<p><strong> </strong><strong>In patients with high-grade Ta tumors, clinicians may perform repeat TUR of the primary tumor site within six weeks of the initial TURBT. (<em>Conditional Recommendation; Evidence Level: Grade C</em>)</strong></p>
Discussion
Discussion
<p>Residual tumor can be found at the time of repeat resection in up to 50% of patients with high-grade Ta disease, with up to 15% of such tumors being upstaged.<sup>157-160</sup> Larger and multifocal tumors are at a particularly increased risk for incomplete initial resection, and it is this incomplete resection that is likely a significant contributing factor to inadequately treated tumors that are then diagnosed as early recurrences.<sup>161</sup> Nevertheless, the Panel acknowledges the paucity of data demonstrating an absolute therapeutic benefit to repeat resection for high-grade Ta tumors, and recognizes that in select cases, for example small high-grade Ta lesions in which a visually complete initial resection was performed, repeat resection may not be necessary. Thus, the Panel advocates careful consideration for repeat resection for these patients.</p>