Which Non-Muscle Invasive Bladder Cancer Is More Valuable For Re-transurethral resection?

INTRODUCTION: We evaluated the re-transurethral resection (re-TUR) pathologies and the comparison of pathology results between transurethral resection of bladder (TUR-B) and re-TUR for non-muscle invasive bladder cancer (NMIBC). Additionally we assessed the factors affecting the re-TUR pathology and tried to define the more valuable re-TUR patient groups. We also aimed to evaluate the effect of re-TUR on recurrence and progression. METHODS: We performed re-TUR to intermediate/high risk NMIBC patients, 4-6 weeks after the index TUR-B. Both TUR-B and re-TUR pathology characteristics, including tumor stage, grade, size, number, lymphovascular invasion (LVI), carcinoma in situ (CIS), variant pathology and intermediate/high risk status were analysed. The recurrence and progression rates were also evaluated according to re-TUR. RESULTS: A total of 78 patients with NMIBC were included to the study. The index TUR-B pathologies were Ta-Low: 6 (7,7%), Ta-High: 5 (6,4%), T1-Low: 14 (17,9%), T1-High: 53 (67,9%). Re-TUR positivity was n: 40 (51 %), and upstaging/upgrading at re-TUR was n: 11 (14 %) in all groups. Re-TUR positivity was significantly higher in high-risk compared to intermediate-risk NMIBC (p:0,026). Re-TUR positivity was higher in patients with hydronephrosis, CIS, LVI, differentiation, size (>3 cm) and multiple tumour presence (p<0,05). There was no significant relationship between recurrence / progression and re-TUR (p>0,05). CONCLUSION: Residual tumour was common after the index TUR-B and upstaging after re-TUR was very important. Re-TUR is critically important in high-risk NMIBC, presence of hydronephrosis, CIS, LVI, variant pathology, size (>3 cm) and multiple number of tumor.