OBJECTIVE: To evaluate predictors of understaging in patients with presumed non-muscle-invasive bladder cancer (NMIBC) identified on transurethral resection of bladder tumour (TURBT) who underwent radical cystectomy (RC) with attention to the role of a restaging TURBT. PATIENTS AND METHODS: We retrospectively evaluated 279 consecutive patients with clinically staged T1 (cT1) disease after TURBT who underwent RC at our institution from April 2000 to July 2011. In all, 60 of these cT1 patients had undergone a restaging TURBT before RC. The primary outcome measure was pathological staging of ≥T2 disease at the time of RC. RESULTS: In all, 134 (48.0%) patients were understaged. Of the 60 patients who remained cT1 after a restaging TURBT, 28 (46.7%) were understaged. Solitary tumour (odds ratio [OR] 0.43, 95% confidence interval [CI] 0.25-0.76, P = 0.004) and fewer prior TURBTs (OR 0.84, 95% CI 0.71-1.00, P = 0.05) were independent risk factors for understaging. CONCLUSIONS: Despite the overall improvement in staging accuracy linked to restaging TURBTs, the risk of clinical understaging remains high in restaged patients found to have persistent T1 urothelial carcinoma who undergo RC. Solitary tumour and fewer prior TURBTs are independent risk factors for being understaged. Incorporating these predictors into preoperative risk stratification may allow for augmented identification of those patients with clinical NMIBC who stand to benefit most from RC.
OBJECTIVE: To evaluate predictors of understaging in patients with presumed non-muscle-invasive bladder cancer (NMIBC) identified on transurethral resection of bladder tumour (TURBT) who underwent radical cystectomy (RC) with attention to the role of a restaging TURBT. PATIENTS AND METHODS: We retrospectively evaluated 279 consecutive patients with clinically staged T1 (cT1) disease after TURBT who underwent RC at our institution from April 2000 to July 2011. In all, 60 of these cT1 patients had undergone a restaging TURBT before RC. The primary outcome measure was pathological staging of ≥T2 disease at the time of RC. RESULTS: In all, 134 (48.0%) patients were understaged. Of the 60 patients who remained cT1 after a restaging TURBT, 28 (46.7%) were understaged. Solitary tumour (odds ratio [OR] 0.43, 95% confidence interval [CI] 0.25-0.76, P = 0.004) and fewer prior TURBTs (OR 0.84, 95% CI 0.71-1.00, P = 0.05) were independent risk factors for understaging. CONCLUSIONS: Despite the overall improvement in staging accuracy linked to restaging TURBTs, the risk of clinical understaging remains high in restaged patients found to have persistent T1 urothelial carcinoma who undergo RC. Solitary tumour and fewer prior TURBTs are independent risk factors for being understaged. Incorporating these predictors into preoperative risk stratification may allow for augmented identification of those patients with clinical NMIBC who stand to benefit most from RC.
Authors: V Hechler; M Rink; D Beyersdorff; M Beer; A J Beer; V Panebianco; M Pecoraro; C Bolenz; G Salomon Journal: Urologe A Date: 2019-12 Impact factor: 0.639
Authors: Sungmin Woo; Valeria Panebianco; Yoshifumi Narumi; Francesco Del Giudice; Valdair F Muglia; Mitsuru Takeuchi; Soleen Ghafoor; Bernard H Bochner; Alvin C Goh; Hedvig Hricak; James W F Catto; Hebert Alberto Vargas Journal: Eur Urol Oncol Date: 2020-03-19
Authors: Thaisa Gvozdenovic Medina Bricio; Gabriel Lion Gouvea; Rafael Vasconcelos Barros; Fernando Chahud; Jorge Elias; Rodolfo B Reis; Valdair F Muglia Journal: Cancer Imaging Date: 2022-05-03 Impact factor: 5.605
Authors: Valeria Panebianco; Yoshifumi Narumi; Ersan Altun; Bernard H Bochner; Jason A Efstathiou; Shaista Hafeez; Robert Huddart; Steve Kennish; Seth Lerner; Rodolfo Montironi; Valdair F Muglia; Georg Salomon; Stephen Thomas; Hebert Alberto Vargas; J Alfred Witjes; Mitsuru Takeuchi; Jelle Barentsz; James W F Catto Journal: Eur Urol Date: 2018-05-10 Impact factor: 20.096