[Accuracy of computer tomography in urinary bladder cancer. Study of 74 patients following radical cystectomy].

The accuracy of computed tomography in staging bladder carcinoma has been investigated in 74 patients who underwent cystectomy (n = 70) and pelvic lymphadenectomy (n = 74). The results of the initial CT findings (prospective analysis) and the results of reviewing all CT scans retrospectively by 3 investigators have been compared. Retrospectively, T-staging was correct in 64%, overstaging was seen in 26% and understaging in 10%. N-staging was correct in 99% (n = 73/74) and obstruction of the upper urinary tract with dilatation of the ureter could be diagnosed in every case. The differences between retrospective and prospective analysis are discussed. Staging errors are seen in patients with tumor infiltration of the prostate or the uterus, with microscopic invasion of the perivesical fat, after irradiation of the pelvis or previous surgery. Metastatic involvement of lymph nodes below 1.5 cm diameter cannot be recognized.