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

Abstract 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...

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Main Authors: 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
Format: Article
Language:English
Published: SpringerOpen 2025-05-01
Series:African Journal of Urology
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Online Access:https://doi.org/10.1186/s12301-025-00504-y
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Summary:Abstract 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.
ISSN:1961-9987