio Guazzoni; Riccardo Autorino; Giuseppe Morgia; Rocco Damiano; Matteo Muto; Roberto La Rocca; Vincenzo Mirone; Ottavio de Cobelli; Mihai Dorin Vartolomei Journal: J Cancer Date: 2018-10-20 Impact factor: 4.207