Ranking of the 2nd-look transurethral electroresection of the superficial carcinoma of the bladder

Objective: Repeat transurethral resection (TUR) for superficial bladder cancer is supposed to a chieve better tumor control and to reduce the number of residual tumors, hence to lower the rate of short-time recurrences. We evaluated the role of a routine second transurethral resection in superficial bladder cancer. Methods: From January 1996 to December 1998, 75 patients with newly diagnosed superficial bladder cancer underwent repeat transurethral resection 8 weeks after the first TUR. We compared the tumor stages, grades, changes in histopathology and the presence of residual tumors after the initial TUR. Results: Residual tumors was verified in 24 patients (32%) on repeat TUR. Stratified by tumors stage at first TUR, residual tumor were seen in 10% of pTaG1, 20,5% of pTaG2, 50% of pTaG3, 50% of pT1G2 and 52,6% of pT1G3 of patients respectively. Residual cancer was endoscopically detectable in 22 of 24 patients. Repeat TUR of unsuspicious former resection sites never revealed residual lesions after initial pTaG1-G2 cancer, and overall residual cancer in only 2 of 75 patients. Conclusions: A significant number of patients with superficial bladder cancer has residual lesions after initial TUR. Routine repeat TUR in all patients can however be limited to high risk cancer (pTaG3, pT1G1-3), since the vast majority of residual lesions remains cystoscopically detectable.