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ESMO 2022: Can MRI-Based Staging of Newly Diagnosed Bladder Cancer Shorten the Time to Appropriate Treatment?

By: Julia Fiederlein
Posted: Monday, September 12, 2022

For a century, transurethral resection of bladder tumor (TURBT) has been the first-line procedure for the staging of bladder cancer. Nicholas D. James, MBBS, PhD, of University Hospitals Birmingham NHS Foundation Trust, United Kingdom, and colleagues conducted the BladderPath study to determine whether the substitution of TURBT with MRI and biopsy in patients with suspected muscle-invasive bladder cancer may shorten the time to appropriate treatment. The first results were presented during the European Society for Medical Oncology (ESMO) Congress 2022 (Abstract 1733MO).

“An MRI-directed pathway led to substantial shortening of time to correct treatment for patients with muscle-invasive bladder cancer with no detrimental effect of time to treatment for patients with non-muscle–invasive bladder cancer,” the investigators commented. “Consideration should be given to incorporation of MRI into the standard pathway for all patients with suspected invasive bladder cancer.”

Between May 2018 and December 2021, 143 patients with suspected bladder cancer were identified. Those with possible muscle-invasive disease (52.1%) were randomly assigned to undergo standard TURBT assessment or MRI-based assessment with tumor biopsy. Patients with probable non-muscle–invasive disease (47.9%) underwent TURBT assessment.

A total of 95% of patients with muscle-invasive bladder cancer followed the correct staging pathway. In patients with muscle-invasive bladder cancer, the median time to appropriate treatment was 98 days with TURBT assessment and 53 days with MRI-based assessment (hazard ratio [HR] = 3.4; log-rank P = .0046). The median times to appropriate treatment were 37 and 31 days, respectively, in all patients (HR = 1.3). 

Disclosure: The study authors reported no conflicts of interest.

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