Shariat - Figure 11
Understaging at First TURBT
FIG. 11: Herr and Donat[12] showed that a significant number of tumors were understaged in a group of 1312 patients with T1 bladder cancer. After performing a second transurethral resection of bladder tumor (TURBT, which is generally indicated in these patients), they found that approximately 48% of patients had persistent NMI bladder cancer. Among this 48%, 25% actually had T1 on the re-resection and 30% were upstaged at the second resection to muscle invasion, showing that understaging is a major problem in the first resection of T1 high-grade bladder cancer.
Whether muscle was present or not at the first resection also determined the likelihood of having remaining cancer and the rate of upstaging. If there was no muscle present, up to 45% of patients with T1 high-grade had muscle invasion on the second TUR.
References
Herr HW, Donat SM. Quality control in transurethral resection of bladder tumours. BJU Int. 2008;102(9 Pt B):1242−6 https://doi.org/10.1111/j.1464-410X.2008.07966.x
