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World Journal of Urology
Published in: World Journal of Urology 6/2012

01-12-2012 | Original Article

Staging of muscle-invasive bladder cancer: can computerized tomography help us to decide on local treatment?

Authors: Stefan Tritschler, Clarissa Mosler, Julia Straub, Alexander Buchner, Alexander Karl, Anno Graser, Christian Stief, Derya Tilki

Published in: World Journal of Urology | Issue 6/2012

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Abstract

Objectives

To assess the power of multi-detector row computerized tomography (MDCT) in daily routine as a basic staging procedure for the decision on local treatment of patients with bladder cancer.

Patients and methods

We retrospectively analysed 276 patients who had undergone radical cystectomy between 2004 and 2008 and correlated the MDCT findings with pathological findings, number of removed lymph nodes and type of urinary diversion.

Results

Accuracy of MDCT in predicting pathological tumour stage was 49% (kappa coefficient, 0.23; P < 0.001). Overstaging occurred in 23.4%, and understaging occurred in 24.7%. Accuracy in predicting lymph node metastases was 54% (kappa coefficient, 0.04; P = 0.297). Overstaging and understaging occurred in 8.3 and 29.4%, respectively. Significantly more ileal conduits were performed in patients with high postoperative pathological tumour stages (P = 0.04) and positive lymph nodes (P = 0.013). In contrast, there was no correlation between preoperative CT tumour/nodal stage and the number of removed lymph nodes (P = 0.44 and P = 0.732, respectively), and between preoperative tumour stage and type of urinary diversion (P = 0.126).

Conclusions

MDCT as a preoperative staging procedure has a low accuracy in predicting the correct tumour and nodal stage, and therefore, it has little impact on decision-making for local treatment of muscle-invasive bladder cancer during radical cystectomy.
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Metadata
Title
Staging of muscle-invasive bladder cancer: can computerized tomography help us to decide on local treatment?
Authors
Stefan Tritschler
Clarissa Mosler
Julia Straub
Alexander Buchner
Alexander Karl
Anno Graser
Christian Stief
Derya Tilki
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
World Journal of Urology / Issue 6/2012
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-011-0817-6

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