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Beitragstitel The impact of bone scintigraphy as primary staging and follow-up imaging on the management of patients with invasive bladder cancer
Beitragscode M018
Autor:innen
  1. Piet Bosshard Inselspital, Universitätsspital Bern Präsentierende:r
  2. Thomas Grüter Inselspital, Universitätsspital Bern
  3. Marc Furrer Inselspital, Universitätsspital Bern
  4. Amir Naiem Inselspital, Universitätsspital Bern
  5. Bernhard Kiss Inselspital, Universitätsspital Bern
  6. Beat Roth Inselspital, Universitätsspital Bern
Präsentationsform Freie Mitteilungen
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Abstract-Text Introduction and Objective: According to current guidelines, bone scan (scintigraphy) is not routinely indicated in patients with invasive bladder cancer unless specific symptoms occur. However, data quality leading to these recommendations are very sparse and of low quality. This large retrospective single center study assessed whether bone scan (BS) imaging affects management of patients with newly diagnosed invasive bladder cancer scheduled for radical cystectomy (RC), and whether there is a place for BS as follow-up imaging following RC. Material and Methods: Retrospective analysis of 1287 consecutive patients who were scheduled for RC with pelvic lymph node dissection due to invasive bladder cancer at our department between 01/2000 and 12/2017. BS were obtained for primary staging prior to intended RC and during follow-up (6, 12, and 18 mts postoperative) in patients withpT3/4and/or pN+ disease. Primary endpoint was the change in patient management according to the BS results. Secondary endpoints were the need for additional imaging due to positive or suspicious BS results, as well as CSS and OS depending on BS results.Results: Of 1287 patients intended for RC, 1149 (89%) had BS as staging imaging. Primary osseous metastatic disease was found in 1.9% (25/1287) of patients. Finally, 87% (1122/1287) of patients underwent RC; 38% (427/1122) of these patients had at least one BS as follow-up imaging. Overall, BS led to a change in planned management in 1.7% (19/1149) of patients as staging diagnostic, and in 1.8% (15/827) of follow-up BS examinations. Additional imaging was performed after 44% (36/82) and 60% (61/101) positive or unclear/suspicious BS as staging and follow-up imaging, respectively. Of all additional imaging, 31% (11/36) as part of the staging and 77% (47/61) as part of follow-up imaging substantiated the suspicion of a bone metastasis. Yet, in 17% (13/78) of patients, with unclear/suspicious findings on follow-up BS, a bone metastasis could be excluded by comparison with the findings of the corresponding staging BS. CSS and OS did not significantly differ depending on the different BS staging results. Conclusions: Primary osseous metastases in patients with invasive bladder cancer rarely occurs. BS had almost no influence on clinical management of these patients, both if obtained as a staging procedure and during follow-up. These results demonstrate the limited value of BS in bladder cancer and question their routine use.