Comparison of the Clinical and Pathologic Staging in Patients Undergoing Radical Cystectomy, the Factors Associated with Upstaging and its Effect on Outcome

Abstract

Bladder cancer is clinically understaged in about half of the cases and no improvements in solving this problem has been observed during the past 25 years. Patients who are clinically upstaged after radical cystectomy have higher recurrence and bladder cancer mortality rates when compared to those who are correctly staged. Currently, reliable predictors of extravesical upstaging at the time of radical cystectomy do not exist. In various studies of T2 staging, hydronephrosis, carcinoma in situ, high- grade disease, lymphovascular invasion, female gender and neutrophil- lymphocyte ratio are found to be associated with upstaging.