RESULTS
A total of 78 patients with intermediate and high risk NMIBC were included to the study. The mean age of the patients was 63.9 ± 9.0 (38- 85 years). There were 72 (92,3 %) male and 6 (7,7 %) female patients. The mean follow-up time was 42,1±29,6 (min 10- max 142) months. According to EAU risk classification; 6 (7,7 %) patients were in the intermediate risk group and 72 (92,3 %) patients were in the high-risk group. The index TUR-B and re-TUR pathologies of the patients were shown in Table 1.
Most of the re-TUR positivity was seen in high_grade patients. Three of (60 %) Ta_High grade patients (n:5) had re-TUR positivity and 1 of them upstaged to MIBC. T1_High grade patients (n:53) had the highest number of re-TUR positivity (n:31) (58,5 %). Eight of the T1_High grade patients upstaged to MIBC (15 %). The patients to whom upstaged to T2 treated with ‘radical cystectomy’ or ‘radiotherapy + chemotherapy’. On the other hand none of the Ta_Low grade patients (n:6) had re-TUR positivity (Table 1).
Re-TUR positivity and up-stage/grade was demonstrated according to tumor stage, tumour grade and intermediate / high-risk NMIBC in Table 2. Re-TUR positivity was n: 40 (51 %), and upstaging/upgrading at re-TUR was n: 11 (14 %) in all groups. There was a statistical significant difference between Re-TUR positivity and T stage/grade (p:0.031). In addition, re-TUR positivity was significantly higher in high-risk compared to intermediate-risk NMIBC (p:0.026). Although the recurrence (n:18) and progression (n:11) were higher in the high_risk group (n:72), the statistical analysis did not show any significant difference (p>0.05). The odds ratio of re-TUR positivity was 5,57 for recurrence (95% CI: 1,7-18,5) and 6,52 for progression (95% CI: 1,3-33,5).
Re-TUR positivity was significantly higher in patients with hydronephrosis, CIS, LVI, variant pathology, size (3 cm>) and multiple tumour presence (p<0.05) (Table 3). In addition different tumor variants such as sarcomatoid, neuroendocrine, micropapillary, plasmacytoid differentiation had worse prognosis than others. In our study there were 4 patients with different variants and 3 of them (75 %) had re-TUR positivity.