Abstract: PD48-01
Sources of Funding: None

Introduction

Repeat TUR is both diagnostic and therapeutic in patients with T1 NMIBC. The depth of lamina propria invasion was shown to have the largest impact on T1 tumors prognosis. We intended to evaluate the influence of lamina propria invasion type at initial TUR on the re-staging pathology._x000D_

Methods

We reviewed from our prospectively maintained database all patients with a high-grade pT1 disease who underwent a re-staging TUR within 6 weeks at our center from January 2015 to May 2016. All pathology specimens were reviewed by a dedicated uro-pathologist. The characteristics of the lamina propria invasion were assessed according to the pathological report to identify focal invasion. The pathology of the second TUR was analyzed regarding the characteristics of the initial resection._x000D_

Results

We included 198 patients, with a median age of 70 years (interquartile range: 63-79). Muscle was present in the initial TUR specimen in 107 patients (54%). Pathology restaging was pT0 in 73 patients (37%), pTis in 44 (22%), pTa in 27 (14%), pT1 in 50 (25%) and pT2 in 4 (2%). Eighty-seven patients (44%) had tumors with minimal lamina propria invasion at initial TUR (53 specimens (27%) with focal invasion, 15 (7.6%) with superficial invasion and 19 (10%) with multifocal superficial invasion). Focal invasion was defined as few malignant cells in the lamina propria, superficial invasion as T1a and multifocal superficial invasion as multiple areas of T1a. Of the patients with minimal lamina propria invasion, residual disease was found in 20 patients (23%). However, none of those patients had T2 disease (Table 1)._x000D_

Conclusions

A significant number of patients with T1 tumors have residual disease at restaging TUR. This is not any different among patients with minimal lamina propria invasion. All patients with T1 tumors should undergo restaging TUR irrespective of the depth of penetration into the lamina propria._x000D_

Funding

None