Outcomes of Second Resection Following Conventional Initial Transurethral Resection of Bladder Tumors

To determine the outcomes of the second transurethral resection of bladder tumors.

Patients with bladder cancer who accepted both initial and second resections in our center from January 2021 to March 2024 were included. Tumor residue in the second resection and short-term oncological outcomes were determined. Multivariate analysis was performed to identify predictive factors for them.

A total of 125 patients were included. Tumor residue and upstaging were confirmed in 15 (12%) and in 1 (0.8%) patient, respectively. A younger age and a longer time (> 6w) to second resection were associated with a higher tumor residual rate (p < 0.05), and they were confirmed as predictors for tumor residue. Differences were not determined between patients with different tumor characteristics (e.g., Ta vs. T1). A median follow-up of 14 (3-40) months was conducted in 100 patients. Intravesical recurrence and progression were determined in 14 (14%) and 4 (4%) patients, with the 1-year recurrence-free and progression-free survivals of 86.5% and 96.9%, respectively. Maintenance BCG therapy was identified as a predictor for tumor recurrence (HR = 6.168, p < 0.05).

A lower tumor residual rate than previously reported was achieved with acceptable short-term oncological outcomes after conventional transurethral resection of bladder tumors. The basis of second resection may need further exploration. Second resection may be prioritized for younger patients and performed within 6 weeks of the initial resection. Maintenance BCG therapy could reduce tumor recurrence after second resection.