Willemien Beukers1, Kirstin A van der Keur1, Raju Kandimalla1, Yvonne Vergouwe2, Ewout W Steyerberg2, Joost L Boormans3, Jorgen B Jensen4, José A Lorente5, Francisco X Real6, Ulrike Segersten7, Torben F Orntoft8, Nuria Malats9, Per-Uno Malmström7, Lars Dyrskjot8, Ellen C Zwarthoff10. 1. Department of Pathology, Erasmus Medical Centre, Rotterdam, the Netherlands. 2. Department of Public Health, Erasmus Medical Centre, Rotterdam, the Netherlands. 3. Department of Urology, Erasmus Medical Centre, Rotterdam, the Netherlands. 4. Department of Urology, Aarhus University Hospital, Aarhus, Denmark. 5. Servei d'Urologia, Hospital del Mar, Barcelona, Spain. 6. Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain; Epithelial Carcinogenesis Group, Cancer Cell Biology Programme, Spanish National Cancer Research Centre-CNIO, Madrid, Spain. 7. Department of Surgical Sciences, Uppsala University, Uppsala, Sweden. 8. Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark. 9. Epithelial Carcinogenesis Group, Cancer Cell Biology Programme, Spanish National Cancer Research Centre-CNIO, Madrid, Spain. 10. Department of Pathology, Erasmus Medical Centre, Rotterdam, the Netherlands. Electronic address: e.zwarthoff@erasmusmc.nl.
Abstract
PURPOSE: Patients with nonmuscle invasive bladder cancer are followed with frequent cystoscopies. In this study FGFR3, TERT and OTX1 were investigated as a diagnostic urinary marker combination during followup of patients with primary nonmuscle invasive bladder cancer. MATERIALS AND METHODS: In this international, multicenter, prospective study 977 patients with nonmuscle invasive bladder cancer were included. A total of 2,496 urine samples were collected prior to cystoscopy during regular visits. Sensitivity was estimated to detect concomitant recurrences. Kaplan-Meier curves were used to estimate the development of future recurrences after urinalysis and a negative cystoscopy. RESULTS: Sensitivity of the assay combination for recurrence detection was 57% in patients with primary low grade, nonmuscle invasive bladder cancer. However, sensitivity was 83% for recurrences that were pT1 or muscle invasive bladder cancer. Of the cases 2% progressed to muscle invasive bladder cancer. Sensitivity for recurrence detection in patients with primary high grade disease was 72% and 7% of them had progression to muscle invasive bladder cancer. When no concomitant tumor was found by cystoscopy, positive urine samples were more frequently followed by a recurrence over time compared to a negative urine sample (58% vs 36%, p <0.001). High stage recurrences were identified within 1 year after a positive urine test and a negative cystoscopy. CONCLUSIONS: Recurrences in patients with primary nonmuscle invasive bladder cancer can be detected by a combination of urine assays. This study supports the value of urinalysis as an alternative diagnostic tool in patients presenting with low grade tumors and as a means to identify high stage tumors earlier.
PURPOSE:Patients with nonmuscle invasive bladder cancer are followed with frequent cystoscopies. In this study FGFR3, TERT and OTX1 were investigated as a diagnostic urinary marker combination during followup of patients with primary nonmuscle invasive bladder cancer. MATERIALS AND METHODS: In this international, multicenter, prospective study 977 patients with nonmuscle invasive bladder cancer were included. A total of 2,496 urine samples were collected prior to cystoscopy during regular visits. Sensitivity was estimated to detect concomitant recurrences. Kaplan-Meier curves were used to estimate the development of future recurrences after urinalysis and a negative cystoscopy. RESULTS: Sensitivity of the assay combination for recurrence detection was 57% in patients with primary low grade, nonmuscle invasive bladder cancer. However, sensitivity was 83% for recurrences that were pT1 or muscle invasive bladder cancer. Of the cases 2% progressed to muscle invasive bladder cancer. Sensitivity for recurrence detection in patients with primary high grade disease was 72% and 7% of them had progression to muscle invasive bladder cancer. When no concomitant tumor was found by cystoscopy, positive urine samples were more frequently followed by a recurrence over time compared to a negative urine sample (58% vs 36%, p <0.001). High stage recurrences were identified within 1 year after a positive urine test and a negative cystoscopy. CONCLUSIONS: Recurrences in patients with primary nonmuscle invasive bladder cancer can be detected by a combination of urine assays. This study supports the value of urinalysis as an alternative diagnostic tool in patients presenting with low grade tumors and as a means to identify high stage tumors earlier.
Authors: Ilaria J Russo; Yongwon Ju; Naheema S Gordon; Maurice P Zeegers; K K Cheng; Nicholas D James; Richard T Bryan; Douglas G Ward Journal: Bladder Cancer Date: 2018-01-20
Authors: Renate Pichler; Gennadi Tulchiner; Josef Fritz; Georg Schaefer; Wolfgang Horninger; Isabel Heidegger Journal: Int J Med Sci Date: 2017-07-19 Impact factor: 3.738