Editing Bladder Cancer: Diagnosis and Evaluation (section)

== Clinical Staging in Patients Diagnosed with Bladder Cancer ==

* '''<span style="color:#ff0000">Pathologic stage is determined by microscopic analysis of radical cystectomy and pelvic lymphadenectomy specimens</span>'''
* '''<span style="color:#ff0000">Clinical stage based on (4):</span>'''
*# '''<span style="color:#ff0000">TURBT pathology</span>'''
*#* See TNM staging in bladder cancer
*#* '''2021 CUA NMIBC Guidelines: Pathological review,''' preferably by a dedicated uro-pathologist, '''should be considered in settings where variant histology is suspected or atypical tumours are seen during TURBT (e.g., sessile mass)'''
*# '''<span style="color:#ff0000">Physical exam, including bimanual exam under anesthesia</span>'''
*# '''<span style="color:#ff0000">Imaging</span>'''
*#* '''<span style="color:#ff0000">Contrast-enhanced cross-sectional imaging of the abdomen and pelvis with upper tract imaging</span>'''
*#* '''<span style="color:#ff0000">Chest radiography</span>'''
*# '''<span style="color:#ff0000">Laboratory investigations</span>'''
*#* '''<span style="color:#ff0000">Liver function tests</span>'''
* '''Understaging in NMIBC'''
**'''There is significant potential for understaging''' in patients with HG, apparently NMIBC, '''especially those that appear to be stage T1.'''
*** '''One third of patients believed to have NMIBC at the time of cystectomy were found to actually have muscle invasion;''' only half of these cases were organ confined.
*** '''Up to 50% of patients with clinical stage T2 tumours are upstaged on pathology.'''