title: Residual tumour in the marginal resection after a complete transurethral resection is associated with local recurrence in Ta/T1 urinary bladder cancer.
abstract: OBJECTIVE
  This study investigated the presence of residual tumour in the marginal resection (MR) after a complete transurethral resection (TURB) of Ta/T1 transitional urinary bladder cancer. The association between positive MR and recurrence was analysed.
  
  
  METHODS
  After macroscopically complete TURB, a marginal resection of 7 mm (corresponding to the diameter of the resection loop) was removed around the entire resection area. Univariate and multivariate Cox regression analyses were performed to assess the influence of residual disease on recurrence.
  
  
  RESULTS
  In all, 94 patients with a median follow-up time of 36 months were included, and residual tumour in the MR was present in 24 (26%). The recurrence rates for all cases, for those with a tumour-positive and a tumour-free MR were 60 (64%), 20 (83%) and 40 (57%), respectively. Local recurrence was found in 14 (58%) of the patients with tumour presence in the MR compared to 13 (19%) of those with a tumour-free margin. A positive MR was significantly associated with overall recurrence (p < 0.001) and local recurrence (p = 0.001).
  
  
  CONCLUSIONS
  Incomplete transurethral resection of bladder cancer is common, as demonstrated in 26% patients with positive MR. The presence of tumour in the MR may be a risk factor for recurrence, and particularly local recurrence.
authors.affiliation: Division of Urology, Department of Clinical and Experimental Medicine, Linköping University, Sweden. Georg.Jancke@lio.se
authors.forename: Georg
authors.initials: G
authors.lastname: Jancke
authors.forename: Johan
authors.initials: J
authors.lastname: Rosell
authors.forename: Staffan
authors.initials: S
authors.lastname: Jahnson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D018365:Neoplasm, Residual; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012044:Regression Analysis; D001749:Urinary Bladder Neoplasms / Q000601:surgery*