Ahmet Dirican, Professor of Medical Oncology at Medicana International İzmir Hospital, shared a post on X:
“In MIBC staging, I looked for answers to some of my questions in the latest recommendations of the International Bladder Cancer Group:
- Is FDG PET really necessary?
- Is anatomical imaging alone sufficient?
- Where does biological integration currently stand?
Answers:
- CT/MRI remain the backbone of staging
- Nodal assessment with conventional imaging is limited (under-staging is common)
- FDG PET/CT is not routine; it may add value in cases with clinical suspicion of nodal involvement or uncertain distant metastasis
- Cystoscopy is mandatory for post-neoadjuvant restaging; however, even combined with imaging, pathological response cannot always be reliably predicted
- ctDNA does not replace imaging; but it is emerging as a clinically meaningful tool, particularly in guiding adjuvant immunotherapy decisions
Bottom line: MIBC staging is no longer purely anatomical – the biological dimension is increasingly part of the discussion.”
Title: Optimal Management of Muscle-invasive Bladder Cancer: Recommendations from the International Bladder Cancer Group
Authors: Shilpa Gupta, Roger Li, Patrick Hensley, Siamak Daneshmand, Bishoy Faltas, Petros Grivas, Niyati Lobo, Maria Carmen Mir, Joshua Meeks, Kent Mouw, Marco Moschini, Andrea Necchi, Karima Oualla, Kamal Pohar, Jonathan Rosenberg, Bogdana Schmidt, Arlene Siefker-Radtke, Gary Steinberg, Arnulf Stenzl, Roger Buckley, Ashish Kamat
Read the Full Article.
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