| Purpose: To evaluate the efficacy of repeat transurethral resection of bladder tumor in the treatment of high-risk non-muscular-invasive bladder cancer,and summarize the clinical significance of secondary resection.Method: Clinical data of patients with bladder cancer admitted to Department of Urology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from September 2017 to September 2019 were collected for retrospective analysis.According to the experimental inclusion criteria,eligible patients were screened for inclusion in the study,and the patients were divided into Re-TURBT group and TURBT group with different surgical treatment methods.When the two groups were treated with TURBT,some patients were treated with TURBT guided by fluorescent cystoscope.SPSS statistical software was used to evaluate the differences in general data,case characteristics,recurrence rate,progression rate,relapse-free survival time and other indicators between the two groups.In addition,subgroup analysis was performed on the differences in cancer tissue residue and tumor recurrence rate in Re-TURBT group treated with TURBT guided by fluorescent cystoscopy.Result: A total of 66 patients were screened and included in this study,28 cases in the Re-TURBT group and 38 cases in the TURBT group.The median follow-up time of Re-TURBT group was 12(5-30)months,and that of TURBT group was 18(5-25)months.There was no statistically significant difference between the two groups in the clinical data including in gender,age,tumor size,number,type,pathological stage,grade,whether combined with CIS,and immediate perfusion,maintenance perfusion drugs and whether to receive fluorescent cystoscopy(P>0.05).The total recurrence rate of Re-TURBT group was 14.3%,and that of TURBT group was 36.8%.The difference between the two groups was statistically significant(P<0.05).The cumulative recurrence rates of the two groups at 3 and 6 months after the operation were 0%,3.6% VS 7.9%,18.4%,respectively,with no statistically significant difference(P>0.05).The cumulative recurrence rates of the two groups were 10.7% VS 31.6%,respectively,1 year after surgery,with statistically significant differences(P<0.05).The tumor progression rates of Re-TURBT group and TURBT group were 3.6% VS 13.2%,respectively,with no statistically significant difference(P>0.05).The mean recurrence free survival time of patients in the Re-TURBT group and the TURBT group was(25.88±1.90)months VS(14.79±1.31)months,respectively.and the difference was statistically significant(P<0.05).In the Re-TURBT group,there were 5 cases of secondary resection with tumor tissue residue,among which 3 cases were found to have CIS,and the positive rate of secondary resection was 17.9%.Whether the secondary electrotomy pathology was positive or not was analyzed in the subgroup,and the difference in tumor recurrence rate between the two subgroups was not statistically significant(P>0.05).In the Re-TURBT group,white light cystoscopy(WLC)and fluorescent cystoscopy(FC)were used to assist TURBT treatment for subgroup analysis.The difference in the positive rate of secondary resection between the two subgroups was statistically significant(P<0.05).The difference of tumor recurrence rate between the two subgroups was not statistically significant.Conclusion:(1)In the short-term follow-up results,repeat transurethral resection of bladder tumor can effectively reduce the recurrence rate of high-risk non-muscular invasive bladder cancer.(2)The repeat transurethral resection of bladder tumor can detect tumor residue after the first resection and correct the postoperative risk classification of non-muscular invasive bladder cancer.(3)Transurethral resection of bladder tumor under fluorescent cystoscopy can reduce the tumor residual rate after the first resection and tumor recurrence rate,and may be possible to reduce unnecessary repeat transurethral resection of bladder tumor. |
PDF Full Text Request