Impact of second-look TURBT on high grade recurrence and intravesical therapy in high-risk non-muscle-invasive bladder cancer: A 20-year experience
In brief
Second-look bladder resection linked to 18-point gain in 3-year recurrence-free survival
In a 20-year review of 853 patients with high-risk bladder cancer receiving intravesical therapy, 58% who had a second resection were free of high-grade recurrence at 3 years, compared with 40% who did not. The retrospective association does not prove the procedure caused the difference, and progression-free survival was similar between groups.
- Journal
- Urologic oncology (Q1)
- Published
- 10 October 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Yakov Klugman, Nicholas M Cordero, Grace Harrington, Mohammad Khan, Joshua Metherell, Ava Giangrasso, et al.
- PMID
- 42859100
- DOI
- 10.1016/j.urolonc.2026.09.006
Why clinicians should know about it
- Picked for Urology (paper of the day, 13 October 2026): Second-look TURBT improves high‑grade recurrence in NMIBC
Abstract
OBJECTIVE: To describe our 20-year experience with second look Transurethral Resection of Bladder Tumor (SL-TURBT) for high-risk non muscle invasive bladder cancer (NMIBC), and whether it was associated with better response to adjuvant intravesical therapy (IVT) and prognosis. METHODS: Retrospective review of our quality assurance TURBT database between 2000 and 2024. All patients with high risk NMIBC who received IVT were included in the study. SL-TURBT was defined as TURBT within 8 weeks of the initial TURBT or if labelled by the clinician as such. Patients were divided into those who received SL-TURBT vs. those who did not. Patients were followed with cystoscopy and urine cytology every 3 months for the first 2 years, then every 6 months for years 3 to 5, then annually thereafter. Annual upper tract imaging was also performed. Kaplan-Meier method was used to depict high grade recurrence (HGRFS) and progression-free (PFS) survival. RESULTS: Of 853 patients were included in the study, 41% received SL-TURBT. Median time between initial and re-TURBT was 5.9 weeks (IQR 4.0-7.1 weeks). Indications for SL-TURBT included absence of detrusor in specimen (35%), T1 high grade disease (32%), Ta high grade (13%), incomplete resection (16%) and CIS (4%). Patients who received IVT exhibited improved 3 years' HGRFS with SL-TURBT (58% compared to 40% without SL-TURBT, log rank P = 0.008). There was no significant difference in PFS. CONCLUSION: Patients with high risk NMIBC who received a SL-TURBT prior to IVT exhibited improved HGRFS compared to those who received IVT without SL-TURBT.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.