A re-staging transurethral resection predicts early progression of superficial bladder cancer
Harry W Herr1, S Machele Donat
1Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. herrh@mskcc.org
Objective:
To determine whether pathology on a re-staging transurethral resection (TUR) predicts the early progression of superficial bladder cancer.
Patients And Methods:
In all, 710 patients presenting with multiple superficial bladder cancers were evaluated by re-staging TUR and followed for 5 years. Tumours were classified by stage as confined to mucosa (Ta) or invading submucosa (T1), and by grade (low- or high-grade). Pathology on re-staging TUR was correlated with the endpoints of tumour recurrence and stage progression.
Results:
Of the 710 patients, 490 (69%) had a recurrence and 149 (21%) progressed over 5 years. Eighty patients had high-grade invasive (T1G3) cancer on re-staging TUR and 61 (76%) progressed to muscle invasion (median time to progression 15 months), compared with 88 of 630 (14%) who had no evidence of tumour (T0) or other than T1 tumours detected on re-staging TUR.
Conclusion:
A re-staging TUR identifies patients with superficial bladder cancer who are at high risk of early tumour progression.