{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T08:20:39Z","timestamp":1785313239422,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2025,11]]},"abstract":"Objectives<\/jats:title>To evaluate whether computed tomography (CT) scans should be performed before or after transurethral resection of bladder tumour (TURBT) for accurate lymph node staging in clinically lymph node\u2010positive bladder cancer (BCa). Additionally, to identify patient factors that can aid in predicting lymph node metastasis.<\/jats:p><\/jats:sec>Patients and Methods<\/jats:title>In this retrospective, multicentre study, we analysed patients with cN+ M0 BCa staged by CT and treated with upfront radical cystectomy (RC) and pelvic lymph node dissection. We stratified patients by the interval between TURBT and CT into three groups: (1) before TURBT; (2) within 30\u2009days after TURBT; and (3) more than 30\u2009days post\u2010TURBT. Staging accuracy, defined as concordance between clinical and pathological lymph node status, was evaluated. We utilised logistic regression analyses to identify patient factors, including the optimal timing of staging, in predicting pathological lymph node status at RC.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 183 patients with cN+ disease, 90 (49%) had pN0 disease at RC. Of these, 40, 36 and 14 were staged before TURBT, within 30\u2009days after TURBT, and more than 30\u2009days post\u2010TURBT, respectively (P<\/jats:italic>\u2009=\u20090.2). Pathological downstaging was most common in cN1 (22%) and cN2 (20%) disease. The overall concordance rate was 23%. The timing of staging did not correlate with pathological lymph node status on logistic regression (all P<\/jats:italic>\u2009>\u20090.05). Lymphovascular invasion (LVI) at TURBT was associated with pN status (odds ratio 4.25, confidence interval 2.02\u20139.34; P<\/jats:italic>\u2009<\u20090.001) at RC.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Overall, we found no association between the timing of CT\u2010based staging and pathological lymph node metastases in cN+ BCa. The data suggest that performing a TURBT prior to staging does not increase the finding of false\u2010positive nodes on imaging. LVI was the only factor at the time of TURBT associated with pathological lymph node metastasis at RC. Limitations include the multicentre retrospective design and the inclusion of only patients with clinically node\u2010positive disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bju.16851","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T14:54:27Z","timestamp":1752072867000},"page":"911-919","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of timing of computed tomography staging and patient factors on the detection of \u2018true\u2019 cN<\/scp>+ bladder cancer"],"prefix":"10.1111","volume":"136","author":[{"given":"Markus","family":"von Deimling","sequence":"first","affiliation":[{"name":"Department of Urology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Department of Urology, Comprehensive Cancer Center Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8847-6799","authenticated-orcid":false,"given":"Marc","family":"Furrer","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital of Bern University of Bern Bern Switzerland"},{"name":"Department of Urology Solothurner Spit\u00e4ler AG Olten and Solothurn Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Department of Urology University of Verona, Azienda Ospedaliera Universitaria Integrata Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5286-9048","authenticated-orcid":false,"given":"Renate","family":"Pichler","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Center Innsbruck Medical University of Innsbruck Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Maas","sequence":"additional","affiliation":[{"name":"Department of Urology Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"},{"name":"Department of Urologic Sciences University of British Columbia Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9499-0169","authenticated-orcid":false,"given":"Karl H.","family":"Tully","sequence":"additional","affiliation":[{"name":"Department of Urology and Neurourology, Marien Hospital Herne Ruhr\u2010University Bochum Herne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Longoni","sequence":"additional","affiliation":[{"name":"Department of Urology Urological Research Institute, Vita\u2010Salute San Raffaele Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3317-6427","authenticated-orcid":false,"given":"Laura S.","family":"Mertens","sequence":"additional","affiliation":[{"name":"Department of Urology The Netherlands Cancer Institute Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Urology University of Texas Southwestern Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3865-5988","authenticated-orcid":false,"given":"Francesco","family":"del Giudice","sequence":"additional","affiliation":[{"name":"Department of Maternal Infant and Urologic Sciences \u201cSapienza\u201d University of Rome, Policlinico Umberto I Hospital Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1274-7200","authenticated-orcid":false,"given":"Roger","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Oncology H. 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