Rasha Gendy1, Warick Delprado2, Phillip Brenner3, Andrew Brooks4, Graham Coombes5, Paul Cozzi1, Peter Nash1, Manish I Patel4. 1. Department of Urology, St George Hospital, Sydney, NSW, Australia. 2. Douglas Hanley Moir Pathology Laboratory, Sydney, NSW, Australia. 3. Department of Urology, St Vincent's Hospital, Sydney, NSW, Australia. 4. Department of Urology, Westmead Hospital and Discipline of Surgery, University of Sydney, Sydney, NSW, Australia. 5. Department of Urology, Concord Hospital, Sydney, NSW, Australia.
Abstract
OBJECTIVES: To evaluate the depth of transurethral resections of bladder tumour (TURBT), residual cancer rates and up-staging rates in a contemporary Australian series. MATERIALS AND METHODS: Specimen reports from a single, major reporting pathology centre, servicing a group of urological oncologists in Sydney were obtained for TURBTs performed between October 2008 and February 2013. We examined the depth of TURBT, rates of repeat-TURBT (re-TUR) and residual cancer rates at the 3-6 month check cystoscopy. RESULTS: One thousand and two hundred and nine transurethral resection specimens retrieved during this period were analysed. There were 162 (13.4%) T1 specimens and 631 (52.2%) Ta specimens, 218 (34.5%) of which were high grade. Muscularis propria was present in 506 (41.9%) specimens in total and in 151 (39.7%) of 380 high-risk specimens (high grade Ta, T1). Of the 380 high-risk non-muscle-invasive tumours, 85 (22.4%) proceeded to re-TUR. Of the 48 T1 specimens and 37 Ta high grade specimens that proceeded to re-TUR, 7 (14.6%) and 1 (2.7%) respectively were upstaged to muscle-invasive disease. Rates of residual disease/early recurrence at 3-6 months was significantly better for those with re-TUR compared to those without 56.8% vs 82.5% (P < 0.001) for Ta high grade and 39.6% vs 84% (P = 0.028) for T1 tumours respectively. CONCLUSION: Re-TUR rates in high-risk non-muscle-invasive bladder cancer are low. However in a contemporary series, the upstaging rates are low, but residual cancer rates high, supporting the need for re-TUR in this population.
OBJECTIVES: To evaluate the depth of transurethral resections of bladder tumour (TURBT), residual cancer rates and up-staging rates in a contemporary Australian series. MATERIALS AND METHODS: Specimen reports from a single, major reporting pathology centre, servicing a group of urological oncologists in Sydney were obtained for TURBTs performed between October 2008 and February 2013. We examined the depth of TURBT, rates of repeat-TURBT (re-TUR) and residual cancer rates at the 3-6 month check cystoscopy. RESULTS: One thousand and two hundred and nine transurethral resection specimens retrieved during this period were analysed. There were 162 (13.4%) T1 specimens and 631 (52.2%) Ta specimens, 218 (34.5%) of which were high grade. Muscularis propria was present in 506 (41.9%) specimens in total and in 151 (39.7%) of 380 high-risk specimens (high grade Ta, T1). Of the 380 high-risk non-muscle-invasive tumours, 85 (22.4%) proceeded to re-TUR. Of the 48 T1 specimens and 37 Ta high grade specimens that proceeded to re-TUR, 7 (14.6%) and 1 (2.7%) respectively were upstaged to muscle-invasive disease. Rates of residual disease/early recurrence at 3-6 months was significantly better for those with re-TUR compared to those without 56.8% vs 82.5% (P < 0.001) for Ta high grade and 39.6% vs 84% (P = 0.028) for T1 tumours respectively. CONCLUSION: Re-TUR rates in high-risk non-muscle-invasive bladder cancer are low. However in a contemporary series, the upstaging rates are low, but residual cancer rates high, supporting the need for re-TUR in this population.
Authors: Giovanni Barchetti; Giuseppe Simone; Isabella Ceravolo; Vincenzo Salvo; Riccardo Campa; Francesco Del Giudice; Ettore De Berardinis; Dorelsa Buccilli; Carlo Catalano; Michele Gallucci; James W F Catto; Valeria Panebianco Journal: Eur Radiol Date: 2019-03-18 Impact factor: 5.315
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: Marco Paciotti; Paolo Casale; Piergiuseppe Colombo; Vittorio Fasulo; Alberto Saita; Giovanni Lughezzani; Roberto Contieri; Nicolò Maria Buffi; Massimo Lazzeri; Giorgio Guazzoni; Rodolfo Hurle Journal: Eur Urol Open Sci Date: 2021-02-24