medigraphic.com
Organo Oficial de la Sociedad Mexicana de Urología

2017, Number 3

<< Back Next >>

Rev Mex Urol 2017; 77 (3)

Second-look histopathologic results in non-muscle-invasive urothelial carcinoma of the bladder: Is repeat resection necessary?

Chamlati-Cuello JM, Garza-Gangemi AM, Gonzaga-Carlos N, Iturriaga-Goyon E, Castillejos-Molina RA

Language: Spanish
References: 22
Page: 183-190
PDF size: 194.15 Kb.


ABSTRACT

Background: There is a high rate of residual tumor reported in repeat resections performed in cases of bladder cancer. The real usefulness and effect of this practice are currently in doubt.
Objective: To describe the results of a second-look resection in patients with non-muscle invasive bladder cancer in relation to the rates of re-staging and residual tumor.
Materials and methods: A retrospective, observational study was conducted on patients that underwent transurethral resection of the bladder due to non-muscle-invasive urothelial carcinoma of the bladder at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, within the time frame of 1984 to 2017. Second-look residual tumor and re-staging rates were analyzed.
Results: Out of 556 medical records, the final analysis included 117 cases, of which only 43 patients (37.75%) underwent a second-look resection. Primary tumor diameter was larger in the study group (3 ± 2 vs 2.3 ± 1.5 cm, p=0.03). Residual tumor was found in 17 cases (39.5%), one of which (2.3%) presented with muscle-invasive disease. In the patients with residual tumor, there was an increase in stage in 2 cases (11.76%), and 3 cases (17.64%) had a change from low grade to high grade tumor.
Conclusions: There is a high percentage of residual tumor in patients diagnosed with non-muscle-invasive urothelial carcinoma of the bladder that underwent initial transurethral resection of the bladder, as well as a considerable re-staging rate.


REFERENCES

  1. Ferlay J, Soerjomataram I, Ervik M, et al. Estimated cancer incidence, mortality and prevalence worldwide in 2012. GLOBOCAN 2012 v1.0: http://globocan.iarc.fr/Pages/ fact_sheets_population.aspx. Consultado el 23 de Abril de 2017.

  2. Burger M, Catto JWF, Dalbagni G, et al. Epidemiology and Risk Factors of Urothelial Bladder Cancer. Eur Urol. 2013;63(2):234-241.

  3. Gaya JM, Palou J, Cosentino M, et al. A second transurethral resection could be not necessary in all high grade non-muscle-invasive bladder tumors. Actas Urol Esp. 2013;36(9): 539-44.

  4. Jakse G, Algaba F, Malmström PU, et al. A Second-Look TUR in T1 Transitional Cell Carcinoma: Why? Eur Urol. 2004;45(5):539-546.

  5. Turner W. T1G3 BladderTumours : The Case for Conservative Treatment. Eur Urol. 2004;45:401-405.

  6. Baltaci S, Bozlu M, Yildirim A, et al. Significance of the interval between first and second transurethral resection on recurrence and progression rates in patients with high-risk non-muscle-invasive bladder cancer treated with maintenance intravesical Bacillus Calmette-Guerin. BJU Int. 2015;116(5):721-726.

  7. Babjuk M, Böhle A, Burger M, et al. EAU Guidelines on Bladder. Cancer. 2016:1-45.

  8. Divrik RT, Ahin AF, Yildirim Ü, et al. Impact of routine second transurethral resection on the long-term outcome of patients with newly diagnosed pT1 urothelial carcinoma with respect to recurrence, progression rate, and diseasespecific survival: A prospective randomised clinical trial. Eur Urol. 2010;58(2):185-190.

  9. Angulo JC, Palou J, García-tello A, et al. Second transurethral resection and prognosis of high-grade non-muscle invasive bladder cancer in patients not receiving Bacillus Calmette-Guérin . Actas Urol Esp. 2014;38(3):164-171.

  10. Van der Heijden AG, Witjes JA. Recurrence, Progression, and Follow-Up in Non-Muscle-Invasive Bladder Cancer. Eur Urol Suppl. 2009;8(7):556-562.

  11. Urdaneta G, Solsona E, Palou J. Intravesical Chemotherapy and BCG for the Treatment of Bladder Cancer : Evidence and Opinion. Eur Urol. 2008;7:542-547.

  12. Herr HW, Donat SM. Quality control in transurethral resection of bladder tumours. BJUI. 2008:1242-1246.

  13. Fritsche H, Burger M, Svatek RS, et al. Characteristics and outcomes of patients with clinical T1 grade 3 urothelial carcinoma treated with radical cystectomy: results from an international cohort. Eur Urol. 2010;57(2):300-309.

  14. El-Barky E, Sebaey A, Eltabey M, et al. The importance of second-look transurethral resection for superficial bladder cancer. J Clin Urol. 2015;8(5).

  15. Shim JS, Choi H, Noh T Il, et al. The clinical significance of a second transurethral resection for T1 high-grade bladder cancer : Results of a prospective study. Korean J Urol. 2015:429-434.

  16. Herr HW. Role of re-resection in non-muscle-invasive bladder cancer. Sci World J. 2011:283-288.

  17. Hashine K, Ide T, Nakashima T, et al. Results of second transurethral resection for high-grade T1 bladder cancer. Urol Ann. 2016:10-15.

  18. Giunchi F, Panzacchi R, Capizzi E, et al. Role of inter-observer variability and quantification of muscularis propria in the pathological staging of bladder cancer. Clin Genitourin Cancer. 2016;14(4):307-312.

  19. Tosoni I, Wagner U, Sauter G, et al. Clinical significance of interobserver differences in the staging and grading of superficial bladder cancer. BJU Int. 2000;85(1):48-53.

  20. Ali MH, Ismail IY, Eltobgy A, et al. Evaluation of secondlook transurethral resection in restaging of patients with nonmuscle-invasive bladder cancer. J Endourol. 2010;24(12):2047-2050.

  21. Husillos-Alonso A, Rodríguez- Fernández E, Heranz Amo et al. MINERVA. Minerva Urol Nefrol. 2014;66(4):233-240.

  22. Divrik RT, Yildirim Ü, Zorlu F, et al. The effect of repeat transurethral resection on recurrence and progression rates in patients with t1 tumors of the bladder who received intravesical mitomycin: a prospective, randomized clinical trial. J Urol. 2006;175(5):1641-1644.




2020     |     www.medigraphic.com