Flow cytometry and cytology as response indicators to M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin).

We evaluated 23 patients treated with neoadjuvant methotrexate, vinblastine, doxorubicin and cisplatin for muscle invasive bladder carcinoma with serial bladder wash flow cytometry and serial urinary cytology. The sensitivities of bladder wash flow cytometry and cytology in detecting bladder cancer were 74 and 47 per cent, respectively, based on subsequent diagnosis from biopsy and cystectomy specimens. Exclusion of those cases without surface carcinoma increased the sensitivities of bladder wash flow cytometry and cytology to 93 and 60 per cent, respectively. Persistently positive bladder wash flow cytometry and cytology correctly predicted residual disease in 88 and 100 per cent, respectively. However, negative bladder wash flow cytometry and cytology after chemotherapy were not reliable indicators of disease-free status.