Purpose: The objective of this study aimed to explore whether the original IVC regimen should be continued after the second TURBT or whether the IVC induction phase should be restarted from the beginning. Methods: A retrospective analysis was performed on 137 patients who underwent a second TURBT at the Affiliated Hospital of Xuzhou Medical University between April 2014 and June 2022. Based on the pathological findings, patients were divided into two groups: group A patients, who did not have a residual tumor on pathological examination after the second TURBT; and group B patients, who had residual tumor. Recurrence was determined using cystoscopy and imaging every three months. The endpoint was recurrence-free survival. Result: In the entire cohort, there was a statistically significant difference in the RFS between patients in the two IVC regimens (p = 0.029). The RFS of patients in group B1 was significantly lower than that of patients in group B2 (p = 0.009). There was no significant difference in RFS between the subgroups A1 and A2 (p = 0.560). Multivariate Cox regression analysis confirmed that the IVC regimen after a second TURBT (p = 0.012) and T stage after a second TURBT (p = 0.005) were both independent predictors for patient RFS. Conclusion: If the pathological findings of the second TURBT specimen is benign, patients can continue their previous treatment regimen without restarting an IVC induction phase. Unnecessary IVC can be avoided in these patients. In contrast, for patients with residual tumors in the second TURBT specimen, the need to restart the IVC induction phase should be emphasized to improve patient prognosis.

Objective Creating two consensus nomograms for predicting overall survival (OS) and cancer-specific survival (CSS) in adult patients with papillary renal cell carcinoma was the aim of this study (pRCC). Method Using the Surveillance, Epidemiology, and End Results (SEER) database, a retrospective analysis of 1074 adult patients with pRCC from 2004 to 2015 was performed. These patients were then randomly divided into two independent cohorts with a ratio of 7:3 (training cohort: 752, validation cohort: 322). In a retrospective analysis of 752 patients from the training cohort, independent prognostic variables affecting OS and CSS were found. R software was used to create prognostic nomograms based on the findings of Cox regression analysis. The performance of the nomograms was assessed using the C-index, AUC curves, calibration curves, and DCA curves. Data from the 107 postoperative pRCC patients at the Affiliated Hospital of Xuzhou Medical University were used to externally validate the nomogram. Results For OS and CSS, the C-indices and AUCs of the training cohort and the validation cohort indicated that the model had excellent discrimination. The DCA curves demonstrate that the model is clinically applicable. The calibration curves in internal and external validation showed that the model's accuracy was high. Conclusion In the current study, we developed and validated a prognostic nomogram that accurately predicts the 3-, 5-, and 8-year OS and CSS of adult patients with pRCC. Clinicians can use this knowledge to direct the clinical management and counseling of patients with pRCC.