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  • Title: Are there any metastases to the chest in non-muscle-invasive bladder cancer patients on follow-up computed tomography?
    Author: Juri H, Koyama M, Azuma H, Narumi Y.
    Journal: Int Urol Nephrol; 2018 Oct; 50(10):1771-1778. PubMed ID: 30117014.
    Abstract:
    PURPOSE: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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