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In the 145 patients suitable for RRFFC analysis, the overall RRFFC in the ARI cohort was 26.9%, but was 42.6% when DM was absent in the resection specimen and 17.6% when DM was present (OR = 2.7, 95% CI = 1.2�C6.3, P http://www.selleck.cn/products/azd4547.html analysis (Table?5). Of the 31 patients with Grade 3 NMIBC, 11 had early re-TURBT (Table?5). Only one of the re-TURBT specimens contained DM. Transurethral resection of bladder tumours must be considered a cancer operation and requires the same attention to surgical principles and quality as that applied to major operations, especially because 4/5 patients have NMIBC and are potentially cured by a good initial resection, albeit with risk of recurrence in the following months and years. There is agreement that a good resection should be augmented with intravesical chemotherapy and immunotherapy where indicated by guidelines [10,11]. Emphasis on TURBT quality is emerging, spearheaded by the work of the EORTC [3], which is showing, probably for the first time, that surgeon factors contribute to early recurrence, even in centres http://www.selleckchem.com/products/MK-1775.html contributing to clinical trials. As early recurrence is unlikely to be the result of tumour biology, the TURBT quality can be assessed by the detection or otherwise of ��residual�� tumour at the first check cystoscopy. The DM status, conversely, is known earlier (within a week of TURBT in most institutions) and consequently, where surgery is deemed complete by subjective assessment, the absence of DM could indicate a low quality initial TURBT [8] and re-TURBT should be performed within 2�C6 weeks [12]. The present study was not designed to demonstrate the natural history of NMIBC, nor to compare http://www.selleckchem.com/products/AZD6244.html demographics and RRFFC between the cohorts. Both cohorts are distinct, from different time periods and contain data on different variables to validate specific aspects of the original study [8]. The RRFFC in the 1980s was significantly higher compared with that from later decades, even in the same institution [4]. This was possibly a result of differing intravesical chemotherapy policies, inferior video equipment in the 1980s and the lower threshold to biopsy lesions as the first follow-up cystoscopy was carried out under General Anaesthesia (GA) [8]. In the present study, therefore, we aimed to assess the value of DM in predicting RRFFC within the particular time period rather than compare the decades. This would explain why in the present study, despite the presence of DM being greater in the 1980s, the RRFFC was higher when compared with the contemporary ARI cohort. Although the standard aim of resecting the tumour base is to obtain DM at TURBT, the specimen does not always contain DM.