Meftun Culpan1, Ferhat Keser1, Hazal Cansu Acar2, Alper Otunctemur3, Eyup Veli Kucuk4, Selcuk Erdem5, Murat Ozer3, Ugur Tolga Sen4, Enes Degirmenci5, Rifat Ergul5, Ramazan Gokhan Atis1, Asif Yildirim1. 1. Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey. 2. Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. 3. Department of Urology, Cemil Tascioglu City Hospital, University of Health Sciences, Istanbul, Turkey. 4. Department of Urology, Istanbul Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey. 5. Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Abstract
PURPOSE: To evaluate the impact of delay in cystoscopic surveillance on recurrence and progression rates in non-muscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS: A total of 407 patients from four high-volume centers with NMIBC that applied for follow-up cystoscopy were included in our study prospectively. Patients' demographics and previous tumor characteristics, presence of tumor in follow-up cystoscopy, the pathology results of the latest transurethral resection of bladder tumor (if tumor was detected), and delay in cystoscopy time were recorded. Our primary outcomes were tumor recurrences detected by follow-up cystoscopy and progression. Multivariate logistic regression analysis was performed using the possible factors identified with univariate analyses (p values ≤0.2). RESULTS: One hundred five patients (25.8%) had tumor recurrence in follow-up cystoscopy and 20 (5.1%) of these patients had disease progression according to grade or stage. In multivariate analysis, the number of recurrences (OR: 1.307, p<0.001) and the cystoscopy delay time (62-147 days, OR: 2.424, p = 0.002; >147 days, OR: 4.883, p<0.001) were significant risk factors for tumor recurrence on follow-up cystoscopy; the number of recurrences (OR: 1.255, p = 0.024) and cystoscopy delay time (>90 days, OR: 6.704, p = 0.002) were significant risk factors for tumor progression. CONCLUSIONS: This study showed that a 2-5 months delay in follow-up cystoscopy increases the risk of recurrence by 2.4-fold, and delay in cystoscopy for more than three months increases the probability of progression by 6.7-fold. We suggest that cystoscopic surveillance should be done during the COVID-19 pandemic according to the schedule set by relevant guidelines. This article is protected by copyright. All rights reserved.
PURPOSE: To evaluate the impact of delay in cystoscopic surveillance on recurrence and progression rates in non-muscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS: A total of 407 patients from four high-volume centers with NMIBC that applied for follow-up cystoscopy were included in our study prospectively. Patients' demographics and previous tumor characteristics, presence of tumor in follow-up cystoscopy, the pathology results of the latest transurethral resection of bladder tumor (if tumor was detected), and delay in cystoscopy time were recorded. Our primary outcomes were tumor recurrences detected by follow-up cystoscopy and progression. Multivariate logistic regression analysis was performed using the possible factors identified with univariate analyses (p values ≤0.2). RESULTS: One hundred five patients (25.8%) had tumor recurrence in follow-up cystoscopy and 20 (5.1%) of these patients had disease progression according to grade or stage. In multivariate analysis, the number of recurrences (OR: 1.307, p<0.001) and the cystoscopy delay time (62-147 days, OR: 2.424, p = 0.002; >147 days, OR: 4.883, p<0.001) were significant risk factors for tumor recurrence on follow-up cystoscopy; the number of recurrences (OR: 1.255, p = 0.024) and cystoscopy delay time (>90 days, OR: 6.704, p = 0.002) were significant risk factors for tumor progression. CONCLUSIONS: This study showed that a 2-5 months delay in follow-up cystoscopy increases the risk of recurrence by 2.4-fold, and delay in cystoscopy for more than three months increases the probability of progression by 6.7-fold. We suggest that cystoscopic surveillance should be done during the COVID-19 pandemic according to the schedule set by relevant guidelines. This article is protected by copyright. All rights reserved.
Authors: Steven Anderson; Kate Rigney; Leah Hayes; Paul Christopher Ryan; Vishwa Chaitanya; Prem Thomas Jacob; Mamoun Abdelrahman; Subhasis K Giri Journal: Ann Med Surg (Lond) Date: 2022-08-18