OBJECTIVES: To test the hypothesis that patients under active surveillance (AS) for Non-muscle Invasive Bladder Cancer (NMIBC) who were negative on longitudinal re-testing by the Xpert® Bladder Cancer Monitor (Xpert BC Monitor) assay may avoid unnecessary cystoscopies and urine cytology (UC). SUBJECTS/PATIENTS OR MATERIALS AND METHODS: This is a prospective cohort study of patients enrolled in the AS protocol for recurrent NMIBC (Bladder Cancer Italian Active Surveillance, BIAS project), whose urine samples were analyzed by Xpert BC Monitor upon entry in the study (T0). Patients who had a negative Xpert test and did not fail AS, underwent additional Xpert tests after 4 (T1), 8 (T2), and 12 (T3) months. The clinical utility of Xpert was assessed by determining the number of cystoscopies and UC that could be avoided within 1 year. RESULTS: Overall, 139 patients were tested with Xpert at T0. Median follow-up was 23 (IQR 17-27) months. Sixty-eight (48.9%) patients failed AS, 65 (46.7%) are currently on AS, and 6 (4.3%) were lost at follow-up. At T0 57 (41.0%) patients had a negative test and 36 (63.2%) are still in AS. In patients with 2 consecutives negative Xpert tests, we could have avoided 73.9% of unnecessary cystoscopies, missing 26.4% failure, up to avoid all cystoscopies with 4 negative tests missing only 12% of failure. All the patients with negative Xpert had negative UC. Failure-free-survival at median follow-up (23 month) stratified for having 0, 1, or ≥2 negative tests was 67.0, 55.1. and 84.1, respectively. CONCLUSION: Our findings suggest that Xpert BC Monitor assay, when it is longitudinally repeated, could significantly reduce the number of unnecessary cystoscopies and UC during their follow-up.
OBJECTIVES: To test the hypothesis that patients under active surveillance (AS) for Non-muscle Invasive Bladder Cancer (NMIBC) who were negative on longitudinal re-testing by the Xpert® Bladder Cancer Monitor (Xpert BC Monitor) assay may avoid unnecessary cystoscopies and urine cytology (UC). SUBJECTS/PATIENTS OR MATERIALS AND METHODS: This is a prospective cohort study of patients enrolled in the AS protocol for recurrent NMIBC (Bladder Cancer Italian Active Surveillance, BIAS project), whose urine samples were analyzed by Xpert BC Monitor upon entry in the study (T0). Patients who had a negative Xpert test and did not fail AS, underwent additional Xpert tests after 4 (T1), 8 (T2), and 12 (T3) months. The clinical utility of Xpert was assessed by determining the number of cystoscopies and UC that could be avoided within 1 year. RESULTS: Overall, 139 patients were tested with Xpert at T0. Median follow-up was 23 (IQR 17-27) months. Sixty-eight (48.9%) patients failed AS, 65 (46.7%) are currently on AS, and 6 (4.3%) were lost at follow-up. At T0 57 (41.0%) patients had a negative test and 36 (63.2%) are still in AS. In patients with 2 consecutives negative Xpert tests, we could have avoided 73.9% of unnecessary cystoscopies, missing 26.4% failure, up to avoid all cystoscopies with 4 negative tests missing only 12% of failure. All the patients with negative Xpert had negative UC. Failure-free-survival at median follow-up (23 month) stratified for having 0, 1, or ≥2 negative tests was 67.0, 55.1. and 84.1, respectively. CONCLUSION: Our findings suggest that Xpert BC Monitor assay, when it is longitudinally repeated, could significantly reduce the number of unnecessary cystoscopies and UC during their follow-up.
Authors: Rodolfo Hurle; Paolo Casale; Alberto Saita; Piergiuseppe Colombo; Grazia Maria Elefante; Giovanni Lughezzani; Vittorio Fasulo; Marco Paciotti; Luigi Domanico; Giulio Bevilacqua; Davide Maffei; Pietro Diana; Nicola Frego; Maria Teresa Sandri; Federica Maura; Emanuela Morenghi; Nicolò M Buffi; Giorgio Guazzoni; Massimo Lazzeri Journal: World J Urol Date: 2019-11-05 Impact factor: 4.226
Authors: Francesco Del Giudice; Giovanni Barchetti; Ettore De Berardinis; Martina Pecoraro; Vincenzo Salvo; Giuseppe Simone; Alessandro Sciarra; Costantino Leonardo; Michele Gallucci; Carlo Catalano; James W F Catto; Valeria Panebianco Journal: Eur Urol Date: 2019-11-05 Impact factor: 20.096
Authors: F Johannes P van Valenberg; Andrew M Hiar; Ellen Wallace; Julia A Bridge; Donna J Mayne; Safedin Beqaj; Wade J Sexton; Yair Lotan; Alon Z Weizer; Godfrey K Jansz; Arnulf Stenzl; John F Danella; Barry Shepard; Kevin J Cline; Michael B Williams; Scott Montgomery; Richard D David; Richard Harris; Eric W Klein; Timothy J Bradford; Fred N Wolk; Karl R Westenfelder; Andrew F Trainer; Timothy A Richardson; Russell B Egerdie; Bernard Goldfarb; Joseph A Zadra; Sijian Ge; Suling Zhao; Iris M Simon; Scott A Campbell; Brian Rhees; Michael P Bates; Russell G Higuchi; J Alfred Witjes Journal: Eur Urol Date: 2018-12-12 Impact factor: 20.096
Authors: Gian Maria Busetto; Angelo Porreca; Francesco Del Giudice; Martina Maggi; Daniele D'Agostino; Daniele Romagnoli; Gennaro Musi; Giuseppe Lucarelli; Katie Palmer; Ascanio Colonna di Paliano; Matteo Muto; Rodolfo Hurle; Daniela Terracciano; Ottavio de Cobelli; Alessandro Sciarra; Ettore De Berardinis; Matteo Ferro Journal: Urol Int Date: 2020-06-09 Impact factor: 2.089
Authors: Matteo Ferro; Evelina La Civita; Antonietta Liotti; Michele Cennamo; Fabiana Tortora; Carlo Buonerba; Felice Crocetto; Giuseppe Lucarelli; Gian Maria Busetto; Francesco Del Giudice; Ottavio de Cobelli; Giuseppe Carrieri; Angelo Porreca; Amelia Cimmino; Daniela Terracciano Journal: J Pers Med Date: 2021-03-23
Authors: Soum D Lokeshwar; Maite Lopez; Semih Sarcan; Karina Aguilar; Daley S Morera; Devin M Shaheen; Bal L Lokeshwar; Vinata B Lokeshwar Journal: Cancers (Basel) Date: 2022-05-24 Impact factor: 6.575