Computerized tomography: an unreliable method for accurate staging of bladder tumors in patients who are candidates for radical cystectomy.

A total of 164 patients with bladder tumors underwent preoperative staging by computerized tomography. All patients were previously untreated, or had undergone only transurethral biopsy or resection of the tumor before computerized tomography. The post-cystectomy histological stage was compared to the preoperative computerized tomography stage. Computerized tomography accuracy according to the tumor, nodes and metastasis classification was only 32.3%, whereas overstaging was found in 39.6% and understaging in 28.1% of the cases. In untouched tumors or after transurethral resection computerized tomography accuracy demonstrated no significant difference. Only 2 of 19 true positive lymph nodes were staged correctly. Of 10 suspicious nodes results of computerized tomography were false positive in 8. Computerized tomography is an unreliable method for accurate preoperative staging of bladder carcinoma. The indication for either an operation, chemotherapy or radiotherapy for the treatment of bladder neoplasms should not be based on computerized tomography findings.