Clinical Research Of Repeat Transurethral Resection On High Risk Non-muscle Invasive Bladder Cancer

Objective:To explore the effects of re-TUR on patients with high-riskNMIBC．Methods: Data from68patients who had been diagnosed with high-riskNMIBC by transurethral resection of bladder tumor(TURBT). Of these patients,28cases were included in experimental group, which underwent a re-TUR2～6weeks after the initial TUR,40cases in control group who didn’t undergore-TUR. All cases were treated with routine bladder perfusion chemotherapy（THP）and followed by regular cystoscopy after the initial TUR. The residualrate of tumor and pathologic staging reassessment restaging were observed inexperimental group. The rates of tumor recurrence and tumor progress werecompared in two groups.Results: In experimental group,13patients (46.43%) with residual tumorwere found during the re-TUR;6patients’(21.43%) pathological stages wereunderestimated at the initial TUR, including2cases of Taup to T1,4cases of T1up to T2, and4cases at T2were removed from the experimental group. Meanfollow-up after the initial TUR was25months (range,12～48months).Follow-up information was obtained for61of the64cases,3cases of thecontrol group were lost. During the follow-up period to experimental group, the total tumor recurrence rate was41.67%(10/24), the recurrence rate was29.17%(7/24) at1year and37.50%(9/24) at2years. The total tumor progressrate was20.83%(5/24), the tumor progress rate was12.50%(3/24) at1year and16.67%(4/24) at2years. The tumor progress rate at the group with tumorresidue was44.44%(4/9), group without tumor residue after the initial TUR was6.67%(1/15)(P<0.05). In the control group, the total recurrence rate was67.57%(25/37), the recurrence rate was56.75%(21/37) at1year and64.86%(24/37) at2years. The tumor total progress rate was29.73%(11/37), thetumor progress rate was18.92%(7/37) at1year and29.73%(11/37) at2years.The recurrence rate in experimental group was significantly lower than controlgroup(P<0.05), but the tumor progress rate had no significant differencesbetween two groups(P>0.05).Conclusion：Although the high-risk NMIBC was defined as NMIBC, theclinical features of high-risk NMIBC are similar to MIBC. And the rate ofresidual, recurrence and progression is high in high-risk NMIBC after treatmentof the initial TUR. High-risk NMIBC underwent a re-TUR has important valuein clinical diagnosis, treatment, and prognosis. Other methods of auxiliarytreatment also may be necessary because re-TUR can’t slow the growth ofbladder cancer.