International urology and nephrology · 2026
Predictors of residual tumour and recurrence in high-grade NMIBC: insights from a multicenter re-TURBT cohort.
СтатьяНазвание и аннотация: Перевод в очереди
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Jaabou Mohammad, Dovey Zachary, Zaytoun Osama, Awan Modassar, Hildebrand Brooke, Bada Maida, Signore Stefano, Falavolti Cristina, Di Marco Massimiliano, Martini Alberto, Papalia Rocco, Bellido Jose, Rabie Ahmad, Buscarini Maurizio
Аннотация
BACKGROUND: Repeat transurethral resection of bladder tumour (re-TURBT) is recommended in high-risk non-muscle-invasive bladder cancer (NMIBC) to improve staging and identify residual disease. Nevertheless, whether it should be performed routinely in current practice remains uncertain. We examined the findings of re-TURBT in a multicentre cohort and assessed factors associated with residual tumour and later recurrence.
METHODS: This retrospective multicentre study included 567 patients with high-grade NMIBC who underwent re-TURBT after primary resection between 2018 and 2024. Clinicopathological variables and oncological outcomes were reviewed. Logistic regression analysis was used to evaluate predictors of residual tumour, and Cox regression analysis was used to assess factors associated with recurrence.
RESULTS: Residual tumour was found in 152 patients (26.8%), and 34 patients (6.0%) were upstaged to muscle-invasive disease. Sessile morphology (OR 1.9, 95%CI 1.3-2.6), multifocal tumours (OR 2.3, 95%CI 1.7-3.2), concomitant carcinoma in situ (OR 2.6, 95%CI 1.9-3.7), and lymphovascular invasion (OR 1.7, 95%CI 1.1-2.4) were independently associated with residual disease. Absence of detrusor muscle in the initial specimen was associated with a higher risk of residual tumour (p < 0.001). Patients with residual tumour had poorer recurrence-free survival. On multivariable Cox analysis, residual tumour (HR 1.95, 95%CI 1.42-2.70), multifocality (HR 2.10, 95% CI 1.55-2.85), carcinoma in situ (HR 1.78, 95%CI 1.30-2.42), and tumour size ≥ 3 cm (HR 1.45, 95%CI 1.05-2.02) were independently associated with recurrence. The overall complication rate was 4.2%, and no major perioperative complications at re-TURBT were recorded.
CONCLUSIONS: Residual tumour after initial TURBT remains frequent in patients with high-grade NMIBC. Repeat resection improves staging, detects occult muscle-invasive disease, and helps identify patients at greater risk of recurrence. These findings support an ongoing role for re-TURBT, particularly in carefully selected high-risk patients.
METHODS: This retrospective multicentre study included 567 patients with high-grade NMIBC who underwent re-TURBT after primary resection between 2018 and 2024. Clinicopathological variables and oncological outcomes were reviewed. Logistic regression analysis was used to evaluate predictors of residual tumour, and Cox regression analysis was used to assess factors associated with recurrence.
RESULTS: Residual tumour was found in 152 patients (26.8%), and 34 patients (6.0%) were upstaged to muscle-invasive disease. Sessile morphology (OR 1.9, 95%CI 1.3-2.6), multifocal tumours (OR 2.3, 95%CI 1.7-3.2), concomitant carcinoma in situ (OR 2.6, 95%CI 1.9-3.7), and lymphovascular invasion (OR 1.7, 95%CI 1.1-2.4) were independently associated with residual disease. Absence of detrusor muscle in the initial specimen was associated with a higher risk of residual tumour (p < 0.001). Patients with residual tumour had poorer recurrence-free survival. On multivariable Cox analysis, residual tumour (HR 1.95, 95%CI 1.42-2.70), multifocality (HR 2.10, 95% CI 1.55-2.85), carcinoma in situ (HR 1.78, 95%CI 1.30-2.42), and tumour size ≥ 3 cm (HR 1.45, 95%CI 1.05-2.02) were independently associated with recurrence. The overall complication rate was 4.2%, and no major perioperative complications at re-TURBT were recorded.
CONCLUSIONS: Residual tumour after initial TURBT remains frequent in patients with high-grade NMIBC. Repeat resection improves staging, detects occult muscle-invasive disease, and helps identify patients at greater risk of recurrence. These findings support an ongoing role for re-TURBT, particularly in carefully selected high-risk patients.