Outcomes of Second Resection Following Conventional Initial Transurethral Resection of Bladder Tumors.

Abstract

Objectives: To determine the outcomes of the second transurethral resection of bladder tumors.

Methods: Patients with bladder cancer who accepted both initial and second resections in our center from January 2021 to March 2024 were included. Tumor residue in the second resection and short-term oncological outcomes were determined. Multivariate analysis was performed to identify predictive factors for them.

Results: A total of 125 patients were included. Tumor residue and upstaging were confirmed in 15 (12%) and in 1 (0.8%) patient, respectively. A younger age and a longer time (> 6w) to second resection were associated with a higher tumor residual rate (p < 0.05), and they were confirmed as predictors for tumor residue. Differences were not determined between patients with different tumor characteristics (e.g., Ta vs. T1). A median follow-up of 14 (3-40) months was conducted in 100 patients. Intravesical recurrence and progression were determined in 14 (14%) and 4 (4%) patients, with the 1-year recurrence-free and progression-free survivals of 86.5% and 96.9%, respectively. Maintenance BCG therapy was identified as a predictor for tumor recurrence (HR = 6.168, p < 0.05).

Conclusions: A lower tumor residual rate than previously reported was achieved with acceptable short-term oncological outcomes after conventional transurethral resection of bladder tumors. The basis of second resection may need further exploration. Second resection may be prioritized for younger patients and performed within 6 weeks of the initial resection. Maintenance BCG therapy could reduce tumor recurrence after second resection.