Jinchao Chen, Teng Li, Xianghui Ning, Shuanghe Peng, Jiangyi Wang, Nienie Qi, Kan Gong
Objective: We investigated the clinical markers for the prediction of residual tumors at repeat transurethral resection (re-TUR) for patients with T1 bladder cancer and evaluated the effect of the residual tumor on the prognosis of the disease.
Methods: We reviewed the clinical data of the patients undergoing transurethral resection of bladder tumor (TURBT) from 2008 to 2015 in our department. Of these, 72 patients with the T1 tumors received re-TUR 2-4 weeks after the initial TUR. A total of 65 patients were followed up, and we recorded the events of tumor recurrence, tumor progression, radical cystectomy and cancer specific death.
Results: On re-TUR, 33.3% (24/72) of the patients had residual tumours. A statistically significant difference was noted between tumour size and possibility of residual tumors at re-TUR. Residual tumors tended to be detected in patients with larger tumors (diameter ≥4 cm) and might be unrelated to tumor grade or number. The mean follow-up period was 24.0 months. Tumour recurrence occurred in 43.1% of the patients (28/65), with 45.0% (9/20) in the patients with residual tumours and 40.0% (18/45) in patients with not (P=0.71). The overall median recurrence-free survival (RFS) was 21.0 month, and there was no significant difference between patients with residual tumours and patients with no residual tumours in RFS (P=0.11). A total of 7.7% (5/65) of the patients suffered recurrence within 3 months, and the rate of tumor progression, the rate of radical cystectomy and cancer specific mortality was 6.2% (4/65), 7.7% (5/65) and 3.1% (2/65), respectively. We noticed that the presence of residual tumours at re-TUR was related to the rate of tumor recurrence within 3 months (P<0.001), but was not related to overall recurrence rate, progression rate, rate of radical cystectomy and cancer specific mortality.
Conclusions: For patients with T1 bladder cancer, larger tumors could be a predictive marker for residual tumors on re-TUR. The presence of residual tumors is associated with early recurrence, but has no relationship with prognosis of the disease.
