Predictors of Residual Tumour in Non-Muscle-Invasive Bladder Cancer Following Repeat Transurethral Resection: A Meta-Analysis.

To systematically evaluate the risk factors associated with positive pathology results following second transurethral resection (re-TUR) in patients with non-muscle invasive bladder cancer (NMIBC), a thorough database search, including PubMed, Embase, Cochrane Library, and CNKI, was performed, limited to studies published up to January 2023. Researchers independently conducted literature screening, data extraction, and meta-analysis using RevMan 5.3, incorporating 15 studies with 1,877 patients. Based on the results, positive pathology results after re-TUR were associated with the following factors: higher pathological grade (OR = -0.24, 95% CI: -0.31-0.17; p <0.001), tumour size ≥3 cm (OR = 0.40, 95% CI: 0.22-0.72; p = 0.003), multiple tumours (OR = 0.47, 95% CI: 0.37-0.61, p <0.001), absence of muscularis propria in the initial resection specimen (OR = 0.19, 95% CI: 0.09-0.39; p <0.001), concurrent carcinoma in situ (CIS, OR = 2.99, 95% CI: 1.52-5.87; p = 0.002), a history of bladder cancer recurrence (OR = 2.32, 95% CI: 1.30-4.13; p = 0.004), and treatment at different medical institutions for the first and second resections (OR = 0.23, 95% CI: 0.12-0.45; p <0.001). This study indicates that higher pathological grade, tumour size ≥3 cm, multiple tumours, the absence of muscularis propria in the initial resection specimen, and concurrent CIS are risk factors for positive pathology results after re-TUR in NMIBC patients. Key Words: Non-muscle invasive bladder cancer, Repeat transurethral resection, Tumour residual, Risk factors, Meta-analysis.