Implications of the COVID19 pandemic on the need and timing of second transurethral bladder tumour resection in high-grade non-muscle invasive bladder cancer
- 17.06.2023
- Original Article
Erschienen in:
- Verfasst von
- Matthias Vanneste
- Bart van der Heij
- Charlotte Elisabeth Christiaansen
- Chris L. Berendsen
- Elisabeth Johanna Margaretha Driessen
- Harman Maxim Bruins
- Erschienen in
- World Journal of Urology | Ausgabe 8/2023
Abstract
Purpose
Due to the COVID19 pandemic, the EAU has recommended to, if needed, postpone second transurethral resection of bladder tumour (TURBT) after BCG induction in selected patients. We aimed to evaluate the oncological outcomes of postponed TURBT and the potential to replace second TURBT by routine cystoscopy and cytology.
Methods
A single-center, retrospective analysis of patients with TaG3/high grade (HG) or T1HG urothelial bladder cancer was performed. All patients underwent a complete TURBT between 2000 and 2013 with presence of detrusor muscle, full BCG induction and routine cystoscopy and cytology, followed by a second TURBT. Results of the cystoscopy, cytology and pathology reports of the TURBT were analyzed by descriptive characteristics, sensitivity, specificity, negative and positive predictive values, as well as survival analyses.
Results
112 patients were included. Residual tumour was present at second TURBT in 21.4%. Upstaging rate from pTaHG to pT1HG and pT1HG to pT2 was 0% and 2.7%, respectively. pT0 was confirmed in 79% of patients, but in 98% of patients with combined negative cytology and cystoscopy after BCG. With a median follow-up of 109 months, the 3-year OS was 85%, RFS 74% and PFS 89%. Sensitivity, specificity, negative predictive value and positive predictive value of cystoscopy and urinary cytology for the presence of residual tumour were 92%, 97%, 98% and 85%, respectively.
Conclusion
This study underpins the recommendation of the EAU NMIBC guideline panel that, if needed and in selected patients, second TURBT may be postponed until after BCG induction treatment in pT1HG disease. Also, routine second TURBT can be omitted in pTaHG disease. Data on replacing second TURBT after BCG treatment by routine cystoscopy and cytology appear promising but require further confirmation in prospective studies.
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- Titel
- Implications of the COVID19 pandemic on the need and timing of second transurethral bladder tumour resection in high-grade non-muscle invasive bladder cancer
- Verfasst von
-
Matthias Vanneste
Bart van der Heij
Charlotte Elisabeth Christiaansen
Chris L. Berendsen
Elisabeth Johanna Margaretha Driessen
Harman Maxim Bruins
- Publikationsdatum
- 17.06.2023
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
World Journal of Urology / Ausgabe 8/2023
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726 - DOI
- https://doi.org/10.1007/s00345-023-04469-x
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