Oncotarget

Clinical Research Papers:

Impact of preoperative diagnostic TURBT on progression-free survival in patients with pathological high-grade, stage T3/T4 bladder urothelial carcinoma

Haichao Huang, Zhenhua Liu, Xin Li, Wei Li, Jinchun Xing, Wei Yu _ and Jie Jin

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Oncotarget. 2017; 8:89228-89235. https://doi.org/10.18632/oncotarget.19159

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Abstract

Haichao Huang1,*, Zhenhua Liu2,*, Xin Li2, Wei Li1, Jinchun Xing1, Wei Yu2 and Jie Jin2

1Department of Urology, The First Affiliated Hospital of Xiamen University, Siming District, Xiamen, Fujian 361003, China

2Department of Urology, Peking University First Hospital and Institute of Urology, Peking University, National Urological Cancer Center, Xicheng District, Beijing 100034, China

*These authors contributed equally to this work

Correspondence to:

Wei Yu, email: yuwei_bjmu@163.com

Jinchun Xing, email: xmcua_2007@163.com

Keywords: diagnostic TURBT, cystoscopic biopsy, progression-free survival, urothelial carcinoma, bladder

Received: March 17, 2017     Accepted: June 28, 2017     Published: July 11, 2017

ABSTRACT

Transurethral bladder tumor resection (TURBT) reportedly increases the circulating tumor cell count in patients with urothelial carcinoma of the bladder (UCB). To determine whether diagnostic TURBT leads to poorer progression-free survival (PFS) than diagnostic cystoscopic biopsy, we retrospectively reviewed the records of 96 consecutive primary pathological high-grade, stage T3/T4 UCB patients treated with radical cystectomy (RC) between January 2009 to December 2013. Clinicopathological features were collected from the medical records. PFS was determined from Kaplan-Meier curves, and potential independent prognostic factors for PFS were identified based on multivariable Cox analysis. During the follow-up period (median, 29 months), 43 patients experienced tumor progression (40 received diagnostic TURBT, 56 received cystoscopic biopsy). Patients who received cystoscopic biopsy had better PFS than those who received diagnostic TURBT (p = 0.008). Additionally, diagnostic TURBT was a significant risk factor for tumor metastasis in both univariable (HR: 2.219; 95% CI: 1.207–4.079; p = 0.010) and multivariable (HR: 2.455; 95% CI: 1.278–4.714; p = 0.007) Cox analyses. The present study provides the first evidence that diagnostic TURBT before RC negatively affects PFS in patients with pathological high-grade, stage T3/T4 UCB.


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