Prognostic value of concomitant carcinoma in situ in radical cystectomy specimens on patients with bladder cancer: A meta-analysis of 24,136 patients

Radical Cystectomy (RC) and pelvic lymph node dissection is the standard treatment in patients with muscle invasive bladder cancer (MIBC) and in patients with very high risk non-MIBC. Despite adequate surgery, up to 50% patients experience disease recurrence and mortality after RC. Accurate predictive factors may help identify patients who are of increased risk of disease recurrence and may, therefore, benefit from intensified therapy such as adjuvant systemic therapy.While it is well known that the presence of concomitant carcinoma in situ (CIS) in TUR specimens increases the risk of progression to MIBC, its prognostic impact in RC specimens remains controversial. We performed a systematic review and meta-analysis to assess the prognostic value of concomitant CIS in RC specimens of bladder cancer (BC) patients.