High-Grade T1 Bladder Cancer: A Clinical Quandary

In 2010, there were an estimated 70,520 new cases of bladder cancer1 of which approximately 13,000 cases were diagnosed as clinical high-grade T1 bladder cancer.2 One of the key components of the evaluation of patients with high-grade T1 bladder cancer is the role of a re-resection or second TUR of the tumor bed 4-6 weeks after the initial diagnosis. This re-resection has both diagnostic and prognostic importance: (1) anywhere from 30-60% of patients will be upstaged to muscle-invasive disease3, and (2) the presence of residual T1 disease implies a 76% chance of progression to muscle-invasive disease4.