Clinical Analysis Of The Second Transurethral Resection In The Management Of Non-muscle Invasive Bladder Cancer

Objectives: To investigate the significance and necessity of second transurethral resection of non-muscle invasive bladder cancer.Methods: We retrospectively reviewed the records of clinical features about 123 patients with non-muscle invasive bladder cancer underwent transurethral resection of bladder cancer between January 1,2013 and December 31,2015 in Tianjin Medical University Cancer Institute and Hospital.According to whether to underwent the restaging transurethral resection,all the patients were stratified into two groups.All of them received intravesical chemotherapy and cystoscopy at followup.We record the patients who have residual tumor and TNM stage were overlooked through review the clinlcal data.We followed up all the patients via making a call or the records of reexamination to know the conditions of them and make a comparison between the two groups.Mean fllow-up time was 26 months(range 6 mo to 48 mos).All statistical analyses performed using SPSS 17.0.Survival curves were constructed by the Kaplan-Meier method,and univariate analysis were done with the log rank test.Multivariate analysis were performed using Cox proportional hazard model and the associated 95% confidence interval was calculated.All reported P values are 2-tailed,and statistical significance was set at P<0.05.Resluts: 1.Basic clinical features of the two groups: of all the 123 cases,69 underwent single transurethral resection,and 54 underwent restaging transurethral resection.In the re TUR group,46 were male and 8 were female.Average age was 58 years old,range from 20-76 years old.27 cases were stage Ta and T1 respectively.24 cases were single tumors and 30 cases were multiple tumors.In regular follow-up group,58 were male and 11 were female.Average age was 59 years old,range from27-82 years old.42 cases were stage Ta and 27 were stage T1.35 cases were single tumors and 34 cases were multiple tumors.The basic clinical festures of the two group including age,gender,number and side of tumor,or pathology stage and grade were no significant difference(P>0.05).2.With the pathological result of the re TUR,we found out 4 cases(7.4%)had residual tumors after initial TURBT.Of the 4 cases,2 residual tumors were found only in the base of tumor.1 patient first diagnosed with grade 2 was actually in grade 1.During the follow-up,the recurrence rate of patients who underwent re TUR was 11.1%(6/54),while 15.9% of patients in regular follow-up group suffered recurrence.There was no significant difference in recurrence rate between two groups(P>0.05).3.Univariate analysis revealed that tumor stage,grade,numbers,prior recurrence rate and EORTC risk stratification correlated with tumor recurrence.In multivariable analysis,only tumor numbers was an independent risk factor for tumor recurrence.Whether receiving re TUR cannot affect the rate of tumor recurrence.Conclusions:The efficacy of reTUR remains to be further studied,improving the quality of first resection and reducing residual tumors should avoid unnecessary restaging transurethral resection.