How to avoid recurrence of bladder tumor?

Mr. Wang found out bladder tumor 6 years ago, because the tumor was still in early stage, he was cured through timely surgery. However, despite his usual attention, the bladder tumor has recurred 3 times within 6 years, is there any way to avoid the recurrence of bladder tumor? For early bladder cancer, it can be cured by surgery. However, the high recurrence rate is 1 characteristic of bladder cancer. In some patients with recurrence, a low-grade malignant tumor recurs and becomes a highly malignant tumor, which is called “tumor progression. After electrosurgery for non-muscle invasive bladder cancer, a significant number of tumor recurrences are due to tumor remnants, especially for intermediate and high grade T1 bladder cancer, and it has been reported in the literature that the tumor remnant rate after the first electrosurgery can reach 33.8%~36%. Some scholars suggest that secondary TUR for non-muscle invasive bladder cancer should be performed within a short period of time after the first electrosurgery, especially for those high-risk stage T1 bladder cancer, to reduce the postoperative tumor recurrence and progression rates and to obtain more accurate tumor pathological staging; the literature reports that secondary TUR can reduce the postoperative tumor recurrence rate from 63.24% to 25.68% and the tumor progression rate from 11.76% in patients with stage T1 bladder cancer. The rate of tumor progression was reduced from 11.76% to 4.05%. There is a consensus on the timing and protocol of secondary electrosurgery, with most recommending secondary electrosurgery at 2-6 weeks postoperatively, when the original tumor site needs to be resected again during surgery. Secondary TUR is recommended for the following conditions: 1) inadequate first TURBT; 2) absence of muscle tissue in the first electrosurgical specimen, except for TaG1 (low grade) tumors and simple carcinoma in situ; 3) stage T1 tumors; 4) G3 (high grade) tumors, except for simple carcinoma in situ. Long laser treatment of bladder tumor has the following advantages: the tumor can be excised in a whole block, which is convenient for pathology to understand the depth and extent of tumor infiltration, and for pathological staging and judgment of tumor recurrence and prognosis; the tumor specimens excised by transurethral bladder tumor electrosurgery are often inaccurately staged, or even cannot be staged; the whole block excision of tumor can minimize the chance of tumor cell detachment and implantation; after the whole block excision of tumor from the root of tumor, the tumor bed can be removed by vaporization and the tumor can be removed by vaporization. The coagulation of the tumor bed by vaporization can close the blood vessels and lymphatic vessels around the tumor and reduce the chance of tumor spread; it can gasify the mucous membrane around the tumor to eliminate the surrounding satellite foci and reduce the recurrence after surgery; the penetration depth of the Dragon laser in the tissue is only 0.3mm, so it can be operated in a fine manner and the depth and scope of cutting can be controlled during surgery, so that the submucosa, superficial muscular layer and deep muscular layer of the bladder can be dissected out. Therefore, Long laser surgery system can treat bladder tumor with the same speed as electrodesiccation, with good effect and less recurrence, but without worrying about bleeding, electrodesiccation syndrome and other complications that occur during and after electrodesiccation, making the surgery safe and with few postoperative complications. Due to the high recurrence of early bladder cancer, it is usually necessary to perfuse the bladder with anti-cancer drugs after surgery. This is a relatively long process, which is relatively beneficial to reduce the recurrence of tumor if it can be persevered. However, it is undeniable that even after insisting on bladder irrigation treatment, a significant number of patients still recur, which is related to the malignancy of the tumor itself at the time of the first surgery (e.g., size of the tumor, presence of multiple tumors at the same time, etc.). If the recurrence of bladder tumor can be detected early, most of the patients can still be completely treated through surgery.