Are there any metastases to the chest in non-muscle-invasive bladder cancer patients on follow-up computed tomography?
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The purpose of the study was to retrospectively determine whether there are metastases to the chest in patients with primary non-muscle-invasive urothelial carcinoma in the bladder on the follow-up computed tomography (CT).
We analyzed 328 patients with follow-up chest CT for urothelial carcinoma of the bladder diagnosed between January 2004 and September 2013. We divided patients into four groups: Ta (n = 74), T1 (n = 78), carcinoma in situ (CIS, n = 25), and ≥ T2 (n = 151). We used the chest CT to determine whether there were positive findings of metastasis. Univariate and multivariate analyses were achieved using categories of T stage, histological grade, multifocal lesions, and recurrence.
On univariate analysis, there were significant differences on T stage (p < 0.001) and histological grade (p = 0.001), and there was no significant difference on multifocal lesions (p = 0.11) and recurrence (p = 0.34). Positive findings of metastases were observed in 1.4% (1/74) of the Ta patients, 0% (0/78) of the T1 patients, 8.0% (2/25) of the patients with carcinoma in situ (CIS), and 27.2% (41/151) of the ≥ T2 patients (p < 0.001). On multivariate analysis, T staging was independent variable for positive findings of metastasis (Odds ratio; 2.84, 95% Confidence Interval; 1.65–4.89). In contrast, histological grade, multifocal lesions, and recurrence were not independent variables.
T stage would affect to metastasis to the chest. It might be appropriate to omit chest CT in patients with Ta or T1 without upstaging in the course of follow-up. We may suggest that the follow-up chest CT in patients with CIS.
KeywordsBladder cancer Metastasis Chest CT Follow-up
We were not supported by any sources of financial grants or other funding.
HJ: data collection, data analysis, manuscript writing. MK: data collection. HA: manuscript editing. YN: manuscript editing
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.
- 7.Kakei Y, Nishio Y, Hashimura T, Takeuchi H, Yoshida O (1992) Clinicopathological analysis on invasion and metastasis in superficial bladder cancer. Hinyoukika Kiyo 38:783–788Google Scholar
- 18.Van der Pol CB, Sahni VA, Ederhaedt SC, Oto A, Akin O, Alexander LF et al American College of Radiology. ACR appropriateness criteria revised 2017. Pretreatment staging for muscle-invasive bladder cancer. https://acsearch.acr.org/docs/69370/Narrative/