[The criteria of patient selection for repeat transurethral resection of non-muscle invasive bladder cancer].

AIM

To evaluate in a prospective study the results of transurethral resection (TUR) for non-muscle invasive bladder cancer (NMIBC) and analyze the prognostic factors for the detection of residual tumor to develop indications for this intervention.

MATERIALS AND METHODS

The study included 111 patients with primary or recurrent NMIBC and intermediate or poor prognosis after visually radical TUR of the bladder. All patients underwent repeat TUR, which included a thorough cystoscopy, biopsy or TUR of all suspicious areas of the bladder, a deep biopsy of the area of the previous resection including the muscular layer. All prognostic tumor characteristics for assessing risk factors were available in 81 patients.

RESULTS

In total, repeat TUR resulted in the detection of 29/111 (26.1%) malignant tumors, while muscle-invasive cancer was diagnosed in 4/29 cases (3.6% of all included patients). The analysis of the relationship of residual tumor detection with various factors showed that the results of repeat TUR correlated with cystoscopic data at the repeat intervention and the degree of the tumor differentiation. Stratification of data depending on these factors revealed that in the absence of a visible tumor and G1, residual tumor was detected in 3.5% of cases, compared with 28.1% for the negative cystoscopy and G2-G3, and 52.6% for the positive cystoscopy regardless of G.

CONCLUSIONS

Cystoscopy may be applied for selecting NMIBC patients with G1 differentiation for repeat TUR. In the absence of cystoscopic confirmation of tumor, the repeat TUR can be avoided.