Detrusor muscle in the first, apparently complete TURBT of resection quality, specimen is a surrogate marker “predicts risk of early recurrence”

الملخص EN

Objective : To determine whether resection of detrusor muscle (DM) in the first, apparently complete TURBT is a surrogate marker of resection quality.

Patient and method : From January 2009 to May 2010, 50 patients with new bladder tumours that were judged to have been completely resected were followed up.

Strict exclusion criteria were applied.

Prospectively recorded tumour size, tumour multiplicity, DM status, grade and stage of tumour, and findings at first follow-up cystoscopy (at 3 months) and at early re-TURBT were evaluated.

Early recurrence (for calculating recurrence rate in the first follow up cystoscope (RR-FFC) was defined as pathologically confirmed tumour on early re-TURBT or recurrence at the first follow-up cystoscopy.

Results : Of 50 patients, DM was present in 41 patients (82 %).

Multivariate analyses revealed that large tumours, high-grade tumours, was independently associated with the presence of DM in the resected specimens.

The RR-FFCs when DM was absent and present were 55.5 % and 21.9 %, respectively.

The absence of DM independently predicted a higher RR-FFC.

This association was also seen in small and low-grade tumours.

Conclusions : DM absence or presence in the first, apparently complete TURBT specimen appears to be a surrogate marker of resection quality by independently predicting the RR-FFC.

So the first follow up cystoscopy in those patients with absent detrusor muscle in the first resection should be done within shorter period.