In this study, US accurately diagnosed bladder cancer in 78.6% (11 of 14) of patients, missing 2 tumors <3 mm and 1 lesion located in a diverticulum. In another study, the combination of grayscale US, multiplanar reconstruction, and 3-D virtual US had a sensitivity of 96.4% and specificity of 88.8% compared with conventional cystoscopy [33]. Despite these results, US has limited ability to identify MIBC or nodal metastatic disease. As cystoscopy allows identification of recurrent neoplasm, concurrent biopsy, and local staging, US has not replaced the need for cystoscopic surveillance for patients with NMIBC. Variant 3: Muscle-invasive bladder cancer with or without cystectomy. Post-treatment surveillance. Following radical cystectomy for MIBC, 5-year recurrence-free survival is approximately 58%; risk factors for recurrence include advanced tumor stage, lymph node involvement, lymphovascular invasion, high tumor grade, and positive surgical margins [10,41-43]. Recurrences can be described as pelvic relapse; surgical bed recurrence; internal and external iliac and obturator lymph node involvement or distant metastatic disease; and osseous, pulmonary, hepatic, extrapelvic lymphadenopathy, peritoneal, and brain metastases. Most recurrences occur within the first 2 years following cystectomy, and most recurrences are distant metastatic disease [44]. Pelvic relapse is seen in 34% of patients, and the 2-year risk of local failure exceeds 30% [45]. Post-Treatment Surveillance of Bladder Cancer In a study of 1,110 patients following radical cystectomy, recurrences were identified in 29.2% (324 of 1,110) of patients, and 61.7% (200 of 324) of recurrences were single-site recurrences with 43 local (22 cystectomy bed and 21 pelvic lymph node) and 138 distant (36 lung, 19 liver, 52 bone, 17 extrapelvic lymph node, 7 peritoneal, 4 brain, and 3 other) [46].
Post Treatment Surveillance of Bladder Cancer. In this study, US accurately diagnosed bladder cancer in 78.6% (11 of 14) of patients, missing 2 tumors <3 mm and 1 lesion located in a diverticulum. In another study, the combination of grayscale US, multiplanar reconstruction, and 3-D virtual US had a sensitivity of 96.4% and specificity of 88.8% compared with conventional cystoscopy [33]. Despite these results, US has limited ability to identify MIBC or nodal metastatic disease. As cystoscopy allows identification of recurrent neoplasm, concurrent biopsy, and local staging, US has not replaced the need for cystoscopic surveillance for patients with NMIBC. Variant 3: Muscle-invasive bladder cancer with or without cystectomy. Post-treatment surveillance. Following radical cystectomy for MIBC, 5-year recurrence-free survival is approximately 58%; risk factors for recurrence include advanced tumor stage, lymph node involvement, lymphovascular invasion, high tumor grade, and positive surgical margins [10,41-43]. Recurrences can be described as pelvic relapse; surgical bed recurrence; internal and external iliac and obturator lymph node involvement or distant metastatic disease; and osseous, pulmonary, hepatic, extrapelvic lymphadenopathy, peritoneal, and brain metastases. Most recurrences occur within the first 2 years following cystectomy, and most recurrences are distant metastatic disease [44]. Pelvic relapse is seen in 34% of patients, and the 2-year risk of local failure exceeds 30% [45]. Post-Treatment Surveillance of Bladder Cancer In a study of 1,110 patients following radical cystectomy, recurrences were identified in 29.2% (324 of 1,110) of patients, and 61.7% (200 of 324) of recurrences were single-site recurrences with 43 local (22 cystectomy bed and 21 pelvic lymph node) and 138 distant (36 lung, 19 liver, 52 bone, 17 extrapelvic lymph node, 7 peritoneal, 4 brain, and 3 other) [46].