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Risk Factors for Early Recurrence After Transurethral Resection of Bladder Cancer

By: Joshua D. Madera, MS
Posted: Wednesday, September 7, 2022

For patients with bladder cancer who are at an increased risk of early recurrence after transurethral resection of bladder cancer, special precautions and close monitoring should be implemented, according to a study published in BMC Cancer. These patients were more likely to have worse outcomes and decreased overall survival as compared with patients who were at an increased risk of late recurrence, explained Ja Hyeon Ku, MD, of the Seoul National University College of Medicine, Korea, and colleagues.

A total of 1,067 patients with urothelial cancer who underwent transurethral resection of bladder cancer were recruited from the Seoul National University Prospective Enrolled Registry. Patients were monitored every 3 months over 1 year. All patients were stratified based on recurrence status: no recurrence (n = 704), early recurrence (n = 208), or late recurrence (n = 155).

A comparison of patients who had early recurrence and those who had late recurrence revealed poorer overall survival (96.4% vs. 100%, respectively) and cystectomy-free survival (85.6% vs. 94.6%, respectively) with early recurrence. Factors that contributed to early recurrence of disease included tumor shape (hazard ratio [HR] = 1.928), tumor location, tumor multiplicity (HR = 1.43 for two to seven tumors, HR = 2.266 for eight or more tumors), high tumor grade, incompleteness of transurethral resection, and a high number of previous such procedures. Moreover, a positive association was identified between low-grade tumors and insufficient transurethral resection depth and late recurrence.

“It is unclear whether insufficient resection depth is a risk factor for late recurrence, since local fulguration is allowed for very small lesions in low-grade tumors. However, even in low-grade tumors, sufficient resection depth should be ensured to avoid late recurrence,” suggested the authors.

Disclosure: The authors reported no conflicts of interest.

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