Restaging Transurethral Resection For Superficial Bladder Tumor; May It Changes The Treatment Options?

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Journal Title, Volume, Page: 
The New Journal of Urology 2009, 5 (2): 57-61
Year of Publication: 
2009
Authors: 
Sacit Nuri GÖRGEL
Atatürk Eğitim ve Araştırma Hastanesi 1, Üroloji Kliniği, İzmir
Mahmoud MUSTAFA
Atatürk Eğitim ve Araştırma Hastanesi 1, Üroloji Kliniği, İzmir
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Cengiz GİRGİN
Atatürk Eğitim ve Araştırma Hastanesi 1, Üroloji Kliniği, İzmir
Çetin DİNÇEL
Atatürk Eğitim ve Araştırma Hastanesi 1, Üroloji Kliniği, İzmir
Preferred Abstract (Original): 

Objective: This study was an evaluation of whether restaging transurethral resection of superficial bladder tumor(TURBT) may change the treatment modalities in patients with superficial bladder tumor.
Material and Methods: A total of 59 patients with mean age of 63.25 years; range 29-85, (53 male, 6 female) who underwent transurethral resection (TUR) and restaging TUR-BT were enrolled. All patients were diagnosed to have superficial bladder tumor; pTa 27 patients, pT1 32 patients. The grades of the tumors were; 15 patients had grade I, 23 patients had grade II and 21 patients had grade III. Restaging TUR (Re-TUR) was done after 4-6 weeks of the first resection. The tumoral lesions were evaluated in terms of stage, grade, tumor volume and tumor location. The repeat resection was done from the region of initial resection and suspicious lesions. The oncologic findings were evaluated in terms of presence of residual tumor and incidence of under staging.
Results: Residual tumor was found in 19 (32.20%) patients, including pT1 15(78.49%) patients and pTa 4 (21.50%) patients and all the tumor were detected at the regions of initial resection. Under staging was observed in 5 pT1 (26.31%) patients, and three patients changed diagnosis to carcinoma insitu (CIS). None of the patients with Ta grade 1 showed under staging or change in diagnosis at Re-TUR. No patient showed progression regards of grades.
Conclusion: The rate of detecting residual tumoral lesions at restaging transurethral resection is not low in all pathological subgroups. The alterations of pathological diagnosis at Re-TUR and the under staging at initial TUR mandated the change in the treatment options especially in pT1 grade III cases.

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