Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer: impact on prognosis?

Irene J. Beijert; Anouk E. Hentschel; Johannes Bründl; Eva M. Compérat; Karin Plass; Oscar Rodríguez; Jose D. Subiela Henríquez; Virginia Hernández; Enrique de la Peña; Isabel Alemany; Diana Turturica; Francesca Pisano; Francesco Soria; Otakar Čapoun; Lenka Bauerová; Michael Pešl; H. Maxim Bruins; Willemien Runneboom; Sonja Herdegen; Johannes Breyer; Antonin Brisuda; Ana Calatrava; José Rubio-Briones; Maximilian Seles; Sebastian Mannweiler; Judith Bosschieter; Venkata R. M. Kusuma; David Ashabere; Nicolai Huebner; Juliette Cotte; Roberto Contieri; Laura S. Mertens; Francesco Claps; Alexandra Masson-Lecomte; Fredrik Liedberg; Daniel Cohen; Luca Lunelli; Olivier Cussenot; Soha el Sheikh; Dimitrios Volanis; Jean-François Côté; Morgan Rouprêt; Andrea Haitel; Shahrokh F. Shariat; A. Hugh Mostafid; Jakko A. Nieuwenhuijzen; Richard Zigeuner; Jose L. Dominguez-Escrig; Jaromir Hacek; Alexandre R. Zlotta; Maximilian Burger; Matthias Evert; Christina A. Hulsbergen-van de Kaa; Antoine G. van der Heijden; Lambertus A. L. M. Kiemeney; Viktor Soukup; Luca Molinaro; Paolo Gontero; Carlos Llorente; Ferran Algaba; Joan Palou; James N’Dow; Maria J. Ribal; Theo H. van der Kwast; Marko Babjuk; Richard J. Sylvester; Bas W. G. van Rhijn

doi:10.1007/s11255-023-03867-9

Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer: impact on prognosis?

Irene J. Beijert
, Anouk E. Hentschel
, Johannes Bründl
, Eva M. Compérat
, Karin Plass
, Oscar Rodríguez
, Jose D. Subiela Henríquez
, Virginia Hernández
, Enrique de la Peña
, Isabel Alemany
, Diana Turturica
, Francesca Pisano
, Francesco Soria
, Otakar Čapoun
, Lenka Bauerová
, Michael Pešl
, H. Maxim Bruins
, Willemien Runneboom
, Sonja Herdegen
, Johannes Breyer

Antonin Brisuda, Ana Calatrava, José Rubio-Briones, Maximilian Seles, Sebastian Mannweiler, Judith Bosschieter, Venkata R. M. Kusuma, David Ashabere, Nicolai Huebner, Juliette Cotte, Roberto Contieri, Laura S. Mertens, Francesco Claps, Alexandra Masson-Lecomte, Fredrik Liedberg, Daniel Cohen, Luca Lunelli, Olivier Cussenot, Soha el Sheikh, Dimitrios Volanis, Jean-François Côté, Morgan Rouprêt, Andrea Haitel, Shahrokh F. Shariat, A. Hugh Mostafid, Jakko A. Nieuwenhuijzen, Richard Zigeuner, Jose L. Dominguez-Escrig, Jaromir Hacek, Alexandre R. Zlotta, Maximilian Burger, Matthias Evert, Christina A. Hulsbergen-van de Kaa, Antoine G. van der Heijden, Lambertus A. L. M. Kiemeney, Viktor Soukup, Luca Molinaro, Paolo Gontero, Carlos Llorente, Ferran Algaba, Joan Palou, James N’Dow, Maria J. Ribal, Theo H. van der Kwast, Marko Babjuk, Richard J. Sylvester, Bas W. G. van Rhijn^*

