Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Division of Urology, Harasanshin Hospital, Fukuoka, Japan.
Anticancer Res. 2019 Aug;39(8):4325-4328. doi: 10.21873/anticanres.13598.
BACKGROUND/AIM: The significance of second transurethral resection (TUR), and identification of predictive factors for residual cancer remain unrevealed. This study aimed to find residual cancer and up-staging rates, as well as predictive factors for residual cancer, in patients who undergo second TUR for non-muscle-invasive bladder cancer (NMIBC).
Patients who underwent second TURs for NMIBC between 2015 and 2017, were included in the study and their clinicopathological characteristics were analyzed for predictors of residual cancer.
Among 143 Japanese patients whose tumors were initially diagnosed as high-risk NMIBC, residual cancers detected at second TURs were, Tis: n=22 (15.4%), Ta: n=15 (10.5%) and T1: n=29 (20.3%). No patients showed up-staging from NMIBC to MIBC. The presence of carcinoma-in situ at initial TUR was an independent risk factor for any residual cancer (Tis, Ta and T1), non-flat residual cancer (Ta and T1), and flat residual cancer (Tis).
The presence of carcinoma-in situ is suggested to be an independent predictor of residual cancer. This may help guide decisions to perform second TUR.
背景/目的：二次经尿道膀胱肿瘤切除术（TUR）的意义以及残留肿瘤的预测因素仍未阐明。本研究旨在发现非肌肉浸润性膀胱癌（NMIBC）患者行二次 TUR 后的残留癌和升级率，以及残留癌的预测因素。
本研究纳入了 2015 年至 2017 年间行二次 TUR 的 NMIBC 患者，并对其临床病理特征进行分析，以寻找预测残留癌的因素。
在 143 例最初诊断为高危 NMIBC 的日本患者中，二次 TUR 发现的残留癌Tis：n=22（15.4%），Ta：n=15（10.5%）和 T1：n=29（20.3%）。无患者从 NMIBC 升级为 MIBC。初始 TUR 时存在原位癌是任何残留癌（Tis、Ta 和 T1）、非平坦残留癌（Ta 和 T1）和平坦残留癌（Tis）的独立危险因素。
原位癌的存在提示为残留癌的独立预测因素。这可能有助于指导行二次 TUR 的决策。
