Richters, Anke and van Ginkel, Noor and Meijer, Richard P. and Wondergem, Maurits and Schoots, Ivo and Vis, Andre N. and Kiemeney, Lambertus A. L. M. and van Rhijn, Bas W. G. and Witjes, J. Alfred and Aben, Katja K. H. and Mertens, Laura S. (2023) Staging fluorodeoxyglucose positron emission tomography/computed tomography for muscle-invasive bladder cancer: a nationwide population-based study. BJU INTERNATIONAL, 132 (4). pp. 420-427. ISSN 1464-4096, 1464-410X
Full text not available from this repository. (Request a copy)Abstract
Objective To provide insight into the use and staging information on lymph-node involvement added by fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in patients with muscle-invasive bladder cancer (MIBC), based on a nationwide population-based cohort study.Patients and methods We analysed a nationwide cohort of patients with MIBC without signs of distant metastases, newly diagnosed in the Netherlands between November 2017 and October 2019. From this cohort, we selected patients who underwent pre-treatment staging with CT only or CT and FDG-PET/CT. The distribution of patients, disease characteristics, imaging findings, nodal status (clinical nodal stage cN0 vs cN+) and treatment were described for each imaging modality group (CT only vs CT and FDG-PET/CT).Results We identified 2731 patients with MIBC: 1888 (69.1%) underwent CT only; 606 (22.2%) underwent CT and FDG-PET/CT, 237 (8.6%) underwent no CT. Of the patients who underwent CT only, 200/1888 (10.6%) were staged as cN+, vs 217/606 (35.8%) who underwent CT and FDG-PET/CT. Stratified analysis showed that this difference was found in patients with clinical tumour stage (cT)2 as well as cT3/4 MIBC. Of patients who underwent both imaging modalities and were staged with CT as cN0, 109/498 (21.9%) were upstaged to cN+ based on FDG-PET/CT. Radical cystectomy (RC) was the most common treatment within both imaging groups. Preoperative chemotherapy was more frequently applied in cN+ disease and in FDG-PET/CT-staged patients. Concordance of pathological N stage after upfront RC was higher among patients staged as cN+ with CT and FDG-PET/CT (50.0% pN+) than those staged as cN+ with only CT (39.3%).Conclusion Patients with MIBC who underwent pre-treatment staging with FDG-PET/CT were more often staged as lymph node positive, regardless of cT stage. In patients with MIBC who underwent CT and FDG-PET/CT, FDG-PET/CT led to clinical nodal upstaging in approximately one-fifth. Additional imaging findings may influence subsequent treatment strategies.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RADICAL CYSTECTOMY; CARCINOMA; MIGRATION; Bladder cancer; urothelial carcinoma; muscle-invasive; staging; FDG-PET/CT; radical cystectomy; imaging |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 26 Mar 2024 13:39 |
| Last Modified: | 26 Mar 2024 13:39 |
| URI: | https://pred.uni-regensburg.de/id/eprint/60592 |
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