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Keywords:

  • urinary bladder neoplasm;
  • tumour burden;
  • risk factor;
  • recurrence

What's known on the subject? and What does the study add?

Size is one of the currently used variables for predicting recurrence and progression of non-muscle-invasive bladder tumour (NMIBT), but size is subjective and not easy to measure.

We evaluate a new and objective variable to replace size, not previously reported. We assess the weight of the transurethral resection specimen as a predictor of recurrence and progression and conclude that this outperforms size as a predictor of recurrence of NMIBT.

OBJECTIVE

  • • 
    To evaluate the role of the weight of the resected specimen after transurethral resection as a predictive factor for recurrence and progression of non-muscle-invasive bladder tumour (NMIBT).

PATIENTS AND METHODS

  • • 
    The weight of the resected tumour was measured consecutively in 144 subjects who underwent transurethral resection of bladder tumours at our institution. The median (interquartile range [IQR]) follow-up was 58 (61.3) months.
  • • 
    The probability of recurrence and progression at 1 and 5 years were calculated using the currently accepted variables.
  • • 
    Thresholds for the specimen weight were determined according to percentiles and receiver–operating characteristic curves.

RESULTS

  • • 
    The median (IQR) weight of the specimen was 6 (16) g.
  • • 
    Multivariate analysis showed that the weight of the resected specimen was an independent predictive risk factor for recurrence at a threshold value of 6 g with a hazard ratio of 1.7 (95% confidence interval: 1.048–2.761) P= 0.03.
  • • 
    Progression was not associated with the weight of the resected specimen.

CONCLUSIONS

  • • 
    The weight of the resected specimen is a new variable for predicting the risk of recurrence of NMIBT.
  • • 
    Tumours weighing >6 g, according to the present data, have a 1.7-fold higher likelihood of recurrence than those tumours that weigh less.