The Linical Efficacy Of Repeat Transurethral Resection（RE-TUR） For Stage T₁ High-grade Bladder Cancer

Objective:To investigate the efficacy of repeated transurethral resection（Re-TUR）for stage T₁ high-grade bladder cancer.Methods:In the Department of Urology of the First Affiliated Hospital of Nanchang University from January 2013 to January 2017,a total of 109 patients with stage T₁high-grade bladder cancer were treated by the single（first）transurethral resection of bladder tumor（TURBT）.There were 66 patients didn’t treated by Re-TURBT（control group）,and 43 patients were treated by Re-TURBT（experience group）.The experience group underwent Re-TURBT within 2-6 weeks after first TURBT.Intravesical perfusion chemotherapy for two groups of patients after operation.To observe the changes of postoperative pathological staging after Re-TURBT,and two groups of patients were followed up according to the 2014 edition of‘the guidelines for diagnosis and treatment of Department of Urology in China’.Cystoscopy was performed every 3 months within 2 years after operation,and cystoscopy was performed every half a year after 2 years.The recurrence rate and progression rate of two groups and residual cancer after Re-TURBT were analyzed to evaluate the efficacy of Re-TURBT on stage Tl high-grade bladder cancer.Result:There was no significant difference in age,sex,follow-up time,tumor size,number of tumors,postoperative perfusion drugs between the two groups（P>0.05）.There were 20.9%patients（9/43）had residual cancer after Re-TURBT.Three of them（7.0%）had elevated tumor histological stage T2,and All of then had underwent radical surgery for bladder cancer.Follow up,the total relapse cases in the observation group and the control group were 35%cases（14/40）and 60.6%cases（40/60）,respectively.There was a statistically significant difference between the two groups（P=0.011<0.05）.The recurrence rate in the six months were 12.5%（5/40）and 31.8%（21/40）.There was a statistically significant difference between the two groups（P=0.025<0.05）.The recurrent rates after half a year were22.5%（9/40）and28.8%（19/66）,the difference was not statistically significant（P=0.477>0.05）.The rates of progression muscular invasive bladder cancer in the observation group and the control group were 7.5%（3/40）and 15.2%（10/66）,and the difference was not statistically significant（p=0.362>0.05）.There were 7.5%cases（3/40）in the observation group and 15.2%cases（10/60）in the control group progressed to musculocutaneous invasive bladder cancer,and there was no significant difference（p=0.362>0.05）.In the observation group,two of then had underwent radical surgery for bladder cancer;in the control group,eight of then had underwent radical surgery for bladder cancer.Conclusion:Re-TURBT has important clinical significance for patients with stage T₁high-grade bladder cancer.Re-TURBT can not only detect the residual tumor after the first TURBT operation,then remove the tumor more thoroughly,further clarify the pathological stages of the tumor and guide the follow-up treatment,and also reduce the early recurrence rate of patients with stage Tl high-grade bladder cancer.