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Introduction <p>pT1 bladder tumors are considered borderline between NMIBT and MIBT. The aim of this study was to demonstrate the impact of a second resection on the staging, progression, and prognosis of high-grade pT1 bladder tumors.</p> Materials and methods <p>This was a retrospective descriptive and analytical study of 43 patients with high-grade pT1 bladder tumors between 2010 and 2020.</p> Results <p>We collected 43 patient files with high-grade pT1 bladder tumors. The second resection revealed residual tumors in 72% of patients. There was initial understaging in 23% of patients. The delay greater than 6&#xa0;weeks between the first and second resection as well as the multifocality of the initial tumor were predictive factors for residual tumor (p = 0.009). The median duration of follow-up was 36.5&#xa0;months with a minimum of 3&#xa0;months and a maximum of 70&#xa0;months. Of the 25 patients who had a recurrence during follow-up, the median time to its occurrence was 12&#xa0;months (range 1–23&#xa0;months). During follow-up, 25 (58%) of our patients presented with tumor recurrence, including 33% with tumor progression in higher stage. Following the second resection the median time to its occurrence(second look), 23% of our patients underwent radical treatment. The presence of residual tumors at the second resection was predictive of recurrence (p = 0.04) and progression (p = 0.038).</p> Conclusions <p>A second resection is recommended for high-grade pT1 bladder tumors, ideally within a maximum of 6&#xa0;weeks. It allows the detection of residual tumors in nearly a third of cases and corrects initial understaging in nearly a quarter of cases, and directs the practitioner towards a better therapeutic indication.</p>

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Impact of re-evaluation resection in the treatment of high-grade pT1 bladder tumors: analysis of 43 cases

  • 期刊论文

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  • 发表日期：

    2025年5月8日

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  • Alexandre Vahina Gamamou,
  • Kayes Chaker,
  • Lahoumbo Ricardo Gnammi,
  • Moez Rahoui,
  • Aboubacar Cherif,
  • Mamadou Bissiriou Bah,
  • Morlaye Fatoumata Bangoura,
  • Mokhtar Bibi,
  • Yacine Ouanes,
  • Ibrahima Bah,
  • Abdoulaye Bobo Diallo,
  • Oumar Raphiou Bah,
  • Yacine Nouira

摘要

Introduction

pT1 bladder tumors are considered borderline between NMIBT and MIBT. The aim of this study was to demonstrate the impact of a second resection on the staging, progression, and prognosis of high-grade pT1 bladder tumors.

Materials and methods

This was a retrospective descriptive and analytical study of 43 patients with high-grade pT1 bladder tumors between 2010 and 2020.

Results

We collected 43 patient files with high-grade pT1 bladder tumors. The second resection revealed residual tumors in 72% of patients. There was initial understaging in 23% of patients. The delay greater than 6 weeks between the first and second resection as well as the multifocality of the initial tumor were predictive factors for residual tumor (p = 0.009). The median duration of follow-up was 36.5 months with a minimum of 3 months and a maximum of 70 months. Of the 25 patients who had a recurrence during follow-up, the median time to its occurrence was 12 months (range 1–23 months). During follow-up, 25 (58%) of our patients presented with tumor recurrence, including 33% with tumor progression in higher stage. Following the second resection the median time to its occurrence(second look), 23% of our patients underwent radical treatment. The presence of residual tumors at the second resection was predictive of recurrence (p = 0.04) and progression (p = 0.038).

Conclusions

A second resection is recommended for high-grade pT1 bladder tumors, ideally within a maximum of 6 weeks. It allows the detection of residual tumors in nearly a third of cases and corrects initial understaging in nearly a quarter of cases, and directs the practitioner towards a better therapeutic indication.