To assess accuracy of vesical imaging-reporting and data system (VI-RADS) 5-point score in detection of muscle invasive
bladder cancer and avoiding second look transurethral resection of the tumors (TURBT). Additionally, to assess safety and efficacy of bipolar
en-block transurethral urethral resection of bladder tumor.
Methods: Patients with bladder mass up to 5 cm were included in the study. VI-RADS 5-point score was done preoperative for all cases
and postoperatively before second look TURBT. Patients were followed up for 12 months.
Results: In all, 80 cases were eligible for the study. Preoperative VI-RADS score at cutoff of 3 had sensitivity of 89.3 %, specificity 83.3
%, postive predective value (PPV) 92.6 %, negative predictive value (NPV) 76.9 %, accuracy of 87.5 %, while at cutoff 2 sensitivity was
82.1%, specificity 91.7%, PPV 95.8%, NPV 68.8%, accuracy of 85.0%. Operative time 28.8 § 9.4 minutes, hemoglobin drop 0.3 §
0.05 g/dl, catheterization time 2.8 § 0.8 days, hospital stay 1.4 § 0.4 days. No complications occurred. Recurrence in field of resection
3.75%. Detrusor muscle was available in 76 cases (95%). Postoperative VI-RADS score at cutoff of 3 had sensitivity of 78.6%, specificity
77.8%, PPV 84.6%, NPV 70.0%, accuracy of 78.3%. At cutoff 2 VI-RADS score sensitivity was 71.4%, specificity 77.8%, PPV 83.3%,
NPV 63.6%, accuracy of 73.9%.
Conclusion: VI-RADS 5-point score showed high sensitivity and specificity in preoperative discrimination of nonmuscle invasive
bladder cancer (NMIBC) from muscle invasive bladder cancer cases and in avoiding unnecessary second look TURBT. Bipolar en-block
TURBT technique is both safe and efficacious in resecting NMIBC cases with low recurrence rate. 2022 Elsevier Inc. All rights reserved. |
