Can restaging transurethral resection of T1 bladder cancer select patients for immediate cystectomy?
OBJECTIVE
We determined whether pathological findings on restaging transurethral resection predict early stage progression of T1 bladder cancer.


METHODS
A cohort of 352 patients presenting with T1 bladder cancer on initial transurethral resection was evaluated by second or restaging transurethral resection. All patients received bacillus Calmette-Guerin therapy and 88% were followed for 5 years. Pathological findings on restaging transurethral resection were correlated with tumor features, stage progression frequency and progression-free survival.


RESULTS
Of the 352 patients with T1 tumors 203 (58%) had residual tumor on restaging transurethral resection, including 92 (26%) with residual nonmuscle invasive (T1) cancer. During 5 years 66% of cases recurred and 35% progressed in stage. Of the 92 patients with residual T1 cancer 75 (82%) progressed to muscle invasion within 5 years compared to 49 of 260 (19%) who had no or nonT1 tumor detected on restaging transurethral resection.


CONCLUSIONS
Restaging transurethral resection identifies patients with T1 bladder cancer who are at high risk for early tumor progression, justifying immediate cystectomy.
Herr
Harry W
HW
Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. herrh@mskcc.org
Donat
S Machele
SM
Dalbagni
Guido
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D014521:Urethra; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*