Value of repeat radical transurethral resection for selected patients with muscle-invasive bladder cancer.

BACKGROUND

This study was conducted to evaluate the efficacy and necessity of repeat transurethral resection (re-TUR) treatment for selected patients with muscle-invasive bladder cancer and to investigate the possibility of bladder sparing.

METHODS

The study included 61 selected patients with invasive bladder cancer who were treated by re-TUR and in whom biopsies of the muscle layer of the tumour bed were negative. Re-TUR was performed within 4-6 weeks of the initial resection. Pirarubicin instillation was scheduled for the bladder-preserving group. The prognosis was compared with that of patients in our previous research, which included 93 selected patients with invasive bladder cancer who were treated by radical TUR. In that research, we found that the overall survival and disease-specific survival rates were 59.1 and 65.2%, respectively. The clinical stage of tumour influenced the survival rates.

RESULTS

Of the 61 patients who underwent re-TUR, 31 never had disease relapse, 19 had disease recurrence and 11 had disease progression. The clinical stage of the tumour influenced the overall survival and disease-specific survival. The 5-year overall survival rate was 70% and disease-specific survival rate was 74%, respectively. Compared with the TUR group, both the overall survival and disease-specific survival rates of the re-TUR group both increased significantly (P < 0.05).

CONCLUSIONS

Re-TUR combined with pirarubicin instillation is a suitable bladder-preserving treatment for selected patients with muscle-invasive bladder cancer, based on good overall survival and disease-specific survival rates demonstrated in this research. The clinical stage of tumour has a major influence on the survival rates.