^*Corresponding author for this work

Antoni van Leeuwenhoek Hospital
Amsterdam UMC - University of Amsterdam
Amsterdam University Medical Centers
University of Regensburg
European Association of Urology
Hôpital Tenon
Autonomous University of Barcelona
Fundacion Hospital Alcorcon
University of Turin
Charles University
Radboud University Medical Center
Zuyderland
Radboud University Nijmegen
Zuyderland Medical Centre
Instituto Valenciano de Oncologia
Medical University of Graz
Royal Surrey Hospital
Medical University of Vienna
Sorbonne Université
Lysosomal Storage Disorders Unit, Royal Free Hospital NHS Foundation Trust and University College London, London, UK
Royal Free Hospital
Princess Margaret Cancer Centre
Princess Margaret Hospital University of Toronto

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Purpose: A re-transurethral resection of the bladder (re-TURB) is a well-established approach in managing non-muscle invasive bladder cancer (NMIBC) for various reasons: repeat-TURB is recommended for a macroscopically incomplete initial resection, restaging-TURB is required if the first resection was macroscopically complete but contained no detrusor muscle (DM) and second-TURB is advised for all completely resected T1-tumors with DM in the resection specimen. This study assessed the long-term outcomes after repeat-, second-, and restaging-TURB in T1-NMIBC patients. Methods: Individual patient data with tumor characteristics of 1660 primary T1-patients (muscle-invasion at re-TURB omitted) diagnosed from 1990 to 2018 in 17 hospitals were analyzed. Time to recurrence, progression, death due to bladder cancer (BC), and all causes (OS) were visualized with cumulative incidence functions and analyzed by log-rank tests and multivariable Cox-regression models stratified by institution. Results: Median follow-up was 45.3 (IQR 22.7–81.1) months. There were no differences in time to recurrence, progression, or OS between patients undergoing restaging (135 patients), second (644 patients), or repeat-TURB (84 patients), nor between patients who did or who did not undergo second or restaging-TURB. However, patients who underwent repeat-TURB had a shorter time to BC death compared to those who had second- or restaging-TURB (multivariable HR 3.58, P = 0.004). Conclusion: Prognosis did not significantly differ between patients who underwent restaging- or second-TURB. However, a worse prognosis in terms of death due to bladder cancer was found in patients who underwent repeat-TURB compared to second-TURB and restaging-TURB, highlighting the importance of separately evaluating different indications for re-TURB.

Original language	English
Pages (from-to)	1323-1333
Number of pages	11
Journal	International urology and nephrology
Volume	56
Issue number	4
Early online date	2023
DOIs	https://doi.org/10.1007/s11255-023-03867-9
Publication status	Published - 1 Apr 2024

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Non-muscle invasive bladder cancer
Prognosis
Re-TURB
Repeat TURB
Restaging TURB
Second TURB

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Second-turb-restaging-turb-or-repeat-turb-in-primary-t1-non-muscle-invasive-bladder-cancer.pdfFinal published version, 1.32 MBLicence: Taverne

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Beijert, I. J., Hentschel, A. E., Bründl, J., Compérat, E. M., Plass, K., Rodríguez, O., Subiela Henríquez, J. D., Hernández, V., de la Peña, E., Alemany, I., Turturica, D., Pisano, F., Soria, F., Čapoun, O., Bauerová, L., Pešl, M., Bruins, H. M., Runneboom, W., Herdegen, S., ... van Rhijn, B. W. G. (2024). Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer: impact on prognosis? International urology and nephrology, 56(4), 1323-1333. https://doi.org/10.1007/s11255-023-03867-9

@article{fbd3b7e44d764d58955e197ae3d6d5ff,

title = "Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer: impact on prognosis?",

