前瞻性评估膀胱癌肌肉侵犯的 VI-RADS 及其对 TURBT 患者再切除/再分期的影响

IF 3.4 2区 医学 Q2 ONCOLOGY
Annals of Surgical Oncology Pub Date : 2025-01-01 Epub Date: 2024-11-04 DOI:10.1245/s10434-024-16424-0
Sukhad Kural, Abhay Kumar Pathak, Shweta Singh, Garima Jain, Mahima Yadav, Sakshi Agarwal, Ishan Kumar, Manjari Gupta, Yashasvi Singh, Ujwal Kumar, Sameer Trivedi, S N Sankhwar, Parimal Das, Lalit Kumar
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引用次数: 0

摘要

背景:膀胱癌(BCa)的诊断依赖于区分肌层浸润性膀胱癌(MIBC)和非肌层浸润性膀胱癌(NMIBC)。经尿道膀胱肿瘤切除术(TURBT)是初步分期和治疗的标准程序。膀胱成像报告和数据系统(VI-RADS)通过先进的成像技术提高了肌肉浸润性诊断的准确性,从而有可能减少对重复 TURBT 的依赖并改善患者管理:我们旨在评估 VI-RADS 在预测 BCa 肌肉侵袭性方面的作用,以及它在预测高风险 NMIBC 的不良病理以避免不必要的重复 TURBT 手术方面的潜力:在这项前瞻性研究中,我们纳入了 62 名接受 TURBT 的 18 岁以上患者。在第二阶段,我们纳入了被选中进行 TURBT 重分期(re-TURBT)的患者,但排除了 T2 肿瘤或低风险 NMIBC 患者。多参数磁共振成像(MRI)检查由放射科医生使用 VI-RADS 5 方法进行评分,病理学家则对 TURBT 和再 TURBT 样本进行分析,以进行准确分期。统计分析评估了 VI-RADS 在 BCa 分期中的作用:结果:在多变量分析中,VI-RADS评分是肌肉侵犯的唯一预测因素。将VI-RADS评分设定为>3时,敏感性、特异性和诊断准确性最高,分别为67.0%、89.0%和78%。VI-RADS对肌肉侵犯的曲线下接收操作特征面积得分在Ta期为85%,T1期为61%,T2期为88%,这显示了VI-RADS在预测MIBC/NMIBC方面的实用性:结论:VI-RADS 可以通过预测肌肉侵犯程度对 BCa 患者进行分层,并识别出可能不需要重复 TURBT 的 NMIBC 病例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prospective Assessment of VI-RADS with Muscle Invasion in Urinary Bladder Cancer and Its Implication on Re-Resection/Restaging TURBT Patients.

Background: Bladder cancer (BCa) diagnosis relies on distinguishing muscle-invasive bladder cancer (MIBC) from non-muscle-invasive bladder cancer (NMIBC) forms. Transurethral resection of the bladder tumor (TURBT) is a standard procedure for initial staging and treatment. The Vesical Imaging-Reporting and Data System (VI-RADS) enhances diagnostic accuracy for muscle invasiveness through advanced imaging techniques, potentially reducing reliance on repeat TURBT and improving patient management.

Objective: We aimed to evaluate the role of VI-RADS in predicting muscle invasiveness in BCa and its potential to predict adverse pathology in high-risk NMIBC to avoid unnecessary repeat TURBT procedures.

Methods: In this prospective study, we included 62 patients over the age of 18 years who underwent TURBT. In a secondary phase, patients selected for restaging TURBT (re-TURBT) were included, but those with T2 tumors or low-risk NMIBC were excluded. Multiparametric magnetic resonance imaging (MRI) examinations were scored by a radiologist using the VI-RADS 5 method, while a pathologist analyzed TURBT and re-TURBT samples for accurate staging. Statistical analysis evaluated the role of VI-RADS in BCa staging.

Results: The VI-RADS score was the only predictive factor for muscle invasion in multivariate analysis. Setting the VI-RADS score at >3 resulted in the highest sensitivity, specificity, and diagnostic accuracy, with values of 67.0%, 89.0%, and 78%, respectively. The receiver operating characteristic area under the curve score for VI-RADS for muscle invasion was 85% for stage Ta, 61% for stage T1, and 88% for stage T2, which shows the utility of VI-RADS in the predictiveness of MIBC/NMIBC.

Conclusion: VI-RADS is effective in stratifying BCa patients by predicting muscle invasiveness and identifying NMIBC cases that may not need repeat TURBT.

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来源期刊
CiteScore
5.90
自引率
10.80%
发文量
1698
审稿时长
2.8 months
期刊介绍: The Annals of Surgical Oncology is the official journal of The Society of Surgical Oncology and is published for the Society by Springer. The Annals publishes original and educational manuscripts about oncology for surgeons from all specialities in academic and community settings.
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