DOI: 10.36347/sjams.2019.v07i07.030

Pages: 2425-2431

Objective: To study the importance of Restaging transurethral resection of bladder tumor (Re-TURBT) in detecting additional disease in patients with non-muscle invasive bladder tumors. Methods: A prospective study was conducted between January 2017 and March 2019 in patients diagnosed with Ta/T1 high-grade bladder cancer. Patients with non-muscle invasive high-grade bladder tumor were included. TUR of visible tumors was conducted to evaluate the bladder cancer invasion into muscular layer. Patients underwent Re-TURBT process within 6-8 weeks followed by first operation. Further, Bacillus-Calmette-Guerin (BCG) vaccination was given. Results: Among 32 patients, 19 had solitary tumors or tumors ≤3 cm in diameter and 13 had multifocal tumors or tumors >3 cm in diameter. Post cystoscopy 15 patients had visible papillary tumors, five patients had erythematous lesions/ mucosal changes suspicious of malignant lesion without visible tumors, and 12 patients had no macroscopic abnormalities. On Re-TURBT, 20 patients were detected with residual tumors and 12 with non-residual tumors. Post BCG vaccination, ten patients had recurrence with higher number of patients in residual tumor group (n=7, 70%). Four patients progressed from T1 high-grade to pT2 disease and two had multiple metastases within 24 months after BCG injection post Re-TURBT. The two-year progression-free survival rate was slightly lower for the residual tumor group than non-residual tumor group (80% vs. 100%). Conclusion: Transurethral resection is a standard treatment approach to manage non-muscle invasive bladder cancer (NMIBC) with essential repeat -TUR to attain adequate tumor resection and to identify patients requiring prompt radical cystectomy.