Claudia Schmitz-Dräger1, Nadine Bonberg2, Beate Pesch2, Tilman Todenhöfer3, Sevim Sahin1, Thomas Behrens4, Thomas Brüning2, Bernd J Schmitz-Dräger5. 1. Urologie(24)/Urologie Schön Klinik Nürnberg Fürth, Fürth, Germany. 2. Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of Ruhr University Bochum (IPA), Bochum, Germany. 3. Department of Urology, Eberhard-Karls-University of Tübingen, Tübingen, Germany. 4. Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of Ruhr University Bochum (IPA), Bochum, Germany; Protein Research Unit Ruhr Within Europe (PURE), Bochum, Germany. 5. Urologie(24)/Urologie Schön Klinik Nürnberg Fürth, Fürth, Germany; Department of Urology, Friedrich-Alexander University, Erlangen, Germany. Electronic address: bernd_sd@yahoo.de.
Abstract
RATIONALE: Numerous molecular urine markers for the diagnosis of bladder cancer have been developed and evaluated mostly in case-control settings through the past decades. However, despite all efforts none of them has been included into clinical decision-making and guideline recommendations until today. The aim of this retrospective longitudinal analysis was to investigate if a molecular marker might be able to replace cystoscopy as a primary examination in diagnosis and follow-up of patients with pTa grade 1-2 bladder cancer. MATERIALS AND METHODS: Totally 36 patients (32 men) with pTa grade 1-2 bladder cancer underwent 232 follow-up examinations including urine analysis, cytology, immunocytology (uCyt+), and urethrocystoscopy (UC). Mean age at study entry was 63 years. Patients were observed through a median follow-up interval of 3.8 years. RESULTS: In summary, 47 Transurethral Resection of Bladder Tumors (TURB) procedures were indicated based upon a positive UC (44) or as re-TURB (3) and 33 tumors (plus 1 case of pTa G0) were histopathologically confirmed. Although uCyt+was positive in 12/13 primary tumors (92.3%), sensitivity dropped to 13/20 (65%) in tumor recurrence presumably because of their smaller size. Urine cytology had a sensitivity and a specificity of 30.3% and 94.9%, respectively, but did not improve the sensitivity of uCyt+alone. If UC was based upon a positive uCyt+test, 8/33 tumors (24.2%) would have been overlooked or diagnosed late. In contrast, 173 UCs (74%) would have been saved and 5 presumably unnecessary TURB procedures would not have been indicated. CONCLUSIONS: This longitudinal study suggests a potential of molecular urine tests in replacing cystoscopy in the follow-up of patients with pTa G1-2 bladder cancer. The use of additional markers might further improve sensitivity of urine testing. A prospective randomized study has been initiated to prospectively investigate the performance of a marker panel against UC.
RATIONALE: Numerous molecular urine markers for the diagnosis of bladder cancer have been developed and evaluated mostly in case-control settings through the past decades. However, despite all efforts none of them has been included into clinical decision-making and guideline recommendations until today. The aim of this retrospective longitudinal analysis was to investigate if a molecular marker might be able to replace cystoscopy as a primary examination in diagnosis and follow-up of patients with pTa grade 1-2 bladder cancer. MATERIALS AND METHODS: Totally 36 patients (32 men) with pTa grade 1-2 bladder cancer underwent 232 follow-up examinations including urine analysis, cytology, immunocytology (uCyt+), and urethrocystoscopy (UC). Mean age at study entry was 63 years. Patients were observed through a median follow-up interval of 3.8 years. RESULTS: In summary, 47 Transurethral Resection of Bladder Tumors (TURB) procedures were indicated based upon a positive UC (44) or as re-TURB (3) and 33 tumors (plus 1 case of pTa G0) were histopathologically confirmed. Although uCyt+was positive in 12/13 primary tumors (92.3%), sensitivity dropped to 13/20 (65%) in tumor recurrence presumably because of their smaller size. Urine cytology had a sensitivity and a specificity of 30.3% and 94.9%, respectively, but did not improve the sensitivity of uCyt+alone. If UC was based upon a positive uCyt+test, 8/33 tumors (24.2%) would have been overlooked or diagnosed late. In contrast, 173 UCs (74%) would have been saved and 5 presumably unnecessary TURB procedures would not have been indicated. CONCLUSIONS: This longitudinal study suggests a potential of molecular urine tests in replacing cystoscopy in the follow-up of patients with pTa G1-2 bladder cancer. The use of additional markers might further improve sensitivity of urine testing. A prospective randomized study has been initiated to prospectively investigate the performance of a marker panel against UC.
Authors: David D'Andrea; Francesco Soria; Sonja Zehetmayer; Kilian M Gust; Stephan Korn; J Alfred Witjes; Shahrokh F Shariat Journal: BJU Int Date: 2019-02-05 Impact factor: 5.588
Authors: Xunian Zhou; Paul Kurywchak; Kerri Wolf-Dennen; Sara P Y Che; Dinanath Sulakhe; Mark D'Souza; Bingqing Xie; Natalia Maltsev; T Conrad Gilliam; Chia-Chin Wu; Kathleen M McAndrews; Valerie S LeBleu; David J McConkey; Olga V Volpert; Shanna M Pretzsch; Bogdan A Czerniak; Colin P Dinney; Raghu Kalluri Journal: Mol Ther Methods Clin Dev Date: 2021-05-29 Impact factor: 6.698
Authors: Rui Batista; Nuno Vinagre; Sara Meireles; João Vinagre; Hugo Prazeres; Ricardo Leão; Valdemar Máximo; Paula Soares Journal: Diagnostics (Basel) Date: 2020-01-13