abstract = "Purpose: A re-transurethral resection of the bladder (re-TURB) is a well-established approach in managing non-muscle invasive bladder cancer (NMIBC) for various reasons: repeat-TURB is recommended for a macroscopically incomplete initial resection, restaging-TURB is required if the first resection was macroscopically complete but contained no detrusor muscle (DM) and second-TURB is advised for all completely resected T1-tumors with DM in the resection specimen. This study assessed the long-term outcomes after repeat-, second-, and restaging-TURB in T1-NMIBC patients. Methods: Individual patient data with tumor characteristics of 1660 primary T1-patients (muscle-invasion at re-TURB omitted) diagnosed from 1990 to 2018 in 17 hospitals were analyzed. Time to recurrence, progression, death due to bladder cancer (BC), and all causes (OS) were visualized with cumulative incidence functions and analyzed by log-rank tests and multivariable Cox-regression models stratified by institution. Results: Median follow-up was 45.3 (IQR 22.7–81.1) months. There were no differences in time to recurrence, progression, or OS between patients undergoing restaging (135 patients), second (644 patients), or repeat-TURB (84 patients), nor between patients who did or who did not undergo second or restaging-TURB. However, patients who underwent repeat-TURB had a shorter time to BC death compared to those who had second- or restaging-TURB (multivariable HR 3.58, P = 0.004). Conclusion: Prognosis did not significantly differ between patients who underwent restaging- or second-TURB. However, a worse prognosis in terms of death due to bladder cancer was found in patients who underwent repeat-TURB compared to second-TURB and restaging-TURB, highlighting the importance of separately evaluating different indications for re-TURB.",

keywords = "Non-muscle invasive bladder cancer, Prognosis, Re-TURB, Repeat TURB, Restaging TURB, Second TURB",

author = "Beijert, \{Irene J.\} and Hentschel, \{Anouk E.\} and Johannes Br{\"u}ndl and Comp{\'e}rat, \{Eva M.\} and Karin Plass and Oscar Rodr{\'i}guez and \{Subiela Henr{\'i}quez\}, \{Jose D.\} and Virginia Hern{\'a}ndez and \{de la Pe{\~n}a\}, Enrique and Isabel Alemany and Diana Turturica and Francesca Pisano and Francesco Soria and Otakar {\v C}apoun and Lenka Bauerov{\'a} and Michael Pe{\v s}l and Bruins, \{H. Maxim\} and Willemien Runneboom and Sonja Herdegen and Johannes Breyer and Antonin Brisuda and Ana Calatrava and Jos{\'e} Rubio-Briones and Maximilian Seles and Sebastian Mannweiler and Judith Bosschieter and Kusuma, \{Venkata R. M.\} and David Ashabere and Nicolai Huebner and Juliette Cotte and Roberto Contieri and Mertens, \{Laura S.\} and Francesco Claps and Alexandra Masson-Lecomte and Fredrik Liedberg and Daniel Cohen and Luca Lunelli and Olivier Cussenot and \{el Sheikh\}, Soha and Dimitrios Volanis and Jean-Fran{\c c}ois C{\^o}t{\'e} and Morgan Roupr{\^e}t and Andrea Haitel and Shariat, \{Shahrokh F.\} and Mostafid, \{A. Hugh\} and Nieuwenhuijzen, \{Jakko A.\} and Richard Zigeuner and Dominguez-Escrig, \{Jose L.\} and Jaromir Hacek and Zlotta, \{Alexandre R.\} and Maximilian Burger and Matthias Evert and \{Hulsbergen-van de Kaa\}, \{Christina A.\} and \{van der Heijden\}, \{Antoine G.\} and Kiemeney, \{Lambertus A. L. M.\} and Viktor Soukup and Luca Molinaro and Paolo Gontero and Carlos Llorente and Ferran Algaba and Joan Palou and James N{\textquoteright}Dow and Ribal, \{Maria J.\} and \{van der Kwast\}, \{Theo H.\} and Marko Babjuk and Sylvester, \{Richard J.\} and \{van Rhijn\}, \{Bas W. G.\}",

note = "Publisher Copyright: {\textcopyright} The Author(s), under exclusive licence to Springer Nature B.V. 2023.",

