Restaging transurethral resection in ta high-grade nonmuscle invasive bladder cancer: a systematic review. Issue 1 (January 2022)

• Record Type: Journal Article
• Authors: Regnier, Sophie; Califano, Gianluigi; Elalouf, Vincent; Albisinni, Simone; Aziz, Atiqullah; Di Trapani, Ettore; Krajewski, Wojciech; Mari, Andrea; D'Andrea, David; Pradère, Benjamin; Soria, Francesco; Afferi, Luca; Moschini, Marco; Ouzaid, Idir; Xylinas, Evanguelos
• Is Part Of: Current opinion in urology. Volume 32:Issue 1(2022)
• Page Start: 54
• Page End: 60
• Publication Date: 2022-01
• Subjects: bacillus Calmette–Guérin -- nonmuscle-invasive bladder cancer -- re-transurethral resection -- second look -- Ta high-grade; Urology -- Periodicals; Review Literature -- Bibliography; Review Literature -- Periodicals; Male Urogenital Diseases -- Bibliography; Male Urogenital Diseases -- Periodicals; Female Urogenital Diseases -- Bibliography; Female Urogenital Diseases -- Periodicals; Urologic Diseases -- Bibliography; Urologic Diseases -- Periodicals; Periodicals; 616.6005
• DOI: 10.1097/MOU.0000000000000949
• Languages: English
• ISSNs: 1473-6586

Abstract

Abstract : Supplemental Digital Content is available in the text Abstract : Purpose of review: The role of a re-transurethral resection (TUR) is clearly demonstrated in T1 high-grade nonmuscle invasive bladder cancer. However, its role remains controversial for Ta high-risk tumors and the recent European guidelines stated that the second look procedure could be avoided for these patients despite harboring a high-risk of both disease recurrence and progression. We aimed to evaluate the added benefit on staging, response to bacillus Calmette–Guérin and oncological outcomes of re-TUR in patients with Ta high-grade nonmuscle invasive bladder cancer. Recent findings: Overall, we identified 15 studies, including 3912 patients from which 743 harbored Ta high-grade disease. Delay between first and second TUR was ranging from 2 to 12 weeks (median 5.6 weeks). The rate of residual disease was 52.8% (range 17–67%). The rate of overall upstaging to T1 and muscle-invasive disease were 10.9 and 4.7%, respectively. Although there was a trend toward improvement of recurrence-free survival outcomes, no definitive conclusions can be drawn due to the retrospective design of the studies included. Summary: Residual tumor is common after initial TUR for Ta high-grade. Re-TUR is useful in reducing the rates of residual disease, may improve staging, response to bacillus Calmette–Guérin and oncological outcomes.