title: [T1 high-grade bladder cancer - value of second operation with prognostuic parameters of first operation: analysis of 167 cases].
abstract: We have evaluated the results of second transurethral resections of the bladder (TURB) after T1 high-grade bladder cancer over a 4.5-year period.From July 2007 to February 2012, 2172 TURB procedures were performed at our institution, of which 1130 were initial resections owing to primary tumour or relapse. Of these, 258 revealed T1 high-grade bladder cancer, and here we investigated tumour characteristics of the initial TURB and results of the second resection.The incidence of T1 high-grade tumours was 22.8% (N=258). Of 167 patients who underwent a second resection, tumour was found in 58.1% (97 of 167). Tumours were mostly multifocal (61.9%) and smaller than 3 cm (69.1%). Histology of the second resection revealed Ta low-grade in 8.4%, Ta high-grade in 16.2%, T1 high-grade in 19.8% and an upstaging to T2 and more in 6.6%. A significant association with the recurrence rate was found for the number of tumours at initial TURB: patients with multiple tumours at initial TURB had a recurrence rate of 69.0% compared with only 46.3% of patients with solitary tumour. For tumour-size and detrusor muscle in specimen a non-significant association was shown.T1 high-grade bladder cancers show a relevant rate of tumour at second TURB which confirms the clinical guidelines of the EAU. A significant association for a tumour-free second TURB in our data was shown for solitary tumours. A non-significant association was shown for tumour-size and when detrusor muscle was present in the specimen. Currently there is no data to determine the best time interval before second resection.
authors.affiliation: Klinik für Urologie und Kinderurologie, HELIOS Klinikum Wuppertal, Zentrum für Forschung in der klinischen Medizin (ZFKM), Universität Witten/Herdecke. david.lazica@helios-kliniken.de
authors.forename: D A
authors.initials: DA
authors.lastname: Lazica
authors.forename: S
authors.initials: S
authors.lastname: Böttcher
authors.forename: S
authors.initials: S
authors.lastname: Degener
authors.forename: F-C
authors.initials: FC
authors.lastname: von Rundstedt
authors.forename: A S
authors.initials: AS
authors.lastname: Brandt
authors.forename: S
authors.initials: S
authors.lastname: Roth
authors.forename: S
authors.initials: S
authors.lastname: Störkel
authors.forename: M J
authors.initials: MJ
authors.lastname: Mathers
mesh_terms: D000368:Aged; D015653:Cystectomy / Q000379:methods*; D003558:Cystoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012086:Reoperation / Q000379:methods; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*