Objectives: The objective of this article is to evaluate the importance of a second-look transurethral resection of
bladder tumour (TURBT) in patients with newly diagnosed superficial bladder cancer and its impact on subsequent
treatment plan.
Methods: We carried out a prospective study on 100 consecutive patients with newly diagnosed superficial bladder
cancer in whom a second-look TURBT was performed two to six weeks after initial resection. We assessed the incidence
of residual tumours, sufficiency of initial pathological staging and grading. We also assessed the need for re-staging and
grading after the second-look TURBT.
Results: Forty-five out of 75 patients (60%) who underwent second-look TURBT had no tumours, 18 (24%) had visible
residual tumours and 12 (16%) had microscopic residual tumours. Of the 30 (40%) patients with residual tumours, five
had pTa, three had carcinoma in situ (CIS), 12 had pT1, and 10 had pT2 disease. Upstaging and change of treatment plan
as a result of the second-look TURBT were necessary in 18/75 (24%) cases, of which 10 cases (13%) underwent radical
cystectomy for muscle-invasive tumours.
Conclusions: A second cystoscopy with or without TURBT is recommended two to six weeks after initial resection
of stage Ta and T1 bladder tumours in patients with high-grade transitional carcinoma of the bladder or in patients with
multiple tumours. Second-look cystoscopy in this category of patients may reveal the need for early change of treatment
plan in about 25% of patients. |
