title: Is repeated transurethral resection justified in patients with newly diagnosed superficial bladder cancer?
abstract: OBJECTIVE
  To assess the value of repeated transurethral resection (TUR) in patients with newly diagnosed superficial bladder cancer.
  
  
  METHODS
  A second TUR was performed in 110 consecutive patients (24 women and 86 men) with newly diagnosed superficial bladder cancer. The mean age was 66 years (range 30 to 85). A second TUR was performed within 4 to 6 weeks after the initial TUR. After the first TUR, the pathologic stage was pTa in 31 patients (28%), pT1 in 76 (70%), and carcinoma in situ in 3 (2%). The pathologic records of the second TUR were reviewed and compared with the findings of the first operation.
  
  
  RESULTS
  Cystoscopy before the second TUR was negative in 79 patients. Of these cases, 14 (17.7%) had cancer histologically. The second TUR was negative in 70 patients (63.6%). Twenty-two (20%) had residual cancer of the same stage, 9 (8.2%) had a lower stage, and 9 (8.2%) had a higher stage. Of 31 patients with Stage pTa and 76 patients with Stage pT1 at the first TUR, 19 (61.3%) and 51 (67.1%) had a negative second TUR, respectively.
  
  
  CONCLUSIONS
  We recommend a second TUR for patients with superficial bladder cancer for several reasons. A negative second TUR provides important prognostic information. In addition, removal of residual cancer is achieved early. Finally, patients with pT1 G3 tumors are at high risk of residual, or even invasive, cancer and should be offered definitive therapy as early as possible.
authors.affiliation: Department of Urology, University Hospital, Karl-Franzens University Graz, Graz, Austria.
authors.forename: Luigi
authors.initials: L
authors.lastname: Schips
authors.forename: Herbert
authors.initials: H
authors.lastname: Augustin
authors.forename: Richard E
authors.initials: RE
authors.lastname: Zigeuner
authors.forename: Guenter
authors.initials: G
authors.lastname: Gallé
authors.forename: Helga
authors.initials: H
authors.lastname: Habermann
authors.forename: Harald
authors.initials: H
authors.lastname: Trummer
authors.forename: Karl
authors.initials: K
authors.lastname: Pummer
authors.forename: Gerhart
authors.initials: G
authors.lastname: Hubmer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D012086:Reoperation; D012189:Retrospective Studies; D020728:Transurethral Resection of Prostate; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*