Sunday June 26, 2022 from 07:30 to 09:00
Assessment of transurethral resection of a bladder tumor as a tool of detection for bladder cancer recurrence
Mariève Lavallée1,2, Vanessa V.B. Bussières1, Karine K.B. Robitaille1, Vincent Fradet1,2.
1Université Laval Research Center, Oncology Axis, CHU de Québec, Quebec, QC, Canada; 2Faculté de Médecine, Université Laval, Quebec, QC, Canada
Introduction: In Canada, bladder cancer ranks fifth in incidence and eighth in cancer death rate. Transurethral resection of a bladder tumor (TURBT) is an invasive surgery to diagnose and resect bladder cancer. Between 31% and 78% of patients with a non-invasive bladder cancer will experience a recurrence. Hence, all patients have cystoscopy followups to prevent potential cancer progression. Suspicious cases undergo TURBT, which confirms or informs the presence of recurrent cancer. The sensitivity of cystoscopy to detect recurrence varies from 57–97% depending on the source. The main objective of this study was to evaluate, on an institutional basis, the sensitivity of a visual recurrence by cystoscopy. To do so, we evaluated the proportion of TURBT following a visual recurrence at cystoscopy, leading to a positive pathological result.
Methods: This retrospective study was carried out using clinical data from the medical records of 217 patients who underwent a followup TURBT between January 2018 and January 2021 at L’Hôtel-Dieu de Québec, in order to analyze the associations between the rate of visual recurrence observed by cystoscopy and the actual rate of cancer recurrence pathologically confirmed with the TURBT.
Results: During the targeted period, 279 TURBT/biopsies were performed. From these, 201 TURBT/biopsies were found to be positive following a suspicious cystoscopy, while 78 TURBT/biopsies were negative. Thus, 72% of visual recurrences by cystoscopy turned out to be actual pathological recurrence of bladder cancer, while 28% were false positives.
Conclusions: Considering that TURBT is a very invasive method for cancer diagnosis, it is essential to determine whether the use of this method is still justified in clinic to confirm bladder cancer recurrence. Our results suggest that cystoscopy can lead to false positives, still justifying the use of TURBT in this context.