Risk Factors for DisconcordanceBetween Pre and Post Radical Cystectomy Stages

PURPOSE: To investigate the correlation between pre and post surgical staging in patients undergoing radical cystectomy (RC), and study the possibility of predicting their disconcordance.MATERIALS AND METHODS: We reviewed medical records of 186 patients diagnosed with transitional cell carcinoma of...

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Main Authors: Seyed Hossein Saadat, Mohammad Omar Al-Tawil
Format: Article
Language:English
Published: Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences 2011-11-01
Series:Urology Journal
Subjects:
Online Access:http://www.urologyjournal.org/index.php/uj/article/view/1237/620
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author Seyed Hossein Saadat
Mohammad Omar Al-Tawil
author_facet Seyed Hossein Saadat
Mohammad Omar Al-Tawil
author_sort Seyed Hossein Saadat
collection DOAJ
description PURPOSE: To investigate the correlation between pre and post surgical staging in patients undergoing radical cystectomy (RC), and study the possibility of predicting their disconcordance.MATERIALS AND METHODS: We reviewed medical records of 186 patients diagnosed with transitional cell carcinoma of the bladder, who had undergone RC between the years 2007 and 2010. We determined the correlation between pre and post surgical stages and then studied the association between stage disconcordance and age, gender, smoking, history of previous transurethral resection of bladder tumor (TURBT) and intravesical treatments, re-TURBT in high-risk superficial bladder tumors, and the treatment delay between diagnosis and RC. Analysis was performed using Chi-Square and Fisher’s Exact tests.RESULTS: Post surgical up-staging occurred in 86 (46.24%) patients and even more (69.35%) if lymph node involvement was also considered as up-staging. Smokers and those with pre surgical stages of ≤ T1 and T2 with no history of re-TURBT had a significantly increased risk of disconcordance. The risk of up-staging was almost halved by an early re-TURBT in high-risk patients.CONCLUSION: Disconcordance between pre and post surgical stages in patients undergoing RC is common. Until better ways of staging are developed, decision making in patients with bladder tumor should be done by extra attention to patients who have risk factors associated with increased risk of up-staging, including smokers and those with nonmuscle-invasive bladder tumors or T2 tumors. An early re-TURBT will decrease the up-staging rate.
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spelling doaj.art-d33e47b0bfd84298b6410f9414db0bbc2022-12-21T19:17:21ZengUrology and Nephrology Research Center, Shahid Beheshti University of Medical SciencesUrology Journal1735-13081735-546X2011-11-0184291297Risk Factors for DisconcordanceBetween Pre and Post Radical Cystectomy StagesSeyed Hossein SaadatMohammad Omar Al-TawilPURPOSE: To investigate the correlation between pre and post surgical staging in patients undergoing radical cystectomy (RC), and study the possibility of predicting their disconcordance.MATERIALS AND METHODS: We reviewed medical records of 186 patients diagnosed with transitional cell carcinoma of the bladder, who had undergone RC between the years 2007 and 2010. We determined the correlation between pre and post surgical stages and then studied the association between stage disconcordance and age, gender, smoking, history of previous transurethral resection of bladder tumor (TURBT) and intravesical treatments, re-TURBT in high-risk superficial bladder tumors, and the treatment delay between diagnosis and RC. Analysis was performed using Chi-Square and Fisher’s Exact tests.RESULTS: Post surgical up-staging occurred in 86 (46.24%) patients and even more (69.35%) if lymph node involvement was also considered as up-staging. Smokers and those with pre surgical stages of ≤ T1 and T2 with no history of re-TURBT had a significantly increased risk of disconcordance. The risk of up-staging was almost halved by an early re-TURBT in high-risk patients.CONCLUSION: Disconcordance between pre and post surgical stages in patients undergoing RC is common. Until better ways of staging are developed, decision making in patients with bladder tumor should be done by extra attention to patients who have risk factors associated with increased risk of up-staging, including smokers and those with nonmuscle-invasive bladder tumors or T2 tumors. An early re-TURBT will decrease the up-staging rate.www.urologyjournal.org/index.php/uj/article/view/1237/620urinary bladder neoplasmsneoplasm stagingcystectomysmoking
spellingShingle Seyed Hossein Saadat
Mohammad Omar Al-Tawil
Risk Factors for DisconcordanceBetween Pre and Post Radical Cystectomy Stages
Urology Journal
urinary bladder neoplasms
neoplasm staging
cystectomy
smoking
title Risk Factors for DisconcordanceBetween Pre and Post Radical Cystectomy Stages
title_full Risk Factors for DisconcordanceBetween Pre and Post Radical Cystectomy Stages
title_fullStr Risk Factors for DisconcordanceBetween Pre and Post Radical Cystectomy Stages
title_full_unstemmed Risk Factors for DisconcordanceBetween Pre and Post Radical Cystectomy Stages
title_short Risk Factors for DisconcordanceBetween Pre and Post Radical Cystectomy Stages
title_sort risk factors for disconcordancebetween pre and post radical cystectomy stages
topic urinary bladder neoplasms
neoplasm staging
cystectomy
smoking
url http://www.urologyjournal.org/index.php/uj/article/view/1237/620
work_keys_str_mv AT seyedhosseinsaadat riskfactorsfordisconcordancebetweenpreandpostradicalcystectomystages
AT mohammadomaraltawil riskfactorsfordisconcordancebetweenpreandpostradicalcystectomystages