Limitations of Computerized Tomography in Staging Invasive Bladder Cancer Before Radical Cystectomy

Paik, Michael L.; Scolieri, Michael J.; Brown, Scott L.; Spirnak, J. Patrick; Resnick, Martin I.

doi:10.1016/s0022-5347(05)67522-2

Cited by 209 publications

(92 citation statements)

References 13 publications

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“…We also analysed stage T3/T4 patients to assess the findings in confirmedly advanced bladder tumours locally, because the staging on CT scan has limited accuracy in some bladder cancer patients (Paik et al, 2000). The relationship between the combined XPD and XRCC1 genotypes and cancer-specific survival was stronger in stage T3/ T4 patients.…”

Section: Discussionmentioning

confidence: 99%

Single nucleotide polymorphisms in DNA repair genes might be prognostic factors in muscle-invasive bladder cancer patients treated with chemoradiotherapy

et al. 2006

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DNA repair enzymes repair DNA damaged by platinum agents and ionising radiation. Single nucleotide polymorphisms (SNPs) in DNA repair genes modulate the repair capacity and might affect response and prognosis following platinum-based chemoradiotherapy (CRT). We investigated associations between the functional SNPs in DNA repair genes and response and survival in muscle-invasive bladder cancer patients treated with CRT to determine the predictive value of the SNPs in patient selection for bladder conservation therapy. The study group comprised 78 patients who underwent CRT for transitional cell carcinoma of the bladder. Single nucleotide polymorphisms in xeroderma pigmentosum complementation groups C (Lys939Gln, A/ C), D (XPD; Lys751Gln, A/C), and G (Asp1104His, G/C), and X-ray repair cross-complementing groups 1 (XRCC1; Arg399Gln, G/ A) and 3 (Thr241Met, T/C) genes were genotyped. Combined genotypes with at least one variant allele in XPD or XRCC1 were significantly associated with improved cancer-specific survival compared with remaining groups (P ¼ 0.009). In multivariate analysis, only the combined XPD and XRCC1 genotypes were independently associated with cancer-specific survival (P ¼ 0.04). The association was stronger in stage T3/T4 patients (P ¼ 0.0008). These results suggest that combined XPD and XRCC1 genotypes might be prognostic factors in muscle-invasive bladder cancer patients treated with CRT.

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Section: Discussionmentioning

confidence: 99%

Single nucleotide polymorphisms in DNA repair genes might be prognostic factors in muscle-invasive bladder cancer patients treated with chemoradiotherapy

et al. 2006

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“…Clinical staging was used, as less than 20% of subjects underwent cystectomy: compared with staging based on examination of cystectomy specimens, this results in the understaging of a considerable proportion of tumours (Paik et al, 2000). However, such misclassification is an implausible explanation for our finding that advanced disease was proportionally twice as common in women as men, as one would have to postulate that clinical and radiological investigations were systematically better at identifying the early signs of advanced disease in women than in men.…”

Section: Discussionmentioning

confidence: 99%

Bladder cancer: worse survival in women from deprived areas

et al. 2004

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In a case-note review of 120 women and 227 men presenting with muscle-invasive bladder tumours in 1998, survival was worse for women in 3 years of follow-up, with the greatest difference, of 19.9%, at 6 months. For more deprived women, 6-month survival was 52.3%, and 32 (37.2%) presented with advanced disease, compared with 73.5%, and three (8.8%) for less deprived women. Bladder cancer is the only common cancer for which women have worse prognosis than men as reported in the UK, continental Europe and North America (Micheli et al, 1998;Coleman et al, 1999;Ries et al, 1999). Studies based on routine registry data from the Netherlands and the US have reported later stage at diagnosis for women than for men and worse stage-specific survival (Fleshner et al, 1996; Mungan et al, 2000a, b). These findings are unexplained. We report the results of a case-note review of patients with newly diagnosed muscle-invasive bladder cancers to explore the reasons for differences in survival by sex. MATERIALS AND METHODSPatients were eligible if they were diagnosed with a muscleinvasive bladder carcinoma in 1998, were residents of Greater Manchester or Lancashire (GML) and had no previous history of bladder cancer.All patients in GML diagnosed with a new bladder tumour in 1998 were identified from the database held at the North Western Cancer Registry, which receives information from all hospitals and pathology laboratories in GML, and death details from the Office of National Statistics (ONS). Pathology reports received by the Registry were reviewed for evidence of muscle-invasive disease (MID). Case notes were requested if pathology confirmed or suggested MID, or information was incomplete. In order to identify patients with a diagnosis of MID based on clinical or radiological, rather than histological, findings, the case notes of patients not in the above categories but who either underwent radiotherapy in 1998 or who died between 1st January 1998 and 31st December 2001 were also requested.Patients were included in the study if they had MID confirmed on histology, or they fulfilled one of the following conditions: residual mass present following resection of a bladder tumour; bladder mass on scan or ultrasound with bladder cancer considered the most likely diagnosis; or a large necrotic bladder tumour on cystoscopy which was not investigated further.The dates of death were obtained from the Registry, and deaths were classified into those due to bladder cancer or other causes, using death certificates and case notes. Stage was determined using pathology reports and case notes, with clinical staging used for all analyses. Initially, tumours were staged as T2, T3, T4a or T4b, but for analyses were classified into advanced (T4b and/or M1) or nonadvanced. Details of histology and grade were obtained from pathology reports.Material deprivation was measured using the Townsend score of the enumeration district (ED) in which the patient lived, determined from Registry postcode details. Scores were classified into five groups based on q...

