Significance Of Repeated Transurethral Resection Of Bladder Tumor And Analysis Of Related Risk Factors

Objective The aim of this study is to compare the recurrence and progression rate of non-muscle invasive bladder cancer(NMIBC)undergoing transurethral resection of bladder tumor(TURBT)and repeated transurethral resection of bladder tumor(Re-TURBT),to investigate the risk factors associated with the recurrence and progression of NMIBC,and the impact of different timing of Re-TURBT on the prognosis of patients.Methods A total of 95 consecutive NMIBC patients with surgery during July 2015 and July 2017 in the First Affiliated Hospital of Anhui Medical University were enrolled and divided into TURBT group(n=55)and Re-TURBT group(n=40)according to preoperative screening criteria.The follow-up deadline was November 1,2017.The survival curve was drawn by Kaplan-Meier method,and the average survival time and survival rate were calculated.Logistic rank test was used in univariate analysis.Cox regression model was used in Multivariate analysis.Results(1)The recurrence rate and progression rate of Re-TURBT were lower than those of TURBT group.The average recurrence-free survival time of TURBT group and Re-TURBT group were 16.94 months vs.21.86 months(P <0.05),and recurrence-free survival rate(RFS)at 12 months was 65.8% VS 86.9%(P <0.05).The progression-free survival rate(PFS)at 18 months was 73.7% VS 86.3%(P <0.05).The mean progression-free survival time was 20.56 months vs 23.23 months(P <0.05).(2)The results of univariate analysis indicated that the group,tumor size,clinical stage and pathological grade were influence factors of tumor recurrence and progression.Multivariate analysis showed that the group,tumor size and pathological grade were the independent risk factors of tumor recurrence;group,tumor size,clinical stage of tumor were the independent risk factors of tumor progression.(3)The patients in Re-TURBT group were divided into two groups according to the length of the interval between TURBT and Re-TURBT: ≤6 weeks and >6 weeks.The mean recurrence-free survival time was 24.00 months vs 16.93 months(P <0.05),with significant difference between two groups.The progression-free survival time between the two groups were 24.00 months vs 21.00 months with no statistical significance(P> 0.05).Conclusion Re-TURBT can reduce the risk of recurrence and progression of bladder cancer.Re-TURBT should be used to reduce the tumor recurrence rate and progression rate in patients with large tumor size(≥30mm),high clinical stage(≥T1 stage)and high pathological grade.In patients undergoing Re-TURBT,the second surgery should be performed within 6 weeks after the first surgery.