Background: Transurethral resection of supercial bladder tumours is well known to be gold standard management. It is
evident from the literature that initial TURBT is not enough for accurate pathological staging in non-muscle invasive
bladder cancer.
Aim: Our study is aimed at role of restaging TURBT in detection of residual disease for pathological upstaging in these high-risk patients to plan
appropriate treatment.
Methods: This is a prospective study of 32 patients with initially diagnosed Ta/T1 high-grade bladder cancer who had restaging TURBT in a
study by Department of urology, NIMS, Hyderabad between January 2016 and December 2018 were included. Low-grade tumors, carcinoma in
situ and muscle invasive bladder tumors were excluded. Data elements collected on patient demographics, presence of residual disease, disease
progression and recurrence in the follow-up period. The data was statistically analyzed using descriptive statistics by SPSS version
17. P value <=0.05 is considered as statistically signicant.
Results: The mean age for patients included in the study was 60.5 years. In our study, we found that 15 out of 32 cases (47%) has been detected
with residual disease ensuring that single TURBT may not been efcient with complete removal of tumor. Six out of 32 cases (19%) had
upstaging and 5 out of 32 cases had concurrent carcinoma in situ leading to change in treatment. Therefore, 11 out of 32 cases (34%) has been
under staged by initial TURBT were adequately staged by restaging TURBT and subjected to radical cystoprostatectomy or chemo radiotherapy,
This mandates the need for restaging TURBT at 6-8 weeks interval for adequate staging and management. Upstaging on restaging TURBT was
seen in 19%. The progression-free survival rate at 16 months was 25 % in patients with residual tumour and 94% in cases without residual disease.
Conclusion: We conclude that restaging TURBT effectively detects residual disease, helping pathological upstaging and planning denitive
treatment in non-muscle invasive high-grade bladder tumour.
Role of second-look transurethral resection of bladder tumors