year = "2024",

month = apr,

day = "1",

doi = "10.1007/s11255-023-03867-9",

language = "English",

volume = "56",

pages = "1323--1333",

journal = "International urology and nephrology",

issn = "0301-1623",

publisher = "Springer Netherlands",

number = "4",

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Beijert, IJ, Hentschel, AE, Bründl, J, Compérat, EM, Plass, K, Rodríguez, O, Subiela Henríquez, JD, Hernández, V, de la Peña, E, Alemany, I, Turturica, D, Pisano, F, Soria, F, Čapoun, O, Bauerová, L, Pešl, M, Bruins, HM, Runneboom, W, Herdegen, S, Breyer, J, Brisuda, A, Calatrava, A, Rubio-Briones, J, Seles, M, Mannweiler, S, Bosschieter, J, Kusuma, VRM, Ashabere, D, Huebner, N, Cotte, J, Contieri, R, Mertens, LS, Claps, F, Masson-Lecomte, A, Liedberg, F, Cohen, D, Lunelli, L, Cussenot, O, el Sheikh, S, Volanis, D, Côté, J-F, Rouprêt, M, Haitel, A, Shariat, SF, Mostafid, AH, Nieuwenhuijzen, JA, Zigeuner, R, Dominguez-Escrig, JL, Hacek, J, Zlotta, AR, Burger, M, Evert, M, Hulsbergen-van de Kaa, CA, van der Heijden, AG, Kiemeney, LALM, Soukup, V, Molinaro, L, Gontero, P, Llorente, C, Algaba, F, Palou, J, N’Dow, J, Ribal, MJ, van der Kwast, TH, Babjuk, M, Sylvester, RJ & van Rhijn, BWG 2024, 'Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer: impact on prognosis?', International urology and nephrology, vol. 56, no. 4, pp. 1323-1333. https://doi.org/10.1007/s11255-023-03867-9

TY - JOUR

T1 - Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer

T2 - impact on prognosis?

AU - Beijert, Irene J.

AU - Hentschel, Anouk E.

AU - Bründl, Johannes

AU - Compérat, Eva M.

AU - Plass, Karin

AU - Rodríguez, Oscar

AU - Subiela Henríquez, Jose D.

AU - Hernández, Virginia

AU - de la Peña, Enrique

AU - Alemany, Isabel

AU - Turturica, Diana

AU - Pisano, Francesca

AU - Soria, Francesco

AU - Čapoun, Otakar

AU - Bauerová, Lenka

AU - Pešl, Michael

AU - Bruins, H. Maxim

AU - Runneboom, Willemien

AU - Herdegen, Sonja

AU - Breyer, Johannes

AU - Brisuda, Antonin

AU - Calatrava, Ana

AU - Rubio-Briones, José

AU - Seles, Maximilian

AU - Mannweiler, Sebastian

AU - Bosschieter, Judith

AU - Kusuma, Venkata R. M.

AU - Ashabere, David

AU - Huebner, Nicolai

AU - Cotte, Juliette

AU - Contieri, Roberto

AU - Mertens, Laura S.

AU - Claps, Francesco

AU - Masson-Lecomte, Alexandra

AU - Liedberg, Fredrik

AU - Cohen, Daniel

AU - Lunelli, Luca

AU - Cussenot, Olivier

AU - el Sheikh, Soha

AU - Volanis, Dimitrios

AU - Côté, Jean-François

AU - Rouprêt, Morgan

AU - Haitel, Andrea

AU - Shariat, Shahrokh F.

AU - Mostafid, A. Hugh

AU - Nieuwenhuijzen, Jakko A.

AU - Zigeuner, Richard

AU - Dominguez-Escrig, Jose L.

AU - Hacek, Jaromir

AU - Zlotta, Alexandre R.

AU - Burger, Maximilian

AU - Evert, Matthias

AU - Hulsbergen-van de Kaa, Christina A.

AU - van der Heijden, Antoine G.

AU - Kiemeney, Lambertus A. L. M.

AU - Soukup, Viktor

AU - Molinaro, Luca

AU - Gontero, Paolo

AU - Llorente, Carlos

AU - Algaba, Ferran

AU - Palou, Joan

AU - N’Dow, James

AU - Ribal, Maria J.

AU - van der Kwast, Theo H.

AU - Babjuk, Marko

AU - Sylvester, Richard J.

