The Implementation of FDG PET/CT for Staging Bladder Cancer: Changes in the Detection and Characteristics of Occult Nodal Metastases at Upfront Radical Cystectomy?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Pretreatment Staging and Evaluation
2.3. Surgical PLND-Template and Histopathology
2.4. Statistical Analysis
3. Results
3.1. Patient Selection and Characteristics
3.2. Diagnostic Accuracy Cohort A
3.3. Occult Lymph Node Metastases
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Cohort A (n = 237) | Cohort B (n = 286) | p-Value | ||
---|---|---|---|---|
Age, years, mean (SD) | 67 (11) | 63 (9) | <0.001 | |
Sex, n (%) | 0.65 | |||
Male | 174 (73) | 215 (75) | ||
Female | 63 (27) | 71 (25) | ||
cT-stage, n (%) | 0.16 | |||
T1 | 75 (32) | 90 (31) | ||
T2 | 106 (45) | 137 (48) | ||
T3 | 48 (20) | 41 (14) | ||
T4 | 8 (3) | 18 (6) | ||
cN-stage, n (%) | 0.009 | |||
N0 | 211 (91) | 272 (95) | ||
N+ (CE-CE) | 21 (9) | 14 (5) | ||
N+ (FDG PET/CT + CE-CT) | 26 (10) | NA |
FDG PET/CT | CE-CT | ||||
---|---|---|---|---|---|
% | 95% CI | % | 95% CI | p-Value | |
Sensitivity | 23 | 0.13–0.38 | 15 | 0.07–0.29 | 0.29 |
Specificity | 92 | 0.87–0.95 | 93 | 0.88–0.96 | 1 |
Positive predictive value | 42 | 0.24–0.63 | 33 | 0.16–0.57 | |
Negative predictive value | 83 | 0.77–0.88 | 81 | 0.76–0.86 | |
Accuracy | 79 | 0.74–0.84 | 77 | 0.72–0.83 | |
Area under the ROC curve | 0.578 | 0.48–0.68 | 0.538 | 0.44–0.63 | 0.21 |
Cohort A (n = 211) | Cohort B (n = 272) | p-Value | ||
---|---|---|---|---|
pT-status (n, %) | 0.97 | |||
0 | 34 (16) | 46 (17) | ||
Cis/1 | 63 (30) | 81 (30) | ||
2 | 41 (19) | 56 (21) | ||
3 | 44 (21) | 64 (24) | ||
4 | 16 (8) | 25 (9) | ||
X | 13 (6) | 0 (0) | ||
pN-status (n, %) | 0.606 | |||
0 | 175 (83) | 213 (78) | ||
1 | 20 (10) | 30 (11) | ||
2–3 | 26 (8) | 29 (11) | ||
Number of lymph nodes removed (median, IQR) | 20 (15–25) | 15 (12–21) | <0.001 | |
Size positive lymph nodes, mm (median, IQR) | 4 (2–10) | 13 (10–25) | <0.001 |
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Einerhand, S.M.H.; Zuur, L.G.; Wondergem, M.J.; Boellaard, T.N.; Barwari, K.; van Leeuwen, P.J.; van Rhijn, B.W.G.; Mertens, L.S. The Implementation of FDG PET/CT for Staging Bladder Cancer: Changes in the Detection and Characteristics of Occult Nodal Metastases at Upfront Radical Cystectomy? J. Clin. Med. 2023, 12, 3367. https://doi.org/10.3390/jcm12103367
Einerhand SMH, Zuur LG, Wondergem MJ, Boellaard TN, Barwari K, van Leeuwen PJ, van Rhijn BWG, Mertens LS. The Implementation of FDG PET/CT for Staging Bladder Cancer: Changes in the Detection and Characteristics of Occult Nodal Metastases at Upfront Radical Cystectomy? Journal of Clinical Medicine. 2023; 12(10):3367. https://doi.org/10.3390/jcm12103367
Chicago/Turabian StyleEinerhand, Sarah M. H., Lotte G. Zuur, Maurits J. Wondergem, Thierry N. Boellaard, Kurdo Barwari, Pim J. van Leeuwen, Bas W. G. van Rhijn, and Laura S. Mertens. 2023. "The Implementation of FDG PET/CT for Staging Bladder Cancer: Changes in the Detection and Characteristics of Occult Nodal Metastases at Upfront Radical Cystectomy?" Journal of Clinical Medicine 12, no. 10: 3367. https://doi.org/10.3390/jcm12103367
APA StyleEinerhand, S. M. H., Zuur, L. G., Wondergem, M. J., Boellaard, T. N., Barwari, K., van Leeuwen, P. J., van Rhijn, B. W. G., & Mertens, L. S. (2023). The Implementation of FDG PET/CT for Staging Bladder Cancer: Changes in the Detection and Characteristics of Occult Nodal Metastases at Upfront Radical Cystectomy? Journal of Clinical Medicine, 12(10), 3367. https://doi.org/10.3390/jcm12103367