Investigation of pathological perfusion chemotherapy after repeated transurethral resection of bladder cancer
Objective To explore the efficacy of continuing initial transurethral resection of bladder cancer(TURBT)perfusion and restarting a new cycle of perfusion in bladder cancer patients with residual tumor components in repeated transurethral resection of bladder cancer(re-TURBT)path-ologic findings.Methods The clinical data of 82 patients with non-muscular invasive bladder cancer treated in the Affiliated Hospital of Xuzhou Medical University from 2014 to 2022 were retrospectively analyzed.According to the different perfusion regimen,the patients were divided into reperfusion group(restart a new round of perfusion chemotherapy regimen,47 cases)and continued perfusion group(continue perfusion chemotherapy after the first electroresection of bladder tumor,35 cases).All pa-tients who underwent secondary resection of bladder tumors underwent cystoscopy and imaging every 3 months to determine the recurrence of bladder tumors.Results Median follow-up time for the reperfu-sion group and the continued perfusion group were 68 and 44 months,respectively.The recurrence rates were 15％and 60％,respectively.The Kaplan-Meier survival curve showed that the RFS of the reperfusion group was significantly longer than that of the reperfusion group(P＜0.001).The results of univariate Cox regression analysis showed that BMI,perfusion regimen and pathological stage after secondary resection of bladder tumor were the influencing factors for bladder cancer recurrence(all P＜0.05).Multivariate Cox regression analysis showed that perfusion scheme and secondary patholog-ical stage were important risk factors for bladder cancer recurrence(all P＜0.05).Conclusions When the pathological results of secondary electrotomy indicated the presence of tumor components,patients who resumed a new round of perfusion chemotherapy regimen had higher RFS and lower recur-rence rate than those who continued the perfusion regimen after the first electrotomy.Therefore,reper-fusion cycles for patients receiving re-TURBT with positive postoperative pathology may help improve their prognosis.
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