ROLE OF EARLY SECOND TURBT IN DETECTION OF RECURRENCE AND DISEASE PROGRESSION IN T1 TCC BLADDER

Abstract :

Introduction : Majority of the Bladder cancers are non-muscle invasive T1 tumours which have a high propensity of recurrence and at times may be under staged during the initial trans-urethral resection. This study aims to evaluate the role of early second transurethral resection of the bladder tumour (TURBT) in timely diagnosing disease recurrence and progression in T1 staged tumours.Materials and methods : It was a prospective study done at the Department of Urology, Army Hospital (Research & Referral), New Delhi over a period of two years from June 2013 to May 2015. The study included 32 patients diagnosed to have T1 Transitional Cell Carcinoma of bladder on histopathology following the initial TURBT.Results : In this study, 23 (71.86%) of the 32 specimen on initial TURBT were deep enough to include the muscularis propria for histopathological staging. In the early second TURBT, 12 (37.55%) patients had residual disease with 7 of them having gross residual disease. On histopathology 5 (15.6%) patients were found to have disease progression to muscle invasion (T2) Conclusion : Early second TURBT (within 6 weeks of first TURBT) has a definitive role in detecting residual disease, early recurrence or progression in patients diagnosed to have T1 tumour on initial resection.

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