Impact of a second transurethral resection on the staging of T1 bladder cancer

Objectives. To evaluate the impact of a second transurethral resection (TUR) on the pathologic stage in a unique patient population with T1 tumors. Methods. Seventy-one patients with Stage T1 transitional cell carcinoma of the bladder were prospectively enrolled and underwent restaging TUR. Fifteen patients underwent immediate cystectomy and 56 patients were treated endoscopically. The patients who underwent immediate cystectomy were the subjects of this report. Results. Fifteen patients underwent immediate cystectomy. At restaging TUR, 13 patients had persistent T1, 1 patient had Tis, and I patient had no residual disease. The pathologic stage at cystectomy revealed the presence of residual disease in 12 of 15 patients, and 3 patients had pT0. Of the 12 patients with residual disease, 3 had residual pT1, 2 had pT1 with pTis, 5 had pTis alone, and 2 had muscle-invasive tumors. Thirteen percent of the patients who underwent immediate cystectomy after restaging TUR had a pathologic stage greater than pT1. Conclusions. Understaging for T1 disease is negligible after restaging TUR. (C) 2002, Elsevier Science Inc.