Sophie Regnier1, Gianluigi Califano1,2, Vincent Elalouf3, Simone Albisinni4, Atiqullah Aziz5, Ettore Di Trapani6, Wojciech Krajewski7, Andrea Mari8, David D'Andrea9, Benjamin Pradère9, Francesco Soria10, Luca Afferi11, Marco Moschini12, Idir Ouzaid1, Evanguelos Xylinas1. 1. Urology Department, Bichat-Claude Bernard Hospital, Assistance-Publique Hôpitaux de Paris, Paris University, Paris, France. 2. Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy. 3. Urology Department, Hôpital Privé Claude Galien, Ramsay Santé, Quincy-Sous-Sénart, France. 4. Urology Department, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium. 5. Urology Department, München Klinik Bogenhausen, Munich, Germany. 6. Urology Department, European Institute of Oncology, Milan, Italy. 7. Department of Urology and Oncological Urology, Wrocław Medical University, Wrocław, Poland. 8. Urology Department, Careggi Hospital, University of Florence, Florence, Italy. 9. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 10. Urology Division, Department of Surgical Sciences, University of Studies of Torino, Turin, Italy. 11. Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland. 12. Department of Medical Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.
Abstract
PURPOSE OF REVIEW: The role of a re-transurethral resection (TUR) is clearly demonstrated in T1 high-grade nonmuscle invasive bladder cancer. However, its role remains controversial for Ta high-risk tumors and the recent European guidelines stated that the second look procedure could be avoided for these patients despite harboring a high-risk of both disease recurrence and progression. We aimed to evaluate the added benefit on staging, response to bacillus Calmette-Guérin and oncological outcomes of re-TUR in patients with Ta high-grade nonmuscle invasive bladder cancer. RECENT FINDINGS: Overall, we identified 15 studies, including 3912 patients from which 743 harbored Ta high-grade disease. Delay between first and second TUR was ranging from 2 to 12 weeks (median 5.6 weeks). The rate of residual disease was 52.8% (range 17-67%). The rate of overall upstaging to T1 and muscle-invasive disease were 10.9 and 4.7%, respectively. Although there was a trend toward improvement of recurrence-free survival outcomes, no definitive conclusions can be drawn due to the retrospective design of the studies included. SUMMARY: Residual tumor is common after initial TUR for Ta high-grade. Re-TUR is useful in reducing the rates of residual disease, may improve staging, response to bacillus Calmette-Guérin and oncological outcomes.
PURPOSE OF REVIEW: The role of a re-transurethral resection (TUR) is clearly demonstrated in T1 high-grade nonmuscle invasive bladder cancer. However, its role remains controversial for Ta high-risk tumors and the recent European guidelines stated that the second look procedure could be avoided for these patients despite harboring a high-risk of both disease recurrence and progression. We aimed to evaluate the added benefit on staging, response to bacillus Calmette-Guérin and oncological outcomes of re-TUR in patients with Ta high-grade nonmuscle invasive bladder cancer. RECENT FINDINGS: Overall, we identified 15 studies, including 3912 patients from which 743 harbored Ta high-grade disease. Delay between first and second TUR was ranging from 2 to 12 weeks (median 5.6 weeks). The rate of residual disease was 52.8% (range 17-67%). The rate of overall upstaging to T1 and muscle-invasive disease were 10.9 and 4.7%, respectively. Although there was a trend toward improvement of recurrence-free survival outcomes, no definitive conclusions can be drawn due to the retrospective design of the studies included. SUMMARY: Residual tumor is common after initial TUR for Ta high-grade. Re-TUR is useful in reducing the rates of residual disease, may improve staging, response to bacillus Calmette-Guérin and oncological outcomes.
Authors: Nicola Longo; Giuseppe Celentano; Luigi Napolitano; Roberto La Rocca; Marco Capece; Gianluigi Califano; Claudia Collà Ruvolo; Francesco Mangiapia; Ferdinando Fusco; Simone Morra; Carmine Turco; Francesco Di Bello; Giovanni Maria Fusco; Luigi Cirillo; Crescenzo Cacciapuoti; Lorenzo Spirito; Armando Calogero; Antonello Sica; Caterina Sagnelli; Massimiliano Creta Journal: Cancers (Basel) Date: 2022-05-11 Impact factor: 6.575