Staging of bladder cancer by transabdominal real-time ultrasound

In the past six years, there were 726 cases of proved bladder cancer in our hospital. Among these, 376 cases received transabdominal ultrasonographic examination of the urinary bladder for evaluation of the bladder tumor. Two hundred and fourteen cases of them were newly diagnosed as bladder cancer and had adequate pathological specimens for staging of the tumor. The retrospective comparison between preoperative local staging of the bladder tumor by ultrasound and final pathological report showed 78.5% of total accuracy, 9.8% of overstaging, and 11.7% of understaging. The accuracy is 87% for stage A tumor; 60.5% for stage B; 41.2% for stage C; 83.3% for stage D. Strong echogenic foci on the surface or in the tumor were detected in 39.3% (84/214) of cases, which may indicate encrusted stones on the surface of the tumor or intratumoral dystrophic calcification. There was no strong correlation between tumor grading and staging, except that most of the grade I lesions were at stage A (30/31, 97%). The preoperative local staging of urinary bladder cancer by real-time ultrasound might be of great value to determine the management planning and prognosis of the patients.