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\begin{document}

\title{HOW ACCURATELY CAN UROLOGISTS PREDICT ELIGIBLE PATIENTS FOR IMMEDIATE
POSTOPERATIVE INTRAVESICAL CHEMOTHERAPY IN BLADDER CANCER?}



\author[1]{Hüseyin Alperen Yıldız}%
\author[2]{Dogan Deger}%
\author[3]{Guven Aslan}%
\affil[1]{Malazgirt State Hospital}%
\affil[2]{Edirne Sultan Murat 1 State Hospital}%
\affil[3]{Dokuz Eylül University}%


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  \date{June 18, 2024}


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\begin{abstract}
Purpose: To assess the ability of urology residents and experienced
urologists to accurately predict pathological features of bladder tumors
based solely on cystoscopic appearance, and evaluate how accurately
urologists can decide eligible patients for postoperative intravesical
chemotherapy. Methods: 104 patients with bladder mass were included, 7
senior urologists and 4 residents joined the study. Before resection,
both specialists and residents were asked to predict the stage, grade of
the tumor, and presence of CIS. We obtained resident predictions for 104
patients and senior predictions for 72 of these patients. Based on these
predictions, eligibility of the patients for single postoperative
immediate chemotherapy were determined according to EAU NMIBC
guidelines. After final pathology report, risk scores recalculated and
compared with surgeons' predictions. Results: In correlation analysis,
strong agreement with the pathological report could not be demonstrated
with any of the stages, grades, and presence of CIS for both senior and
resident urologists. Urology residents' predictions were slightly more
accurate than the senior urologists'. According to senior urologists'
predictions, 14/72 (19,4\%) of the patients, and according to residents'
predictions, 19/104 (18,2\%) of the patients were found to be either
overtreated or undertreated. Conclusions: Cystoscopic visual prediction
is not sufficient to decide on immediate postoperative intravesical
chemotherapy regardless of the experience, and we need more objective
parameters to improve the appropriate patient selection. What's known:
In patients with non-muscle invasive bladder cancer (NMIBC), decision of
immediate postoperative chemotherapy instillation is made by urologists
according to clinical and ``presumed'' pathological parameters as
definitive pathology is unkown. Therefore, the concordance of this
presumption with the final pathology is important. What's new: In our
study, we demonstrated that urologists' predictions on pathological
features are not reliable to decide on immediate postoperative
intravesical chemotherapy instillation and better criteria for patient
selection are needed.%
\end{abstract}%



\sloppy


HOW ACCURATELY CAN UROLOGISTS PREDICT ELIGIBLE PATIENTS FOR IMMEDIATE
POSTOPERATIVE INTRAVESICAL CHEMOTHERAPY IN BLADDER CANCER?

H\selectlanguage{ngerman}üseyin Alperen Y\selectlanguage{polish}ı\selectlanguage{english}ld\selectlanguage{polish}ı\selectlanguage{english}z \textsuperscript{a,*}, M\selectlanguage{ngerman}üslim Do\selectlanguage{polish}ğ\selectlanguage{english}an
De\selectlanguage{polish}ğ\selectlanguage{english}er\textsuperscript{b}, G\selectlanguage{ngerman}üven Aslan \textsuperscript{c}

\textsuperscript{a} Department of Urology, Malazgirt State Hospital,
Mu\selectlanguage{polish}ş, \selectlanguage{english}Turkey

\textsuperscript{b} Department of Urology, Edirne State Hospital,
Edirne, Turkey

\textsuperscript{c} Department of Urology, Dokuz Eyl\selectlanguage{ngerman}ül University,
School of Medicine, \selectlanguage{polish}İ\selectlanguage{english}zmir, Turkey

Short Title: CAN UROLOGISTS CHOOSE RIGHT PATIENTS FOR SI?

*Corresponding Author: H\selectlanguage{ngerman}üseyin Alperen Y\selectlanguage{polish}ı\selectlanguage{english}ld\selectlanguage{polish}ı\selectlanguage{english}z

Malazgirt State Hospital, Department of Urology

Address: Saltukgazi Mahallesi, Hastane Cd., Malazgirt, Mu\selectlanguage{polish}ş, \selectlanguage{english}Turkey,
49400

Tel: +902324443511

E-mail: h.alperenyildiz@gmail.com

Acknowledgments:

None

Disclosure Statement:

The authors have no conflicts of interest to declare.

Funding Sources:

The authors received~no~specific~funding~for this work.

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