Evidence map›Paper›PMID 30386649›Full record

ArticleCentral European journal of urology2018

Is there a role for second transurethral resection in pTa high-grade urothelial bladder cancer?

Anuj Deep Dangi, Ramani Manoj Kumar, Thomas Alex Kodiatte, Mahasampth Gowri, Santosh Kumar, Antony Devasia, Nitin Kekre

Abstract read
In one paragraph

Article in Central European journal of urology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Canadian Urological Association guideline on the management of non-muscle-invasive bladder cancer - Full-text.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2021
    Article
  4. Article
  5. Article
  6. Article
  7. Author's Reply.Central European journal of urology · 2019
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Anuj Deep DangiDepartment of Urology, Christian Medical College and Hospital, Vellore, India.
Ramani Manoj KumarDepartment of Pathology, Christian Medical College and Hospital, Vellore, India.
Thomas Alex KodiatteDepartment of Pathology, Christian Medical College and Hospital, Vellore, India.
Mahasampth GowriDepartment of Bio-Statistics, Christian Medical College and Hospital, Vellore, India.
Santosh KumarDepartment of Urology, Christian Medical College and Hospital, Vellore, India.
Antony DevasiaDepartment of Urology, Christian Medical College and Hospital, Vellore, India.
Nitin KekreDepartment of Urology, Christian Medical College and Hospital, Vellore, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEvidence for second transurethral resection of bladder tumour (TURBT) for pTa high-grade lesions is limited. This study aims to examine the role of a second TURBT in the pTa high-grade group and to generate recurrence and progression data for this group. MATERIAL AND

methodsWe retrospectively studied the clinical profiles and outcomes of all patients diagnosed with high-grade pTa lesions at first TURBT, between the years 2006-2015. Firstly, in patients who underwent a complete first TURBT, we calculated the proportion of patients with positive findings on second TURBT. Secondly, we assessed whether those who underwent a second TURBT had a longer recurrence-free survival compared to those who underwent a single TURBT.

resultsOne hundred and twelve patients had a pTa high-grade urothelial bladder tumor (WHO 2004 classification) at first TURBT, out of whom 43 (38.3%) had a second TURBT. Indications for second TURBT were high-grade lesions (n = 36), absence of detrusor muscle (n = 2), and incomplete resection (n = 5). Out of the 36 patients who had a complete first TURBT and underwent a second look TURBT, 7 patients had positive findings (3 carcinoma in situ, 2 pTa low-grade lesions and 2 pTa high-grade lesions) and there was no upstaging. Of the 5 patients with an incomplete first TURBT, one upstaged to pT1 on second TURBT. Of the 81 patients who followed up with us, 25.9% had a recurrence and 8.6% progressed. The estimated median recurrence free survival was 60 months (95% CI 29.2-90.7) for the whole group and 76 months vs. 45 months for the second and single TURBT group respectively - a difference that was clinically, though not statistically, significant. Multiple (≥2) tumours had a lower recurrence free survival (HR of 4.60, CI 1.67-12.63, p = 0.003).

conclusionsOf the patients with pTa high-grade tumours who had a second TURBT after a complete first TURBT, 19.4% had a positive finding. Multiple tumours are four times as likely to recur as solitary tumours. The role of a second TURBT in this group needs to be studied in larger patient cohorts before a recommendation regarding its lack of clinical utility can be made conclusively.

Indexed as

pTa high graderecurrencesecond transurethral resection of bladder tumoururothelial cancer bladderWHO 2004 pathological classification

Identifiers

PMID30386649
PMCPMC6202620

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.