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Significance of second transurethral resection on patient outcomes in muscle-invasive bladder cancer patients treated with bladder-preserving multimodal therapy

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Abstract

Purpose

Although the role of second transurethral resection of bladder tumor (TURB) is well established in high-risk non-muscle-invasive bladder cancer, to the best of our knowledge, there is no study regarding the role of a second transurethral resection (TUR) after a complete first TURB in multimodal therapy (MMT). The aim of this study was to evaluate the role of a second TUR on disease-specific survival (DSS) and overall survival (OS) rates in muscle-invasive bladder cancer (MIBC) patients who were treated with MMT.

Methods

We assessed the data of 90 patients (stage T2-4, N0-1, M0 urothelial cancer) who were treated with MMT at our clinic between January 2000 and June 2014. Patients with incomplete initial TURB were excluded. A total of 43 patients had a second TUR before starting radiochemotherapy of MMT (group 1), and 47 patients (group 2) were treated with MMT without having a second TUR. The impact of second TUR on DSS and OS rates was the primary outcome measure of the study.

Results

Mean (SD, range) age and mean follow-up of the patients were 65.1 (7.1, 52–81) years and 60.3 (38.3, 6–159) months, respectively. The two groups were similar with regard to sex, age, presence of hydronephrosis, lymph node involvement and stage. The 5-year DSS rate was better in group 1 compared to group 2 (68 vs. 41 %) (p = 0.046). The 5-year OS rates of the patients were 63.7 and 40.1 % in groups 1 and 2, respectively (p = 0.054). Multivariate analysis revealed that second TUR, lymph node involvement, presence of hydronephrosis and tumor stage were independent prognostic factors for DSS.

Conclusions

Second TUR should be performed in patients with MIBC who are going to be treated with bladder-preserving MMT protocols.

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Authors’ contribution

S Baltaci and K Turkolmez developed the protocol/project; N Hamidi: collected or managed the data and wrote/edited the manuscript; O Gulpinar and Y Beduk analyzed the data; E Suer wrote/edited the manuscript and analyzed the data; MI Gokce collected or managed the data.

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Authors and Affiliations

  1. Department of Urology, Ankara University School of Medicine, Ankara, Turkey

    Evren Suer, Nurullah Hamidi, Mehmet Ilker Gokce, Omer Gulpinar, Kadir Turkolmez, Yasar Beduk & Sumer Baltaci

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  1. Evren Suer
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  2. Nurullah Hamidi
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  3. Mehmet Ilker Gokce
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  4. Omer Gulpinar
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  5. Kadir Turkolmez
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  6. Yasar Beduk
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  7. Sumer Baltaci
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Corresponding author

Correspondence to Nurullah Hamidi.

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Suer, E., Hamidi, N., Gokce, M.I. et al. Significance of second transurethral resection on patient outcomes in muscle-invasive bladder cancer patients treated with bladder-preserving multimodal therapy. World J Urol 34, 847–851 (2016). https://doi.org/10.1007/s00345-015-1710-5

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  • DOI: https://doi.org/10.1007/s00345-015-1710-5

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