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Inicio Actas Urológicas Españolas La probabilidad de detección de tumor residual en la segunda resección transur...
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Vol. 46. Issue 7.
Pages 423-430 (September 2022)
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Vol. 46. Issue 7.
Pages 423-430 (September 2022)
Artículo original
La probabilidad de detección de tumor residual en la segunda resección transuretral del cáncer de vejiga urotelial PT1 según los factores de riesgo
The probability of residual tumor detection in the second transurethral resection of PT1 urothelial bladder cancer according to the risk factors
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M. Culpana,
Corresponding author
mculpan@gmail.com

Autor para correspondencia.
, O. Kazanb, H. Cansu Acarc, A. Iplikcib, G. Atisb, A. Yildirimb
a Department of Urology, Istanbul Medeniyet University, Istanbul, Turkey
b Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
c Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Abstract
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Resumen
Objetivo

Analizar los factores predictivos de tumores residuales en la segunda resección tras la resección transuretral inicial del tumor de vejiga en pacientes con tumores pT1 y desarrollar un método sencillo para predecir la probabilidad de detección del tumor residual.

Material y métodos

En nuestro estudio retrospectivo se incluyeron pacientes con cáncer de vejiga pT1 que se sometieron a una segunda resección entre 2 y 6 semanas después de la primera resección transuretral del tumor de vejiga. Se registraron los datos demográficos de los pacientes y las características del tumor en la primera y segunda resección.

Resultados

En nuestro análisis se incluyeron 144 pacientes con un seguimiento de 53 meses. En el análisis de regresión logística univariante, el grado del tumor, el carcinoma in situ concomitante, el aspecto macroscópico del tumor (sólido frente a papilar) y la presencia de una histología diferente, fueron factores de riesgo significativos para el tumor residual. En el análisis multivariante, solo el grado del tumor fue un factor predictivo independiente del tumor residual en la segunda resección transuretral (OR: 5,62; IC del 95%: 1,228-25,708; p=0,026). Según nuestros resultados, los pacientes con el riesgo más alto tienen una probabilidad de detección de tumor residual del 90,9% en la segunda resección, y en los pacientes con el riesgo más bajo es del 25,4%.

Conclusiones

El grado del tumor, el aspecto macroscópico del tumor (sólido frente a papilar) y el carcinoma in situ concomitante fueron predictores significativos de tumores residuales en la segunda resección de pacientes con cáncer de vejiga no músculo invasivo pT1 primario. Descubrimos que se podía calcular la probabilidad de un tumor residual para así determinar estrategias adaptadas al riesgo en función de estas probabilidades.

Palabras clave:
Cáncer de vejiga
Factores predictivos
Re-RTU
Tumor residual
Segunda resección
Abstract
Objective

To analyze the predictive factors for residual tumors in the second resection after the initial transurethral resection of bladder tumor (TUR-BT) in patients with pT1 tumors and to develop a simple method to predict the probability of residual tumor detection.

Material and methods

Patients with pT1 bladder cancer who underwent a second resection within 2 to 6 weeks after the initial transurethral resection of bladder tumor were included in our retrospective study. The patients’ demographics and the tumor characteristics of the initial and second resections were recorded.

Results

A total of 144 patients were included in our analysis with a 53-month follow-up. In the univariate logistic regression analysis, tumor grade, concomitant carcinoma in situ, macroscopic appearance of the tumor (solid vs papillary), and presence of a variant histology, were significant risk factors for residual tumor. In the multivariate analysis, tumor grade was the only independent predictor of residual tumor at second transurethral resection (OR: 5.62, 95% CI: 1.228–25.708, p=0.026). According to our findings, the patients with the highest risk have a 90.9% residual tumor detection probability at the second resection, and the patients with the lowest risk have 25.4%

Conclusions

Tumor grade, macroscopic appearance of the tumor (solid vs papillary), and concomitant carcinoma in situ, were important predictors of residual tumors at second resection of primary pT1 non-muscle invasive bladder cancer patients. We were able to calculate the probability of residual tumor which helped us determine risk adapted strategies according to these probabilities.

Keywords:
Bladder cancer
Predictive factors
Re-TUR
Residual tumor
Second resection

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