Lack of value of routine preoperative bone and liver scans in cystectomy candidates.

A retrospective review of 341 patients with bladder cancer revealed 58 candidates for cystectomy. These patients were evaluated preoperatively by radionuclide bone and/or liver scans in an attempt to increase the accuracy of clinical staging. In the face of a normal history, physical examination, liver function tests or serum alkaline phosphatase routine preoperative bone and liver scans in cystectomy candidates did not contribute significantly to clinical staging or choice of treatment. Since liver and bone scans add significantly to the cost of the illness their use should not be routine but reserved only for those special cases when they are indicated.