Does repeat transurethral resection of bladder tumor influence the diagnosis and prognosis of T1 bladder cancer? A systematic review and meta-analysis

Lin, Lede; Guo, Xiaotong; Ma, Yucheng; Zhu, Jiang; Li, Xiang

doi:10.1016/j.ejso.2022.06.005

Cited by 2 publications

(5 citation statements)

References 73 publications

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“…The pooled RR were 1.10 (95%CI: 1.01 × 10 1. 19 ) and 1.15 (95%CI: 1.03-1.28), respectively [44]. While reTURB did not improve long-term RFS (5-year, 10-year, 15-year) in T1 patients.…”

Section: Discussionmentioning

confidence: 86%

“…Even more profound is the rate of upstaging from Ta to T1 or T1 to T2 at reTURB, which has been observed in up to 28% of initial T1 and 9.5% of initial TaHG tumors, respectively [ 39 ]. A recent meta-analysis finds that the residual and upstaging rates of T1 BC in reTURB were around 50% and 10%, respectively [ 44 ]. All of these are much higher than that of patients who underwent ERBT.…”

Section: Discussionmentioning

confidence: 99%

“…However, a recent meta-analysis demonstrated that short-term RFS (1-year and 3-year) of the reTURB group was better compared with the TURB group. The pooled RR were 1.10 (95%CI: 1.01 × 10 1.19 ) and 1.15 (95%CI: 1.03–1.28), respectively [ 44 ]. While reTURB did not improve long-term RFS (5-year, 10-year, 15-year) in T1 patients.…”

Section: Discussionmentioning

confidence: 99%

“…While reTURB did not improve long-term RFS (5-year, 10-year, 15-year) in T1 patients. The pooled RR were 1.12 (95%CI: 0.97–1.30), 1.11 (95%CI: 0.82–1.50) and 1.37 (95%CI: 0.50–3.74), respectively [ 44 ]. Nearly all of the included patients had undergone initial cTURB and all the patients with T1 tumors.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

A Systematic Review on the Role of Repeat Transurethral Resection after Initial en Bloc Resection for Non-Muscle Invasive Bladder Cancer

Zhou

Yang

et al. 2022

JCM

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International guidelines recommend repeat transurethral resection of bladder tumors (reTURB) for selected patients with high-risk non-muscle invasive bladder cancer to remove possible residual tumors, restage tumors and improve the therapeutic outcome. However, most evidence supporting the benefits of reTURB is from conventional TURB. The role of reTURB in patients receiving initial En bloc resection of bladder tumor (ERBT) is still unknown. PubMed, Embase, Web of Science, The Cochrane Library, and China National Knowledge Infrastructure (CNKI) were systematically searched. Finally, this systematic review and meta-analysis included twelve articles, including 539 patients. The rates of residual tumor and tumor upstaging detected by reTURB after ERBT were 5.9% (95%CI, 2.0%–11.1%) and 0.0% (95%CI, 0.0%–0.5%), respectively. Recurrence-free survival, tumor recurrence and progression were comparable between patients with and without reTURB after initial ERBT. The pooled hazard ratios of 1-year, 2-year, 3-year and 5-year recurrence-free survival were 0.74 (95%CI, 0.36–1.51; p = 0.40), 0.76 (95%CI, 0.45–1.26; p = 0.28), 0.83 (95%CI, 0.53–1.32; p = 0.43) and 0.83 (95%CI, 0.56–1.23; p = 0.36), respectively. The pooled relative risks of recurrence and progression were 0.87 (95%CI, 0.64–1.20; p = 0.40) and 1.11 (95%CI, 0.54–2.32; p = 0.77), respectively. Current evidence demonstrates that reTURB after ERBT for bladder cancer can detect relatively low rates of residual tumor and tumor upstaging and appears not to improve either recurrence or progression.

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“…The pooled RR were 1.10 (95%CI: 1.01 × 10 1. 19 ) and 1.15 (95%CI: 1.03-1.28), respectively [44]. While reTURB did not improve long-term RFS (5-year, 10-year, 15-year) in T1 patients.…”

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A Systematic Review on the Role of Repeat Transurethral Resection after Initial en Bloc Resection for Non-Muscle Invasive Bladder Cancer

Zhou

Yang

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…However, the risks of progression, cancer-specific mortality, and all-cause mortality were significantly lower at 3–4 months for those who did not undergo the repeated TUR-BT. In a meta-analysis, the repeated TUR-BT reduced the risk of recurrence, progression, cancer-specific mortality, and overall mortality 18 , 19 . Although the repeated TUR-BT could be related to high-risk patients or incomplete resection of initial TUR-BT, a similar U-shaped curve was shown regardless of the presence or absence of the repeated TUR-BT.…”

Section: Discussionmentioning

confidence: 99%

Optimal timing for the first cystoscopic follow-up using time-to-treatment initiation analysis of oncologic outcomes in primary non-muscle invasive bladder cancer

Kim,

Lee,

Nguyen

et al. 2024

Sci Rep

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Various guidelines recommend the first follow-up cystoscopy at 3 months; however, no data exist on the optimal timing for initial follow-up cystoscopy. We tried to provide evidence on the timing of the first cystoscopy after the initial transurethral resection of bladder tumor (TUR-BT) for patients with non-muscle invasive bladder cancer (NMIBC) using big data. This was a retrospective National Health Insurance Service database analysis. The following outcomes were considered: recurrence, progression, cancer-specific mortality, and all-cause mortality. Exposure was the time-to-treatment initiation (TTI), a continuous variable representing the time to the first cystoscopy from the first TUR-BT within 1 year. Additionally, we categorized TTI (TTIc) into five levels: < 2, 2–4, 4–6, 6–8, and 8–12 months. A landmark time of 1 year after the initial TUR-BT was described to address immortal-time bias. We identified the optimal time for the first cystoscopy using Cox regression models with and without restricted cubic splines (RCS) for TTI and TTIc, respectively. Among 26,660 patients, 16,880 (63.3%) underwent cystoscopy within 2–4 months. A U-shaped trend of the lowest risks at TTI was observed in the 2–4 months group for progression, cancer-specific mortality, and all-cause mortality. TTI within 0–2 months had a higher risk of progression (aHR 1.36; 95% confidence intervals [CI] 1.15–1.60; p < 0.001) and cancer-specific mortality (aHR 1.29; 95% CI 1.05–1.58; p = 0.010). Similarly, TTI within 8–12 months had a higher risk of progression (aHR 2.09; 95% CI 1.67–2.63; p < 0.001) and cancer-specific mortality (aHR 1.96; 95% CI 1.48–2.60; p < 0.001). Based on the RCS models, the risks of progression, cancer-specific mortality, and all-cause mortality were lowest at TTI of 4 months. The timing of the first cystoscopy follow-up was associated with oncologic prognosis. In our model, undergoing cystoscopy at 4 months has shown the best outcomes in clinical course. Therefore, patients who do not receive cystoscopy at approximately 4 months for any reason need more careful follow-up to predict a poor clinical course.

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Does repeat transurethral resection of bladder tumor influence the diagnosis and prognosis of T1 bladder cancer? A systematic review and meta-analysis

Cited by 2 publications

References 73 publications

A Systematic Review on the Role of Repeat Transurethral Resection after Initial en Bloc Resection for Non-Muscle Invasive Bladder Cancer

A Systematic Review on the Role of Repeat Transurethral Resection after Initial en Bloc Resection for Non-Muscle Invasive Bladder Cancer

Optimal timing for the first cystoscopic follow-up using time-to-treatment initiation analysis of oncologic outcomes in primary non-muscle invasive bladder cancer

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