The probability of residual tumor detection in the second transurethral resection of PT1 urothelial bladder cancer according to the risk factors

Abstract

Objective: To analyze the predictive factors for residual tumors in the second resection after the initial transurethral resection of bladder tumor (TUR-BT) in patients with pT1 tumors and to develop a simple method to predict the probability of residual tumor detection.Material and methods: Patients with pT1 bladder cancer who underwent a second resection within 2 to 6 weeks after the initial transurethral resection of bladder tumor were included in our retrospective study. The patients' demographics and the tumor characteristics of the initial and second resections were recorded.Results: A total of 144 patients were included in our analysis with a 53-month follow-up. In the univariate logistic regression analysis, tumor grade, concomitant carcinoma in situ, macros-copic appearance of the tumor (solid vs papillary), and presence of a variant histology, were significant risk factors for residual tumor. In the multivariate analysis, tumor grade was the only independent predictor of residual tumor at second transurethral resection (OR: 5.62, 95% CI: 1.228-25.708, p = 0.026). According to our findings, the patients with the highest risk have a 90.9% residual tumor detection probability at the second resection, and the patients with the lowest risk have 25.4%Conclusions: Tumor grade, macroscopic appearance of the tumor (solid vs papillary), and conco-mitant carcinoma in situ, were important predictors of residual tumors at second resection of primary pT1 non-muscle invasive bladder cancer patients. We were able to calculate the pro-bability of residual tumor which helped us determine risk adapted strategies according to these probabilities.(c) 2022 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.