Relationship of MRI and clinical staging to outcome in invasive bladder cancer treated by radiotherapy.
OBJECTIVE
To compare MRI and clinical staging of invasive bladder cancer prospectively and identify additional prognostic features on MRI before radiotherapy.


METHODS
143 patients with a pathological diagnosis of transitional cell carcinoma underwent MRI (1.0 T) of the abdomen and pelvis before radical radiotherapy. Tumour size, site, degree of infiltration, presence of adenopathy and hydronephrosis were assessed and an appropriate radiological stage assigned. Following radiotherapy all patients received regular cystoscopic follow-up. Date of first relapse and date of death were recorded.


RESULTS
The median follow-up was 2.8 years for survivors. Those patients upstaged from T2a clinically to T3b on MRI had a significantly worse outcome (P = 0.0078). In univariate analysis a number of MRI features were significantly associated with adverse outcome: tumour size, circumferential tumour extent, and presence of hydronephrosis (all P < 0.05). After adjustment for clinical T stage and histological grade, all these MRI features and the MRI T stage were found to confer additional prognostic information in predicting early disease relapse and death (P < 0.05).


CONCLUSIONS
This study demonstrates that MRI before radiotherapy provides valuable additional prognostic information compared to clinical staging.
Robinson
P
P
Departments of Diagnostic Radiology, Christie Hospital, Manchester, UK.
Collins
C D
CD
Ryder
W D
WD
Carrington
B M
BM
Hutchinson
C E
CE
Bell
D
D
Logue
J P
JP
Read
G
G
Cowan
R A
RA
D000368:Aged; D000704:Analysis of Variance; D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000532:radiotherapy*