T1 G3 bladder cancer: A second-look endoscopic resection can help achieve a correct staging of a “superficial-invasive” tumor

4651 Background: About one third of urothelial bladder cancers is staged as T1. High grade (G3) T1 tumors present elevated recurrence and progression rates, with a metastatic and lethal potential ten times higher in comparison to other Ta-T1 cancers. Standard treatment, encompassing a transurethral resection plus endovesical Bacillus Calmette-Guerin (TUR + BCG), leads to 80% disease-free rates at 5 years. It is yet to be determined if BCG-non responders present a rapid recurrence, residual disease or a previously undetected mioinvasive lesion. A repeat resection reveals residual disease in more than 30%, and muscle invasion in up to 10% of T1 patients. In order to better stage T1 G3 patients we modified our traditional approach, now routinely repeating the endoscopic resection after the first intervention. Methods: 44 consecutive cases of T1G3 were diagnosed by TUR. 36 patients were males and 8 females; median age was 70 years (range 2 - 40). A repeat-TUR was performed four to six weeks after the first pr...