@article{3101036,
    title = "The impact of re-transurethral resection on clinical outcomes in a large multicentre cohort of patients with T1 high-grade/Grade 3 bladder cancer treated with bacille Calmette–Guérin",
    author = "Gontero, P. and Sylvester, R. and Pisano, F. and Joniau, S. and Oderda, M. and Serretta, V. and Larré, S. and Di Stasi, S. and Van Rhijn, B. and Witjes, A.J. and Grotenhuis, A.J. and Colombo, R. and Briganti, A. and Babjuk, M. and Soukup, V. and Malmström, P.-U. and Irani, J. and Malats, N. and Baniel, J. and Mano, R. and Cai, T. and Cha, E.K. and Ardelt, P. and Vakarakis, J. and Bartoletti, R. and Dalbagni, G. and Shariat, S.F. and Xylinas, E. and Karnes, R.J. and Palou, J.",
    journal = "BJU international (Papier)",
    year = "2016",
    volume = "118",
    number = "1",
    pages = "44-52",
    publisher = "Wiley-Blackwell Publishing Ltd",
    doi = "10.1111/bju.13354",
    keywords = "BCG vaccine, adult;  aged;  Article;  bladder cancer;  cancer grading;  cancer growth;  cancer prognosis;  cancer recurrence;  cancer specific survival;  cohort analysis;  controlled clinical trial;  controlled study;  detrusor muscle;  female;  human;  major clinical study;  male;  multicenter study;  overall survival;  priority journal;  retrospective study;  transurethral resection;  treatment outcome",
    abstract = "Objectives: To determine if a re-transurethral resection (TUR), in the presence or absence of muscle at the first TUR in patients with T1-high grade (HG)/Grade 3 (G3) bladder cancer, makes a difference in recurrence, progression, cancer specific (CSS) and overall survival (OS). Patients and methods: In a large retrospective multicentre cohort of 2451 patients with T1-HG/G3 initially treated with bacille Calmette–Guérin, 935 (38%) had a re-TUR. According to the presence or absence of muscle in the specimen of the primary TUR, patients were divided in four groups: group 1 (no muscle, no re-TUR), group 2 (no muscle, re-TUR), group 3 (muscle, no re-TUR) and group 4 (muscle, re-TUR). Clinical outcomes were compared across the four groups. Results: Re-TUR had a positive impact on recurrence, progression, CSS and OS only if muscle was not present in the primary TUR specimen. Adjusting for the most important prognostic factors, re-TUR in the absence of muscle had a borderline significant effect on time to recurrence [hazard ratio (HR) 0.67, P = 0.08], progression (HR 0.46, P = 0.06), CSS (HR 0.31, P = 0.07) and OS (HR 0.48, P = 0.05). Re-TUR in the presence of muscle in the primary TUR specimen did not improve the outcome for any of the endpoints. Conclusions: Our retrospective analysis suggests that re-TUR may not be necessary in patients with T1-HG/G3, if muscle is present in the specimen of the primary TUR. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd"
}