Predicting Histopathological Outcomes from Cystoscopic Findings in Newly Diagnosed Bladder Cancer: A Prospective Observational Study

Initial TURBT cystoscopic findings accurately predict histopathological outcomes in newly diagnosed bladder cancer, achieving an 81.05% diagnostic accuracy. Larger (>3 cm) and sessile tumors strongly indicate MIBC, while solitary, pedunculated tumors are associated with NMIBC. The high NPV (63.64%-99.17%) supports reliable exclusion of incorrect diagnoses, particularly in resource-limited settings. High-quality TURBT, with detrusor muscle sampled in 89.4% of cases, reduces understaging and guides treatment decisions. However, lower sensitivity for high-grade NMIBC suggests that repeat TURBT could enhance staging accuracy. Future multicenter studies incorporating repeat TURBT (re-TURBT) and advanced cystoscopic technologies are needed to improve predictions and personalize treatment. Cystoscopic findings during TURBT reliably predict histopathological outcomes, particularly for LGTa tumors, with high NPV across stages.