Influence of the Presence of Muscularis Propria on Recurrence and the Quality of Transurethral Resection in Low-Grade, Stage pTa Bladder Tumors

Abstract

Objective Transurethral resection (TUR) of the bladder and intravesical chemotherapy is the standard treatment option for non-muscle-invasive bladder tumors. Inadequate tumor resection results in early recurrence and staging inaccuracies, which all will change the course of the disease. High-quality TUR treatment is therefore an important factor in the treatment of non-muscle-invasive bladder tumors. In this study, we investigated the significance of detecting the presence of muscularis propria (MP) in pathology specimens of low-grade, stage pTa tumors in patients who were treated with TUR due to primary bladder tumors, with regard to recurrence, time to recurrence and progression. Materials and Methods Initially, 841 patients who were treated with TUR due to primary bladder tumors were enrolled in the study. A total of 597 patients were excluded from the study because they failed to meet the study criteria. Group 1 consisted of patients with MP detected in the pathology specimens; whereas group 2 consisted of patients whose TUR specimens did not include MP. The patients were evaluated with regard to gender, tumor number, presence or absence of MP, and recurrence status. Results MP was observed in only 14 (15.2%) of 92 patients with recurrence, but not in the remaining 78 (84.8%) (p=0.004). Progression occurred in 4 (14.2%) patients of group 1 and 28 (29%) patients of group 2 (p=0.159). In univariate analysis, tumor multiplicity (p=0.003) and the absence of MP (p=0.004) were found to have effects on recurrence. In multivariate analysis, these two parameters were also found to be have effects on recurrence (p=0.004). Conclusion In this study, it was pointed out that MP presence in the pathology specimens of low-grade stage pTa tumors is an indicator of a high quality TUR and, a well-done TUR is important for the prevention of recurrence.

Keywords

• Bladder tumor
• recurrence
• tumor volume
• muscularis propria