Scholarlink

Background <p>Repeat transurethral resection of bladder tumour (re-TURBT) is recommended in high-risk non-muscle-invasive bladder cancer (NMIBC) to improve staging and identify residual disease. Nevertheless, whether it should be performed routinely in current practice remains uncertain. We examined the findings of re-TURBT in a multicentre cohort and assessed factors associated with residual tumour and later recurrence.</p> Methods <p>This retrospective multicentre study included 567 patients with high-grade NMIBC who underwent re-TURBT after primary resection between 2018 and 2024. Clinicopathological variables and oncological outcomes were reviewed. Logistic regression analysis was used to evaluate predictors of residual tumour, and Cox regression analysis was used to assess factors associated with recurrence.</p> Results <p>Residual tumour was found in 152 patients (26.8%), and 34 patients (6.0%) were upstaged to muscle-invasive disease. Sessile morphology (OR 1.9, 95%CI 1.3–2.6), multifocal tumours (OR 2.3, 95%CI 1.7–3.2), concomitant carcinoma in situ (OR 2.6, 95%CI 1.9–3.7), and lymphovascular invasion (OR 1.7, 95%CI 1.1–2.4) were independently associated with residual disease. Absence of detrusor muscle in the initial specimen was associated with a higher risk of residual tumour (<i>p</i> &lt; 0.001). Patients with residual tumour had poorer recurrence-free survival. On multivariable Cox analysis, residual tumour (HR 1.95, 95%CI 1.42–2.70), multifocality (HR 2.10, 95% CI 1.55–2.85), carcinoma in situ (HR 1.78, 95%CI 1.30–2.42), and tumour size ≥ 3&#xa0;cm (HR 1.45, 95%CI 1.05–2.02) were independently associated with recurrence. The overall complication rate was 4.2%, and no major perioperative complications at re-TURBT were recorded.</p> Conclusions <p>Residual tumour after initial TURBT remains frequent in patients with high-grade NMIBC. Repeat resection improves staging, detects occult muscle-invasive disease, and helps identify patients at greater risk of recurrence. These findings support an ongoing role for re-TURBT, particularly in carefully selected high-risk patients.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Predictors of residual tumour and recurrence in high-grade NMIBC: insights from a multicenter re-TURBT cohort

  • 期刊论文

  • 发表日期：

    2026年7月4日

查看全文
  • Mohammad Jaabou,
  • Zachary Dovey,
  • Osama Zaytoun,
  • Modassar Awan,
  • Brooke Hildebrand,
  • Maida Bada,
  • Stefano Signore,
  • Cristina Falavolti,
  • Massimiliano Di Marco,
  • Alberto Martini,
  • Rocco Papalia,
  • Jose Bellido,
  • Ahmad Rabie,
  • Maurizio Buscarini

摘要

Background

Repeat transurethral resection of bladder tumour (re-TURBT) is recommended in high-risk non-muscle-invasive bladder cancer (NMIBC) to improve staging and identify residual disease. Nevertheless, whether it should be performed routinely in current practice remains uncertain. We examined the findings of re-TURBT in a multicentre cohort and assessed factors associated with residual tumour and later recurrence.

Methods

This retrospective multicentre study included 567 patients with high-grade NMIBC who underwent re-TURBT after primary resection between 2018 and 2024. Clinicopathological variables and oncological outcomes were reviewed. Logistic regression analysis was used to evaluate predictors of residual tumour, and Cox regression analysis was used to assess factors associated with recurrence.

Results

Residual tumour was found in 152 patients (26.8%), and 34 patients (6.0%) were upstaged to muscle-invasive disease. Sessile morphology (OR 1.9, 95%CI 1.3–2.6), multifocal tumours (OR 2.3, 95%CI 1.7–3.2), concomitant carcinoma in situ (OR 2.6, 95%CI 1.9–3.7), and lymphovascular invasion (OR 1.7, 95%CI 1.1–2.4) were independently associated with residual disease. Absence of detrusor muscle in the initial specimen was associated with a higher risk of residual tumour (p < 0.001). Patients with residual tumour had poorer recurrence-free survival. On multivariable Cox analysis, residual tumour (HR 1.95, 95%CI 1.42–2.70), multifocality (HR 2.10, 95% CI 1.55–2.85), carcinoma in situ (HR 1.78, 95%CI 1.30–2.42), and tumour size ≥ 3 cm (HR 1.45, 95%CI 1.05–2.02) were independently associated with recurrence. The overall complication rate was 4.2%, and no major perioperative complications at re-TURBT were recorded.

Conclusions

Residual tumour after initial TURBT remains frequent in patients with high-grade NMIBC. Repeat resection improves staging, detects occult muscle-invasive disease, and helps identify patients at greater risk of recurrence. These findings support an ongoing role for re-TURBT, particularly in carefully selected high-risk patients.