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  • Asad, DannaUmeå universitet,Urologi och andrologi,Umeå Univ, Dept Surg & Perioperat Sci Urol & Androl, S-90185 Umeå, Sweden. (author)

A prospective multicenter study of visual response-evaluation by cystoscopy in patients undergoing neoadjuvant chemotherapy for muscle invasive urinary bladder cancer

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • 2021-11-21
  • Informa UK Limited,2022
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-468911
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-468911URI
  • https://doi.org/10.1080/21681805.2021.2002402DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-189869URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-181455URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding Agencies|Swedish Research Council funding for clinical research in medicine (ALF) in Vasterbotten, VLL, Sweden [BasALF/VLL RV-848051]; Cancer Research Foundation in Norrland, Umea, Sweden [CFF LP 13-2000]
  • Purpose To evaluate a method of transurethral visual response-staging in patients with urothelial muscle-invasive urinary bladder cancer (MIBC), undergoing neoadjuvant chemotherapy (NAC) and radical cystectomy (RC). Methods A prospective study at four Swedish cystectomy centers, cystoscopy was performed after final NAC-cycle for MIBC. Fifty-six participants underwent cystoscopy for visual staging of the tumor immediately pre-RC. Visual assessments were correlated to pathoanatomical outcomes post-RC. Results Seventeen tumors were classified as complete response (CR), i.e. pT0. Twenty-five patients had residual MIBC and 14 had non-muscle invasive residual tumors (NMIBC). Of the 39 patients with residual tumor, 25 were correctly identified visually (64%). Eleven patients were pN+. The diagnostic accuracy of cystoscopy to correctly identify complete response or remaining tumor was 70% (CI = 56-81%) with a sensitivity of 64% (CI = 47-79%), specificity 82% (CI = 57-96%), PPV 89% (CI = 74-96%) and NPV 50% (CI =38-61%). Twenty-eight cystoscopy evaluations showed signs of residual tumors and 3/28 (11%) were false positive. In 4/14 patients assessed having residual NMIBC the estimates were correct, 8/14 had histopathological MIBC and 2/14 had CR. In 11/14 patients (79%), the suggested visual assessment of MIBC was correct, 2/14 had NMIBC and 1/14 had CR. Twenty-eight cystoscopies had negative findings, 14 were false negatives (50%), when cystoscopy falsely predicted pT0. Among them there were eight patients with pTa, pT1 or pTis and six MIBC-tumors. In 17 patients with histopathological pT0, 14 were correctly identified with cystoscopy (82%). Conclusion Cystoscopy after the final NAC-cycle cannot robustly differentiate between NAC-responders and non-responders. Visually, negative MIBC-status cannot be determined safely.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Styrke, JohanUmeå universitet,Urologi och andrologi,Umeå Univ, Dept Surg & Perioperat Sci Urol & Androl, S-90185 Umeå, Sweden.(Swepub:umu)jonste00 (author)
  • Hagsheno, MohammadUppsala universitet,Institutionen för kirurgiska vetenskaper,Uppsala Univ, Sweden (author)
  • Johansson, MarkusUmeå universitet,Urologi och andrologi,Umeå Univ, Dept Surg & Perioperat Sci Urol & Androl, S-90185 Umeå, Sweden. (author)
  • Huge, YlvaLinköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland(Swepub:liu)ylvhu61 (author)
  • Svensson, Johan,1978-Umeå universitet,Statistik,Umeå Univ, Umeå Sch Business Econ & Stat USBE, Dept Stat, Umeå, Sweden.(Swepub:umu)josv0027 (author)
  • Pelander, SofiaLinköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland(Swepub:liu)n/a (author)
  • Lauer, JanNyköping Cty Hosp, Dept Surg, Nyköping, Sweden. (author)
  • Netterling, HansUmeå universitet,Urologi och andrologi,Umeå Univ, Dept Surg & Perioperat Sci Urol & Androl, S-90185 Umeå, Sweden.(Swepub:umu)halu0001 (author)
  • Abdul-Sattar Aljabery, FirasLinköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland(Swepub:liu)firab05 (author)
  • Sherif, AmirUmeå universitet,Urologi och andrologi,Umeå Univ, Dept Surg & Perioperat Sci Urol & Androl, S-90185 Umeå, Sweden.(Swepub:umu)amsh0008 (author)
  • Umeå universitetUrologi och andrologi (creator_code:org_t)

Related titles

  • In:Scandinavian journal of urology: Informa UK Limited56:1, s. 20-262168-18052168-1813

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