AUTHOR=Fan Junjie , Zhang Xing , Fan Jinhai , Li Lei , He Dalin , Wu Kaijie 

TITLE=Risk Stratification for the Rate and Location of Residual Bladder Tumor for the Decision of Re-Transurethral Resection of Bladder Tumor

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.788568

DOI=10.3389/fonc.2022.788568

ISSN=2234-943X

ABSTRACT=Introduction: To assess the rate and location of residual tumour in re-transurethral resection of bladder tumour (re-TURBT) and develop a risk stratification tool to assist clinicians making treatment decisions.
Patients and Methods: The data of 144 patients with high-risk bladder cancer who received re-TURBT were retrospectively reviewed. The rate and location of residual tumours were recorded. Logistic regression was performed to explore risk factors for residual tumour, and a risk classification tool was developed.
Results: Among the 144 patients, the rates of residual tumour and tumour location at the base of the primary tumour were 22.2% and 10.4%, respectively. Non-urothelial carcinoma subspecialist, piecemeal resection and the absence of detrusor muscle in the first specimen were defined as risk factors. Patients were categorized into low-, intermediate- and high-risk groups according to the number of risk factors. The rate of residual tumour in the high-risk group was significantly higher than that in the low- and intermediate-risk groups (50% vs. 7.8%, P=0.001; 50% vs. 18.6%, P=0.002). Moreover, high-risk patients benefit more from second resection at the base of the primary tumour due to the high rate of residual tumour located at this site than low- and intermediate-risk patients (23.5% vs. 2.0%, P=0.002; 23.5% vs. 10.2%, P=0.083).
Conclusions: Risk stratification based on the subspecialist category, operative method, and presence or absence of detrusor muscle in the first specimen could help identify patients who benefit from re-TURBT and second resection the base of the primary tumour.