IBCN 2022: The Accuracy of Cystoscopy in Predicting Detrusor Invasion in Newly Diagnosed Bladder Cancer Patients

(UroToday.com) The prognosis of muscle-invasive bladder cancer (MIBC) has not improved during the last three decades. Transurethral resection of the bladder tumor (TURBT) is the standard procedure for local tumor staging. Studies have shown TURBT to have a substantial number of limitations, including the spread of circulating tumor cells (CTCs). This urges the development of an alternative local staging strategy. They aimed at expanding the available evidence on the accuracy of cystoscopy to predict muscle invasion in newly diagnosed bladder cancer (BC) patients.


They included 304 newly diagnosed BC patients from one of 6 collaborating Dutch hospitals between July 2020 and February 2022. Predictions of detrusor muscle invasion using a 5-point Likert scale alongside the histopathology data were recorded. The sensitivity, specificity, predictive values, and 95% confidence intervals were determined using a standard contingency table.

A total of 217 (72.4%) of the confirmed carcinomas received a histopathological diagnosis of non-muscle-invasive bladder cancer (NMIBC), 65 (21.6%) were classified as (muscle invasive bladder cancer (MIBC), and 2 (0.7%) were unknown. Cystoscopy could predict detrusor invasion with a sensitivity of 69.2% (95%CI: 56.6-80.1), and a specificity of 90.2% (95%CI: 85.6-93.7). This corresponded to a positive predictive value (PPV) of 66.2% and a negative predictive value (NPV) of 91.3%.

In summary, this study showed a moderate accuracy of cystoscopy to predict detrusor invasion. This result does not support cystoscopy to replace TURBT for local staging.

Presented by: Christine van Straten, Radboud University Medical Center, Nijmegen, The Netherlands

Written by: Stephen B. Williams, MD, MBA, MS @SWilliams_MD on Twitter during the International Bladder Cancer Network Annual Meeting, September 28-October 1, 2022, Barcelona, Spain