Pd41-04 urothelial bladder ptx tumours. how to predict positivity of the immediate second tur

You have accessJournal of UrologyBladder Cancer: Staging1 Apr 2015PD41-04 UROTHELIAL BLADDER PTX TUMOURS. HOW TO PREDICT POSITIVITY OF THE IMMEDIATE SECOND TUR Carles Xavier Raventós Busquets, Ignacio Arroyo Soto, Carles Gasanz Serrano, Juan María Bastarós Hernández, Fernando Lozano Palacio, Jordi Temprana Salvador, Inés De Torres Ramírez, Miguel Angel López pacios, and Juan Morote Robles Carles Xavier Raventós BusquetsCarles Xavier Raventós Busquets More articles by this author , Ignacio Arroyo SotoIgnacio Arroyo Soto More articles by this author , Carles Gasanz SerranoCarles Gasanz Serrano More articles by this author , Juan María Bastarós HernándezJuan María Bastarós Hernández More articles by this author , Fernando Lozano PalacioFernando Lozano Palacio More articles by this author , Jordi Temprana SalvadorJordi Temprana Salvador More articles by this author , Inés De Torres RamírezInés De Torres Ramírez More articles by this author , Miguel Angel López paciosMiguel Angel López pacios More articles by this author , and Juan Morote RoblesJuan Morote Robles More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2412AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Current guidelines recommend a second TUR if there is no muscle in the specimen after initial resection. Re TUR represents a second surgical maneuvre on these patients who usually have other comorbidities and increases risk of surgical and post operative complications. In our series up to 73% of the Re TURs are negative. The aim of this study is to better select those patients who really need Re TUR based on initial tumour features, age and comorbidities. METHODS Re TUR was performed in 55 patients from 154 with diagnosed pTx (from January 2010 to June 2013). It took place 4-8 weeks after first resection. Main significant criteria to decide Re TUR from those not re-resected were: age (younger), ASA (I-II), Solid pattern, Tumour size (> 1 cm) and High Grade. CIS presence was always re-resected after BCG induction according to our protocols. To analyse how to predict positive pathology versus pT0/low grade of second TUR, univariate a multivariate logistic regression analysis (Bstep method (LR)) was performed. Variables included were those with significant different values between both groups: Age, High grade, Solid pattern, Single/multiple and Tumour Size RESULTS 72,7% of Re TURs were negative. Positive cases were 15: 3 pT2, 3 pTx, 5 pT1 HG (1 pT1a and 4 pT1b/c), 3 CIS and 1 pT1 LG (it was included in pT0 group). Multivariate analysis showed that age (p < 0,01), multiple tumour (p 0,04) and tumour size (> 1 cm) (p 0,05) were independent predictors for ReTUR positivity after initial pTx diagnosis. CONCLUSIONS Immediate second TUR should be mandatory after initial pTx in older patients, when multiple tumours, or with lesions above 1cm size. These variables should be considered when building a nomogram that helps us to decide which patients may really benefit from Re TUR avoiding unnecessary re-interventions. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e841 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Carles Xavier Raventós Busquets More articles by this author Ignacio Arroyo Soto More articles by this author Carles Gasanz Serrano More articles by this author Juan María Bastarós Hernández More articles by this author Fernando Lozano Palacio More articles by this author Jordi Temprana Salvador More articles by this author Inés De Torres Ramírez More articles by this author Miguel Angel López pacios More articles by this author Juan Morote Robles More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...