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The role of repeat transurethral resection in the management of high‐risk superficial transitional cell bladder cancer

Tumour may recur because of the persistence of tumour after an incomplete TUR, a lesion that has been overlooked, a new lesion developed from circulating tumour cells during the TUR, or a true new occurrence caused by the growth of a microscopic lesion to a macroscopic one. An incomplete TUR will compromise the patient’s outcome, and therefore the recurrence rate at the first follow-up cystoscopy (RR-FFC). The early RRFFC between institutions is of major interest; Brausi et al. [2] analysed the variability among institutions in the RR-FFC in 2410 patients from seven phase III trials of the European Organisation for the Research and Treatment of Cancer (EORTC). The RR-FFC varied widely among institutions and could not be explained by tumour characteristics, number of tumours at TUR or the use of adjuvant intravesical instillations (Table 1) [2]. The authors suggested that these variations can only be attributed to the differing quality of the TUR performed by the various centres.