Brun A, Koutlidis N, Thibault T, Escoffier A, Bardet F, Cormier L
Service d'urologie et andrologie, centre hospitalier universitaire François-Mitterrand, Dijon, France; Service d'urologie, centre hospitalier William Morey, Chalon sur Saône, France.
Service d'urologie, centre hospitalier William Morey, Chalon sur Saône, France.
Prog Urol. 2023 Mar;33(3):125-134. doi: 10.1016/j.purol.2022.12.012. Epub 2023 Jan 4.
Restaging transurethral resection (re-TUR) of high grade T1 bladder cancer (HGT1-BC) is recommended but the impact in terms of recurrence-free survival (RFS) and progression-free survival (PFS) is discussed. The objective of this study was to evaluate our practice of re-TUR for these tumors and its impact on overall survival (OS), RFS and PFS.
A retrospective observational study was conducted between 2010 and 2020. The inclusion criteria was the presence of newly diagnosed HGT1-BC. Patients with incomplete resection, suspicion of infiltrating tumor, upper tract urothelial cancer, or metastatic disease were ineligible. Two groups were defined : Group 1 with re-TUR and Group 2 without re-TUR. RFS and PFS were evaluated.
A total of 78 patients were included, including 50 (64,1%) in group 1. There were no significant differences between the two groups. The mean time to re-TUR was 8 weeks and 60% residual tumor was found. Initial under-staging was found in 12% of cases. RFS and PFS were significantly better in Group 1 (P=0.0019; P=0,02). No significant were found between the groups in OS and specific survival (SS).
Performing a re-TUR for high grade T1 bladder tumors allows detection of residual tumor and decreases the risk of under-evaluation. It is associated with a significant improvement in RFS and PFS with no impact on OS and SS.
推荐对高级别T1期膀胱癌（HGT1-BC）进行再次经尿道膀胱肿瘤切除术（re-TUR），但对于其对无复发生存期（RFS）和无进展生存期（PFS）的影响仍存在争议。本研究的目的是评估我们对这些肿瘤进行re-TUR的实践及其对总生存期（OS）、RFS和PFS的影响。
2010年至2020年进行了一项回顾性观察研究。纳入标准为新诊断的HGT1-BC。切除不完全、怀疑浸润性肿瘤、上尿路尿路上皮癌或转移性疾病的患者不符合纳入标准。定义了两组：第1组进行re-TUR，第2组未进行re-TUR。评估RFS和PFS。
共纳入78例患者，其中第1组50例（64.1%）。两组之间无显著差异。再次TUR的平均时间为8周，发现60%有残留肿瘤。12%的病例存在初始分期不足。第1组的RFS和PFS明显更好（P=0.0019；P=0.02）。两组在OS和特异性生存期（SS）方面无显著差异。
对高级别T1期膀胱肿瘤进行re-TUR可发现残留肿瘤并降低评估不足的风险。它与RFS和PFS的显著改善相关，对OS和SS无影响。
