PD42-12 MODELING THE CONTRIBUTION OF PREOPERATIVE VI-RADS SCORE TO PREDICT FINAL PATHOLOGIC LYMPH-NODES INVOLVEMENT IN PATIENTS WITH MIBC UNDERGONE RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyCME1 May 2022PD42-12 MODELING THE CONTRIBUTION OF PREOPERATIVE VI-RADS SCORE TO PREDICT FINAL PATHOLOGIC LYMPH-NODES INVOLVEMENT IN PATIENTS WITH MIBC UNDERGONE RADICAL CYSTECTOMY Francesco Del Giudice, Martina Pecoraro, Maurizio Del Monte, Marco Bicchetti, Emanuele Messina, Ailin Dehghanpour, Benjamin I. Chung, Ettore De Berardinis, Alessandro Sciarra, Carlo Catalano, and Valeria Panebianco Francesco Del GiudiceFrancesco Del Giudice More articles by this author , Martina PecoraroMartina Pecoraro More articles by this author , Maurizio Del MonteMaurizio Del Monte More articles by this author , Marco BicchettiMarco Bicchetti More articles by this author , Emanuele MessinaEmanuele Messina More articles by this author , Ailin DehghanpourAilin Dehghanpour More articles by this author , Benjamin I. ChungBenjamin I. Chung More articles by this author , Ettore De BerardinisEttore De Berardinis More articles by this author , Alessandro SciarraAlessandro Sciarra More articles by this author , Carlo CatalanoCarlo Catalano More articles by this author , and Valeria PanebiancoValeria Panebianco More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002603.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Muscle invasive bladder cancers (MIBCs) eligible for radical cystectomy (RC) are frequently associated with subsequent pathologic regional LN involvement (pN1-3). Involvement increases with the depth of invasion, thus preoperative tools aiming to predict final histology would assume particular relevance given that a significant subset of patients may be rendered long term disease free with surgery alone. We explored the ability of the novel Vesical-Imaging Reporting and Data System (VI-RADS) score to correlate with pN+ status and lymph node density (LNd) at RC pathology report. METHODS: Patients’ ineligible neoadjuvant chemotherapy who underwent multiparametric magnetic resonance imaging (mpMRI) of the bladder prior to staging trans-urethral resection of bladder tumor (TURBT) followed by RC and extended pelvic lymph-node dissection (ePLND) for cT2-4 N0 M0 MIBC. Multivariable logistic regression model and receiver operating characteristics curve (ROC) were used to asses VI-RADS features to predict final pN+ status and higher LNd. RESULTS: n=128 T2–T4a, cN0–M0 patients (VI-RADS Score 5, n= 39, Score 4, n=52, Score 3, n=37) were examined. pN+ rate was 27% with n=10 (7.8%), n=26 (20.3%) presenting with pN1 and pN2 respectively. Mean lymph node density (SD) was 9% (1.5%). Increasing VI-RADS score was independently associated with higher odd of LN+ status (OR, 1.79, 95%CI: 1.24 – 2.47). Moreover, VI-RADS score 5 presented an area under the curve (AUC) of 0.89 (95%CI: 0.74 – 0.96) for LNd threshold of 5.7% when compared to preoperative VI-RADS 3-4. CONCLUSIONS: VI-RADS is a novel tool potentially able to preoperatively predict MIBCs at higher risk for presenting pN+ status at final RC histological report. In future VI-RADS could serve as a non-invasive method to aid urologists planning the extent of LN template thus balancing the benefit and morbidity of extended vs. limited LN dissection at the moment of RC. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e700 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Francesco Del Giudice More articles by this author Martina Pecoraro More articles by this author Maurizio Del Monte More articles by this author Marco Bicchetti More articles by this author Emanuele Messina More articles by this author Ailin Dehghanpour More articles by this author Benjamin I. Chung More articles by this author Ettore De Berardinis More articles by this author Alessandro Sciarra More articles by this author Carlo Catalano More articles by this author Valeria Panebianco More articles by this author Expand All Advertisement PDF DownloadLoading ...