Endoscopic appearance of a tumor can predict the stage of bladder cancer

Timing of radical cystectomy influences patients’ survival, however, the surgery in Central Europe is very often unnecessarily delayed in every fourth case [1]. Moreover, five-year postoperative survival in this region does not exceed 32% and definitively needs improvement [2]. Prediction of the stage of bladder cancer at the time of primary transurethral resection of the tumor (TUR) can potentially accelerate radical treatment in patients with muscle-invasive bladder cancer (MIBC). This allows early qualification for neoadjuvant chemotherapy and proper preparation for cystectomy, especially lifestyle changes, and nutritional and educational interventions. Grzegółkowski et al. presented results of clinical staging of bladder cancer in a series of 272 patients. Based on ultrasonography, endoscopy and physical examination they noticed accurate clinical staging in as many as 88% of cases [3]. We congratulate the authors on their fantastic work and excellent results. Simultaneously, we believe that there are two important issues that deserve discussion at this point. First, it should be highlighted that the authors presented clinical data from an experienced, high volume bladder cancer center. Even taking into account that residents were included in the study, it should be debated whether these results can be representative and are feasible to obtain in an average urological department. To the best of our knowledge, the impact of urologist experience on the accuracy of bladder cancer stage prediction has never been Endoscopic appearance of a tumor can predict the stage of bladder cancer