Impact of timing of computed tomography staging and patient factors on the detection of 'true' + bladder cancer

To evaluate whether computed tomography (CT) scans should be performed before or after transurethral resection of bladder tumour (TURBT) for accurate lymph node staging in clinically lymph node-positive bladder cancer (BCa). Additionally, to identify patient factors that can aid in predicting lymph...

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Detalles Bibliográficos
Autores: von Deimling, Markus|||0000-0002-9954-3413, Furrer, Marc|||0000-0001-8847-6799, Pichler, Renate|||0000-0001-5286-9048, Maas, Moritz, Tully, Karl Heinrich|||0000-0002-9499-0169, Mertens, Laura S.|||0000-0003-3317-6427, Taylor, Jacob, Del Giudice, Francesco|||0000-0003-3865-5988, Li, Roger|||0000-0003-1274-7200, Gallioli, Andrea|||0000-0002-3316-5691, Albisinni, Simone|||0000-0001-5529-3064, Crocetto, Felice|||0000-0002-4315-7660, Velev, Maud, Afferi, Luca|||0000-0002-5472-1933, Mari, Andrea|||0000-0001-9070-5706, Laukhtina, Ekaterina|||0000-0002-8953-0272, Fisch, Margit, Spiess, Philippe E., Lotan, Yair|||0000-0001-5692-2723, Moschini, Marco|||0000-0002-3084-2458, Black, Peter C., Antonelli, Alessandro|||0000-0002-7455-8803, Kiss, Bernhard|||0000-0002-4691-556X, Shariat, Shahrokh|||0000-0002-6627-6179, Pradere, Benjamin|||0000-0002-7768-8558, Bianchi, Alberto, Longoni, Mattia, Klemm, Jakob, Singla, Nirmish
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:dnet:uabarcelona_::c36b6aa5d335654f02dfbc699ff7f8d2
Acceso en línea:https://ddd.uab.cat/record/328188
https://dx.doi.org/urn:doi:10.1111/bju.16851
Access Level:acceso abierto
Palabra clave:cN+
Lymph node staging
Computed tomography
Radical cystectomy
Template
Urinary bladder neoplasms
Urothelial cancer
Descripción
Sumario:To evaluate whether computed tomography (CT) scans should be performed before or after transurethral resection of bladder tumour (TURBT) for accurate lymph node staging in clinically lymph node-positive bladder cancer (BCa). Additionally, to identify patient factors that can aid in predicting lymph node metastasis. In this retrospective, multicentre study, we analysed patients with cN+ M0 BCa staged by CT and treated with upfront radical cystectomy (RC) and pelvic lymph node dissection. We stratified patients by the interval between TURBT and CT into three groups: (1) before TURBT; (2) within 30 days after TURBT; and (3) more than 30 days post-TURBT. Staging accuracy, defined as concordance between clinical and pathological lymph node status, was evaluated. We utilised logistic regression analyses to identify patient factors, including the optimal timing of staging, in predicting pathological lymph node status at RC. Among 183 patients with cN+ disease, 90 (49%) had pN0 disease at RC. Of these, 40, 36 and 14 were staged before TURBT, within 30 days after TURBT, and more than 30 days post-TURBT, respectively (P = 0.2). Pathological downstaging was most common in cN1 (22%) and cN2 (20%) disease. The overall concordance rate was 23%. The timing of staging did not correlate with pathological lymph node status on logistic regression (all P.

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