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“…The accuracy of CT and MRI for the detection of lymph node metastasis was 55% and 60%, respectively. 5 Various treatment modalities in combination with radical cystectomy, particularly adjuvant or neoadjuvant platinumbased chemotherapy, have been tested according to various protocols in order to improve the survival of patients with invasive bladder cancer. There appears to be a slight benefit for the chemotherapy-surgery combination compared with surgery alone, particularly when chemotherapy is delivered in the neoadjuvant setting.…”

Section: Introductionmentioning

confidence: 99%

¹⁸F‐fluorodeoxyglucose positron emission tomography–computed tomography for preoperative lymph node staging in patients undergoing radical cystectomy for bladder cancer: A prospective study

Hitier-Berthault¹,

Ansquer

Branchereau³

et al. 2012

Int J of Urology

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Abbreviations & AcronymsObjectives: The objective of our study was to analyze the diagnostic performance of 18 F-fluorodeoxyglucose positron emission tomography-computed tomography for lymph node staging in patients with bladder cancer before radical cystectomy and to compare it with that of computed tomography. Methods: A total of 52 patients operated on between 2005 and 2010 were prospectively included in this prospective, mono-institutional, open, non-randomized pilot study. Patients who had received neoadjuvant chemotherapy or radiotherapy were excluded. 18 F-fluorodeoxyglucose positron emission tomography-computed tomography in addition to computed tomography was carried out for lymph node staging of bladder cancer before radical cystectomy. Lymph node dissection during radical cystectomy was carried out. Findings from 18 F-fluorodeoxyglucose positron emission tomography-computed tomography and computed tomography were compared with the results of definitive histological examination of the lymph node dissection. The diagnostic performance of the two imaging modalities was assessed and compared. Results: The mean number of lymph nodes removed during lymph node dissection was 16.5 Ϯ 10.9. Lymph node metastasis was confirmed on histological examination in 22 cases (42.3%). This had been suspected in five cases (9.6%) on computed tomography and in 12 cases (23.1%) on 18 F-fluorodeoxyglucose positron emission tomographycomputed tomography. Sensitivity, specificity, positive predictive value, negative predictive value, relative risk and accuracy were 9.1%, 90%, 40%, 57.4%, 0.91 and 55.7%, respectively, for computed tomography, and 36.4%, 86.7%, 66.7%, 65%, 2.72, 65.4%, respectively, for 18 F-fluorodeoxyglucose positron emission tomography-computed tomography. Conclusions:18 F-fluorodeoxyglucose positron emission tomography-computed tomography is more reliable than computed tomography for preoperative lymph node staging in patients with invasive bladder carcinoma undergoing radical cystectomy.

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Limitations of Computerized Tomography in Staging Invasive Bladder Cancer Before Radical Cystectomy

Cited by 209 publications

References 13 publications

Single nucleotide polymorphisms in DNA repair genes might be prognostic factors in muscle-invasive bladder cancer patients treated with chemoradiotherapy

Single nucleotide polymorphisms in DNA repair genes might be prognostic factors in muscle-invasive bladder cancer patients treated with chemoradiotherapy

Bladder cancer: worse survival in women from deprived areas

¹⁸F‐fluorodeoxyglucose positron emission tomography–computed tomography for preoperative lymph node staging in patients undergoing radical cystectomy for bladder cancer: A prospective study

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Limitations of Computerized Tomography in Staging Invasive Bladder Cancer Before Radical Cystectomy

Cited by 209 publications

References 13 publications

Single nucleotide polymorphisms in DNA repair genes might be prognostic factors in muscle-invasive bladder cancer patients treated with chemoradiotherapy

Single nucleotide polymorphisms in DNA repair genes might be prognostic factors in muscle-invasive bladder cancer patients treated with chemoradiotherapy

Bladder cancer: worse survival in women from deprived areas

18F‐fluorodeoxyglucose positron emission tomography–computed tomography for preoperative lymph node staging in patients undergoing radical cystectomy for bladder cancer: A prospective study

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¹⁸F‐fluorodeoxyglucose positron emission tomography–computed tomography for preoperative lymph node staging in patients undergoing radical cystectomy for bladder cancer: A prospective study