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Purpose <p>Repeat transurethral resection (re-TURBT) is recommended for all patients with high-risk bladder cancer to improve staging and oncologic outcomes. However, contemporary evidence on the role of re-TURBT is lacking. We therefore examined the contemporary rates of upstaging at re-TURBT and the association of re-TURBT with disease recurrence and progression.</p> Materials and methods <p>We identified patients with an incident diagnosis of high-grade Ta, low-grade T1 and high-grade T1 urothelial carcinoma of the bladder between 2010 and 2022. The association of re-TURBT with disease recurrence and progression was evaluated using Cox regression. Rates and predictors of residual tumor and upstaging at re-TURBT were evaluated using univariable logistic regression.</p> Results <p>A total of 328 patients were included, of whom 88 (27%) underwent re-TURBT. Among those who underwent re-TURBT, 9 (10%) were upstaged to ≥ T2, while 39 (44%) were found to have residual non-muscle invasive disease. Median follow-up time was 13 and 24 months for RFS and PFS, respectively. In a multivariable analysis, re-TURBT was not associated with a significant difference in disease recurrence or progression compared with no re-TURBT. In unadjusted analysis, a higher Charlson index was associated with an increased risk of upstaging and residual tumors. A greater number of tumors was associated with increased risks of residual tumor at re-TURBT.</p> Conclusions <p>In a contemporary cohort of patients with bladder cancer, the rate of upstaging at re-TURBT was 10%, lower than historical studies. The rate of residual non-muscle invasive disease remains high at 44%. Re-TURBT was not associated with a statistically significant difference in disease recurrence or progression.</p>

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Repeat transurethral resection and contemporary oncologic outcomes among patients with non-muscle invasive urothelial carcinoma of the bladder

  • 期刊论文

  • 发表日期：

    2026年1月13日

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  • Agustin Perez-Londoño,
  • Sumedh Kaul,
  • Aaron Fleishman,
  • Ruslan Korets,
  • Heidi Rayala,
  • Peter Chang,
  • Andrew A. Wagner,
  • Joaquim Bellmunt,
  • Aria F. Olumi,
  • Boris Gershman

摘要

Purpose

Repeat transurethral resection (re-TURBT) is recommended for all patients with high-risk bladder cancer to improve staging and oncologic outcomes. However, contemporary evidence on the role of re-TURBT is lacking. We therefore examined the contemporary rates of upstaging at re-TURBT and the association of re-TURBT with disease recurrence and progression.

Materials and methods

We identified patients with an incident diagnosis of high-grade Ta, low-grade T1 and high-grade T1 urothelial carcinoma of the bladder between 2010 and 2022. The association of re-TURBT with disease recurrence and progression was evaluated using Cox regression. Rates and predictors of residual tumor and upstaging at re-TURBT were evaluated using univariable logistic regression.

Results

A total of 328 patients were included, of whom 88 (27%) underwent re-TURBT. Among those who underwent re-TURBT, 9 (10%) were upstaged to ≥ T2, while 39 (44%) were found to have residual non-muscle invasive disease. Median follow-up time was 13 and 24 months for RFS and PFS, respectively. In a multivariable analysis, re-TURBT was not associated with a significant difference in disease recurrence or progression compared with no re-TURBT. In unadjusted analysis, a higher Charlson index was associated with an increased risk of upstaging and residual tumors. A greater number of tumors was associated with increased risks of residual tumor at re-TURBT.

Conclusions

In a contemporary cohort of patients with bladder cancer, the rate of upstaging at re-TURBT was 10%, lower than historical studies. The rate of residual non-muscle invasive disease remains high at 44%. Re-TURBT was not associated with a statistically significant difference in disease recurrence or progression.