AU - van Rhijn, Bas W. G.

PY - 2024/4/1

Y1 - 2024/4/1

N2 - Purpose: A re-transurethral resection of the bladder (re-TURB) is a well-established approach in managing non-muscle invasive bladder cancer (NMIBC) for various reasons: repeat-TURB is recommended for a macroscopically incomplete initial resection, restaging-TURB is required if the first resection was macroscopically complete but contained no detrusor muscle (DM) and second-TURB is advised for all completely resected T1-tumors with DM in the resection specimen. This study assessed the long-term outcomes after repeat-, second-, and restaging-TURB in T1-NMIBC patients. Methods: Individual patient data with tumor characteristics of 1660 primary T1-patients (muscle-invasion at re-TURB omitted) diagnosed from 1990 to 2018 in 17 hospitals were analyzed. Time to recurrence, progression, death due to bladder cancer (BC), and all causes (OS) were visualized with cumulative incidence functions and analyzed by log-rank tests and multivariable Cox-regression models stratified by institution. Results: Median follow-up was 45.3 (IQR 22.7–81.1) months. There were no differences in time to recurrence, progression, or OS between patients undergoing restaging (135 patients), second (644 patients), or repeat-TURB (84 patients), nor between patients who did or who did not undergo second or restaging-TURB. However, patients who underwent repeat-TURB had a shorter time to BC death compared to those who had second- or restaging-TURB (multivariable HR 3.58, P = 0.004). Conclusion: Prognosis did not significantly differ between patients who underwent restaging- or second-TURB. However, a worse prognosis in terms of death due to bladder cancer was found in patients who underwent repeat-TURB compared to second-TURB and restaging-TURB, highlighting the importance of separately evaluating different indications for re-TURB.

AB - Purpose: A re-transurethral resection of the bladder (re-TURB) is a well-established approach in managing non-muscle invasive bladder cancer (NMIBC) for various reasons: repeat-TURB is recommended for a macroscopically incomplete initial resection, restaging-TURB is required if the first resection was macroscopically complete but contained no detrusor muscle (DM) and second-TURB is advised for all completely resected T1-tumors with DM in the resection specimen. This study assessed the long-term outcomes after repeat-, second-, and restaging-TURB in T1-NMIBC patients. Methods: Individual patient data with tumor characteristics of 1660 primary T1-patients (muscle-invasion at re-TURB omitted) diagnosed from 1990 to 2018 in 17 hospitals were analyzed. Time to recurrence, progression, death due to bladder cancer (BC), and all causes (OS) were visualized with cumulative incidence functions and analyzed by log-rank tests and multivariable Cox-regression models stratified by institution. Results: Median follow-up was 45.3 (IQR 22.7–81.1) months. There were no differences in time to recurrence, progression, or OS between patients undergoing restaging (135 patients), second (644 patients), or repeat-TURB (84 patients), nor between patients who did or who did not undergo second or restaging-TURB. However, patients who underwent repeat-TURB had a shorter time to BC death compared to those who had second- or restaging-TURB (multivariable HR 3.58, P = 0.004). Conclusion: Prognosis did not significantly differ between patients who underwent restaging- or second-TURB. However, a worse prognosis in terms of death due to bladder cancer was found in patients who underwent repeat-TURB compared to second-TURB and restaging-TURB, highlighting the importance of separately evaluating different indications for re-TURB.

KW - Non-muscle invasive bladder cancer

KW - Prognosis

KW - Re-TURB

KW - Repeat TURB

KW - Restaging TURB

KW - Second TURB

UR - https://www.scopus.com/pages/publications/85177042504

U2 - 10.1007/s11255-023-03867-9

DO - 10.1007/s11255-023-03867-9

M3 - Article

C2 - 37980689

SN - 0301-1623

VL - 56

SP - 1323

EP - 1333

JO - International urology and nephrology

JF - International urology and nephrology

IS - 4

ER -

Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer: impact on prognosis?

Abstract

UN SDGs

Keywords

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