Abstract

Objective: The time interval between transurethral resection (TUR) and cystectomy can vary substantially in patients with bladder cancer. We evaluated the time intervals between the first and last TURs and between the last TUR and cystectomy in an attempt to define a relationship between the time interval and the oncological outcome after cystectomy.

Materials and methods: The study included 176 patients (128 males, 48 females; mean age 68 years; range 34-91 years) who underwent cystectomy for bladder cancer. Of these, 63 patients (35.8%) underwent multiple TURs prior to cystectomy. We evaluated the time intervals between the first and last TURs and between the last TUR and radical cystectomy and correlations were sought with tumor staging and grading.

Results: The average time intervals between the first and last TURs and between the last TUR and cystectomy were 924 days and 49 days, respectively. A significant correlation was found between the time interval from the first to the last TUR and alterations in both tumor stage and tumor grade (p=0.001). With respect to tumor staging, understaging was found in 28 patients (44.4%) and overstaging was found in 10 patients (15.9%), while the stage of the tumor remained unchanged in 25 patients (39.7%). Undergrading was found in 19 patients (30.2%), overgrading in 11 patients (17.5%), and the grading did not change in 33 patients (52.4%). However, both tumor staging and grading did not show any significant correlation with the time interval between the last TUR and cystectomy  (p=0.62 and p=0.27, respectively).

Conclusion: The patients undergoing multiple TURs prior to cystectomy showed significant increases in both tumor stage and grade due to the prolonged waiting period compared to patients undergoing cystectomy directly after TUR. The time interval of 49 days was not associated with increases in tumor staging or grading by the time of cystectomy.