How is bladder cancer staged prior to radical cystectomy?

Updated: Nov 27, 2016
  • Author: Michael Christopher Large, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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  • Upon recognition of disease that may prove amenable to radical cystectomy, preoperative staging is essential for stratifying the chance of disease eradication and recurrence risk, as well as for identifying patients with metastatic foci who are not candidates for surgery. Preoperative staging involves the following:

    • The patient is examined under anesthesia to determine if the mass is fixed (pT4) or mobile. In women, this includes a bimanual pelvic examination; in men, this includes a bimanual examination with one hand per rectum and the other on the lower abdominal wall.

    • CT scanning of the abdomen and pelvis is performed. Both overstaging (20%) and understaging (50%) are common if only one study is performed.

    • Chest radiography is performed to assess for metastatic deposits.

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