Can restaging transurethral resection of T1 bladder cancer select patients for immediate cystectomy?: Herr HW, Donat SM, Dalbagni G, Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY

Purpose ermined whether pathological findings on restaging transurethral resection predict early stage progression of T1 bladder cancer. als and Methods rt of 352 patients presenting with T1 bladder cancer on initial transurethral resection was evaluated by second- or restaging transurethral resection. All patients received bacillus Calmette-Guerin therapy and 88% were followed for 5 years. Pathological findings on restaging transurethral resection were correlated with tumor features, stage progression frequency, and progression-free survival. s 352 patients with T1 tumors, 203 (58%) had residual tumor on restaging transurethral resection, including 92 (26%) with residual nonmuscle invasive (T1) cancer. During 5 years, 66% of cases recurred and 35% progressed in stage. Of the 92 patients with residual T1 cancer, 75 (82%) progressed to muscle invasion within 5 years compared with 49 of 260 (19%) who had no or non-T1 tumor detected on restaging transurethral resection. sions ing transurethral resection identifies patients with T1 bladder cancer who are at high risk for early tumor progression, justifying immediate cystectomy.