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Magnetic Resonance Imaging Assessment of Carcinogen-induced Murine Bladder Tumors
Published on: March 29, 2019
A comparison between clinical and pathologic staging in patients with bladder cancer
A Mehrsai1, D Mansoori, M Taheri Mahmoudi
1Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Urology Journal
|September 18, 2007
Summary
Accurate clinical staging for invasive bladder cancer is challenging. Transurethral resection of bladder tumor (TURBT) often understages invasive cancers, impacting treatment decisions.
Area of Science:
- Urology
- Oncology
- Diagnostic Imaging
Background:
- Accurate staging of bladder cancer is crucial for effective treatment planning.
- Clinical staging methods and transurethral resection of bladder tumor (TURBT) findings are frequently used to estimate tumor stage.
- However, the accuracy of these methods in reflecting the true pathologic stage requires further investigation.
Purpose of the Study:
- To evaluate the accuracy of clinical staging methods and TURBT results in estimating the pathologic stage of bladder cancer.
- To compare the accuracy of bimanual examination, tumor size, hydronephrosis, CT scan findings, and TURBT results against the final pathologic diagnosis from cystectomy specimens.
Main Methods:
- A retrospective analysis of 32 patients who underwent radical cystectomy for bladder cancer.
- Data collected included bimanual examination, cystoscopy, TURBT pathology, and CT scan findings (tumor size, depth, lymph node involvement, hydronephrosis).
- Comparison of clinical and TURBT findings with the pathologic results of cystectomy specimens.
Main Results:
- Bimanual examination showed 82% specificity and 46% sensitivity for extravesical involvement. Tumor size >5 cm had 93% sensitivity but 58% positive predictive value for extravesical involvement.
- Hydronephrosis was present in 15 patients, with 93% having bladder muscle involvement.
- CT scan had 70% specificity and 46% sensitivity for lymphadenopathy/perivesical fat involvement. TURBT failed to obtain muscle samples in 11 cases, and 4 patients had lower tumor grades reported than in the cystectomy specimen.
Conclusions:
- Clinical staging of invasive bladder cancer has limited accuracy for assessing surrounding fat and lymph node involvement.
- Tumor size greater than 5 cm may indicate extravesical extension.
- Hydronephrosis is a significant indicator of bladder muscle involvement, and TURBT frequently understages invasive bladder cancer.
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