[Clinical-pathology relationship in bladder cancer].

OBJECTIVES: Analyze the role of the Computerized Axial Tomography (TAC) like image study of pre-surgery stadification, in the subjected patients to radical cystectomy, for the treatment of muscle infiltrate bladder cancer.

METHODS: Retrospective study of cohorts on 63 subjected patients to radical cystectomy for bladder cancer, in oneself service, between january of 1995 and december of 2.005. The capacity of the TAC was determined for the stadification bladder (pT), node (pN) and the results were compared, with the obtained ones in the pathological anatomy after the radical cystectomy, acording to TNM clasification. The possible impact of this image technique was evaluated in the change of surgical attitude in these patients.

RESULTS: The estimate of bladder affectation with TAC was correct in 28.6%, sub-estadificate in 50.8%, and up-estadificate in 20.6%. The TAC for the bladder possesses a lower sensibility the more outpost it is this affectation. It specificity is higher the more advanced locally is the cancer, oscillating among 44% in the pT2 and 94% in the pT4. Regarding the estadification node, it is correct in 73.5% of all cases, although this percentage depends almost exclusively on the patients with negative node (N -). These data offer us a sensibility of 28%, specificity of 55%, positive predictive value of 68% and negative predictive of 67%.

SUMMARY: The impact of the TAC in the clinical estadification of the infiltrate bladder cancer is relatively low. The biggest benefit is obtained in patient with suspicion of advanced illness. Its limitation to this group would suppose a significant reduction of costs, with low risk of an inappropriate surgical handling.