When patients with muscle-invasive bladder cancer undergo treatment before surgery, doctors look for a "clinical complete response." This is a way to see if the cancer seems to have disappeared during initial treatments. The goal is to help decide if they can spare the bladder during the final surgery.
However, this review of 1,075 patients found that these clinical results do not always match what surgeons find under the microscope after removing the bladder. While some cases aligned, many did not. Specifically, the data showed a concordance rate of only 0.51 between clinical and pathological responses.
Because the current definition of a clinical response is not a reliable predictor for surgical success, doctors should be cautious about using it alone to make big treatment decisions. One study in the group also had a high risk of bias because the person performing the exam could influence the results.
