title: Is a second transurethral resection necessary for newly diagnosed pT1 bladder cancer?
abstract: OBJECTIVE
  We evaluated the potential benefit of a second transurethral resection in patients with newly diagnosed pT1 transitional cell carcinoma of the bladder.
  
  
  METHODS
  Between January 2001 and May 2003, 80 patients with stage T1 bladder cancer were included in this protocol in which all patients prospectively received second TUR within 2 to 6 weeks following the initial resection. Patients with incomplete resections were excluded from study. The pathological findings of the second TUR were reviewed.
  
  
  RESULTS
  Of the 80 patients who underwent second resection, 18 (22.5%) had macroscopic tumors before resection. However, with the addition of microscopic tumors, overall residual disease was determined in 27 (33.8%) patients. Of the 27 patients 7 had pTa, 14 had pT1, 3 had pT1+pTis and 3 had pT2 disease. Residual cancers were detected in 5.8%, 38.2% and 62.5% in G1, G2 and G3 tumors, respectively. The risk of residual tumor directly correlated with the grade of the initial tumor (p = 0.009).
  
  
  CONCLUSIONS
  Although second TUR dramatically changed the treatment strategy in a small percentage of cases, we strongly recommend performing second TUR in all cases of primary pT1 disease, especially in high grade cases.
authors.affiliation: Department of Urology, SSK Tepecik Teaching Hospital, Izmir, Turkey. tdivrik@hotmail.com.tr
authors.forename: Taner
authors.initials: T
authors.lastname: Divrik
authors.forename: Umit
authors.initials: U
authors.lastname: Yildirim
authors.forename: A Skin
authors.initials: AS
authors.lastname: Eroğlu
authors.forename: Ferruh
authors.initials: F
authors.lastname: Zorlu
authors.forename: Haluk
authors.initials: H
authors.lastname: Ozen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D012086:Reoperation; D014521:Urethra; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*