Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan.
Division of Uro-Oncology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan.
Int Urol Nephrol. 2019 Aug;51(8):1335-1342. doi: 10.1007/s11255-019-02172-8. Epub 2019 May 25.
In recent years, second-look transurethral resection of bladder tumors (TURBT) has been recommended for patients with stage T1 bladder cancer after the initial TURBT for restaging and deciding the subsequent treatment. However, we believe that second-look TURBT has therapeutic benefits, such as low incidence of recurrence and progression. Therefore, we compare the differences in long-term outcome between patients who did and did not accept second-look TURBT for stage T1 bladder cancer.
We assessed 504 patients diagnosed with urothelial carcinoma who underwent initial TURBT between January 2012 and December 2016 at a single medical center; of these patients, 177 were diagnosed with T1 bladder cancer during the initial TURBT, and we excluded no muscle from the specimen in the initial TURBT. The patients were categorized into groups 1 and 2 based on the acceptance of second-look TURBT, which was performed within 4-14 weeks after the initial TURBT. Group 1 underwent second-look TURBT, but group 2 did not. Both groups were followed-up for recurrence-free survival (RFS) and progression-free survival (PFS), and the risk factors for recurrence and progression were analyzed.
In total, 93 (52.5%) patients in group 1 underwent second-look TURBT, and 84 (47.5%) in group 2 did not. The 2-year RFS rates were 74.6% and 60.0% and the PFS rates were 91.2% and 87.5% in groups 1 and 2, respectively.
This study demonstrated higher recurrence-free and progression-free survival rates for patients who underwent second-look TURBT. This result emphasizes the importance of second-look TURBT in stage T1 bladder cancer not only for restaging but also for therapeutic benefit.
近年来，对于初次经尿道膀胱肿瘤电切术（TURBT）治疗的 T1 期膀胱癌患者，建议行二次 TURBT 以进行分期和决定后续治疗。然而，我们认为二次 TURBT 具有治疗益处，如复发和进展的发生率较低。因此，我们比较了接受和未接受二次 TURBT 的 T1 期膀胱癌患者的长期预后差异。
我们评估了 2012 年 1 月至 2016 年 12 月在一家医疗中心接受初次 TURBT 的 504 例尿路上皮癌患者；其中 177 例患者在初次 TURBT 时被诊断为 T1 膀胱癌，且初次 TURBT 时标本中未切除肌肉。根据是否接受初次 TURBT 后 4-14 周内进行的二次 TURBT，将患者分为 1 组和 2 组。1 组行二次 TURBT，2 组不行。两组均随访复发无进展生存（RFS）和无进展生存（PFS），并分析复发和进展的危险因素。
共有 93（52.5%）例 1 组患者行二次 TURBT，84（47.5%）例 2 组患者不行。1 组和 2 组的 2 年 RFS 率分别为 74.6%和 60.0%，PFS 率分别为 91.2%和 87.5%。
本研究表明，行二次 TURBT 的患者具有更高的无复发生存率和无进展生存率。这一结果强调了二次 TURBT 在 T1 期膀胱癌中的重要性，不仅用于分期，还具有治疗益处。
