Routine Second Transurethral Resection of Bladder Tumor in T1 and High Grade Urothelial Carcinoma with Muscle Present In Biopsy – Is It Necessary in All Cases?
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 9
Abstract
Abstract:Second transurethral resection of bladder tumour (TURBT) after primary TURBT is recommended after incomplete initial TURBT, when detrusor is not present in specimen. Routine restage – TURBT from the base of revious tumour bed is indicated in all T1 or high grade tumours. We assessed incidence of residual tumour, upgradation of tumour and the need of second transurethral resection (TUR) and who can be benefited from second procedure.All the patients with pathologically proven T1 or high grade urinary bladder urothelial carcinoma (UC) diagnosed from August 2013 to July 2017 were included in this study. Repeat TUR was performed in all patients within four weeks. Patients with visible residual tumour or specimen with no detrusor muscle as per histo-pathological examination (HPE) were excluded from study. Specimen from second resection was examined for any residual tumour, stage and grade of residual tumour.Total 75 patients underwent second transurethral resection from August 2013 to July 2017. Only 8 (10.66%) patient had residual tumour in repeat resection. Only 3 (4%) patients had stage up gradation. Rates of residual tumour and upgradation of stage were less than previous study. In the subset of patients with single papillary or single sessile <3cm tumour chance of detection of residual tumour and up staging of tumour is very less.Second TURBT is standard care for all high grade or pT1 urothelial carcinoma. There is a question about additional benefit of second TUR in a small subset of patients where there is nonvisible tumour after primary resection and detrusor muscle is present in the specimen with single, < 3 cm initial tumor. Keywords:Second transurethral resection, Urothelial cell carcinoma of urinary bladder, High grade, T1 stage
Authors and Affiliations
Krishnendu Maiti, Atanu Jana, . Moumita Maiti
Keywords
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