Ricerc@Sapienza

Bladder cancer (BCa) is a highly prevalent disease worldwide and one with the highest managment costs. Surgical management of non muscle and muscle invasive bladder cancer (NMIBC, MIBC) differs substantially. The initial transurethral resection of bladder tumor (TURBT) is the first diagnostic and therapeutic procedure for NMIBC, instead, only a diagnostic procedure for MIBC patients suitable for radical cystectomy (RC). For this reason, prognosis and treatment of patients with BCa requires accurate staging at the time of diagnosis.
Recently, a reporting system standardizing multiparametric magnetic resonance imaging (mpMRI) of the bladder, the Vesical Imaging-Reporting and Data system (VI-RADS), has been developed with the aim to differentiate NMIBC from MIBC.
The category of high-risk NMIBC (HR-NMIBCs) undergo repeated transurethral resection of bladder tumor site (Re-TURBT) due to risk of persistent and/or understaged disease after initial TURBT.
In light of the background, the aim of the project are to prospectively asses the use of VI-RADS in NMI-and-MIBC discrimination at TURBT, to identify HR-NMIBCs who could potentially avoid Re-TURBT and to detect those at higher risk for understaging after TURBT.
Patients referred for bladder cancer (BCa) suspicion, at our institution will be offered multiparametric magnetic-resonance-imaging (mpMRI) of the bladder before TURBT. According to VI-RADS, a cutoff >= 3 to define MIBC will be assumed. Primary TURBT reports (whole cohort) will be compared with preoperative VI-RADS scores to assess accuracy of mpMRI in discriminating NMI-and-MIBC.
At the same time, re-TURBT reports from HR-NMIBCs will be compared with preoperatively recorded VI-RADS scores to assess accuracy of mpMRI in predicting Re-TURBT outcomes.