scholarly journals Utility of Urinalysis as a Follow-up Surveillance Tool in Nonmuscle Invasive Bladder Cancer

2021 ◽  
Vol 19 (4) ◽  
pp. 244-251
Author(s):  
Minuk Park ◽  
Bumjin Lim ◽  
Dalsan You ◽  
In Gab Jeong ◽  
Cheryn Song ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Odds Ratio ◽  
Medical Center ◽  
Cancer Recurrence ◽  
Invasive Bladder Cancer ◽  
Low Grade ◽  
Asan Medical ◽  
Urine Testing ◽  
Nonmuscle Invasive Bladder Cancer

Purpose: To evaluate the association between microscopic hematuria (MH) detected by surveillance urinalysis and cancer recurrence in nonmuscle invasive bladder cancer (NMIBC) patients.Materials and Methods: A total of 1,082 NMIBC patients who underwent transurethral resection of bladder tumor (TURB) procedures at Asan Medical Center between January 2017 and December 2019 were included. We retrospectively reviewed the follow-up data for these cases including cystoscopy, urinalysis, and urine cytology. The association between urine testing and cancer recurrence was assessed by both univariable and multivariable logistic regression analysis.Results: The study patients had a median age of 68 years (interquartile range, 60–75 years) and comprised 898 men and 184 women. Among the 1,428 TURB procedures conducted in this series, 548 of the lesions (38.4%) were diagnosed as low-grade and 880 (61.6%) as highgrade cancers. A total of 3,309 follow-up cystoscopies were conducted during the study period and were divided into high-grade (HG) (2,011 cases) and low-grade (LG) (1,298 cases) groups according to the latest TURB pathology. MH was found to have a statistically significant association with NMIBC recurrence in both the LG (odds ratio [OR], 1.57; 95% confidence interval [CI], 1.107–2.223; p=0.011) and HG (OR, 1.90; 95% CI, 1.434–2.517; p<0.001) groups.Conclusions: Urinalysis during follow-up may provide important information on cancer recurrence in NMIBC patients.

Mid-Term Follow-Up of “En Bloc” Resection of Nonmuscle Invasive Bladder Cancer: Results from a Prospective Single-Center Study

Videourology ◽  
2016 ◽  
Vol 30 (3) ◽  
Author(s):  
Rodolfo Hurle ◽  
Massimo Lazzeri ◽  
Piergiuseppe Colombo ◽  
NicolòMaria Buffi ◽  
Emanuela Morenghi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Invasive Bladder Cancer ◽  
Single Center ◽  
En Bloc ◽  
Single Center Study ◽  
Center Study ◽  
Nonmuscle Invasive Bladder Cancer

scholarly journals Impact of maintenance therapy using a half dose of the bacillus Calmette–Guérin Tokyo strain on recurrence of intermediate and high-risk nonmuscle invasive bladder cancer: a retrospective single-center study

BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Dai Koguchi ◽  
Kazumasa Matsumoto ◽  
Takahiro Hirayama ◽  
Shigetaka Moroo ◽  
Momoko Kobayashi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Maintenance Therapy ◽  
Cancer Recurrence ◽  
Invasive Bladder Cancer ◽  
Bacillus Calmette Guerin ◽  
Efficacy And Safety ◽  
Kaplan Meier ◽  
Half Dose ◽  
Nonmuscle Invasive Bladder Cancer

Abstract Background Data are scarce regarding intravesical maintenance therapy (MT) with the low-dose bacillus Calmette–Guérin (BCG) Tokyo strain. We investigated the efficacy and safety of MT with a half dose of the Tokyo strain for patients following transurethral resection of nonmuscle invasive bladder cancer (NMIBC). Methods This study retrospectively reviewed clinical data on 78 patients diagnosed with intermediate or high-risk NMIBC followed by either MT (n = 38) or IT alone (n = 40) between January 2012 and March 2018. Statistical analysis was performed to compare recurrence-free survival (RFS) and adverse effects between the two groups. BCG was instilled once weekly for 6 weeks as IT, then once weekly in 2-week for a total of 20 instillations over 3 years. Results Kaplan–Meier analyses showed that patients undergoing MT had significantly better RFS than did those undergoing IT alone (hazard ratio (HR):0.32, 95% confidence interval (CI):0.12–0.89, P = 0.02). The 3-year RFS was 65.0% in the IT group and 89.5% in the MT group. Multivariate analysis showed that MT was associated with a reduced risk of recurrence (HR: 0.32, 95% CI:0.11–0.93, P = 0.03). One MT patient (2.6%) exhibited progression. Conclusions The BCG Tokyo strain showed acceptable efficacy and safety in patients undergoing MT; thus, it is a potential treatment for preventing bladder cancer recurrence.

scholarly journals Urinary Metabolic Signatures Detect Recurrences in Non-Muscle Invasive Bladder Cancer

Cancers ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 914 ◽  
Author(s):  
Alba Loras ◽  
M. Carmen Martínez-Bisbal ◽  
Guillermo Quintás ◽  
Salvador Gil ◽  
Ramón Martínez-Máñez ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
1H Nmr ◽  
Partial Least Square ◽  
Proton Nuclear Magnetic Resonance ◽  
Invasive Bladder Cancer ◽  
Low Grade ◽  
Muscle Invasive Bladder Cancer ◽  
Invasive Approach ◽  
Muscle Invasive

Patients with non-muscle invasive bladder cancer (NMIBC) undergo lifelong monitoring based on repeated cystoscopy and urinary cytology due to the high recurrence rate of this tumor. Nevertheless, these techniques have some drawbacks, namely, low accuracy in detection of low-grade tumors, omission of pre-neoplastic lesions and carcinomas in situ (CIS), invasiveness, and high costs. This work aims to identify a urinary metabolomic signature of recurrence by proton Nuclear Magnetic Resonance (1H NMR) spectroscopy for the follow-up of NMIBC patients. To do this, changes in the urinary metabolome before and after transurethral resection (TUR) of tumors are analyzed and a Partial Least Square Discriminant Analysis (PLS-DA) model is developed. The usefulness of this discriminant model for the detection of tumor recurrences is assessed using a cohort of patients undergoing monitoring. The trajectories of the metabolomic profile in the follow-up period provide a negative predictive value of 92.7% in the sample classification. Pathway analyses show taurine, alanine, aspartate, glutamate, and phenylalanine perturbed metabolism associated with NMIBC. These results highlight the potential of 1H NMR metabolomics to detect bladder cancer (BC) recurrences through a non-invasive approach.

scholarly journals 733 Long-Term Outcomes of Outpatient Laser Ablation for Recurrent Non-Muscle Invasive Bladder Cancer: A Retrospective Cohort Study

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Grover ◽  
S Raj ◽  
B Russell ◽  
K Thomas ◽  
R Nair ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Laser Ablation ◽  
Bladder Tumour ◽  
Invasive Disease ◽  
Invasive Bladder Cancer ◽  
Low Grade ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

Abstract Aim Non-muscle-invasive bladder cancer (NMIBC) is the most prevalent form of bladder cancer, predominantly affecting the elderly population. The most common treatment for recurrent NMIBC is transurethral resection of the bladder tumour (TURBT), which carries a risk of perioperative morbidity and mortality in this often-co-morbid population. Outpatient laser ablation of low-grade NMIBC recurrences is a minimally invasive treatment option, but long-term efficacy is poorly reported. Method We retrospectively reviewed the case notes of all patients treated with Holmium:YAG laser ablation from 2008-2016. Data regarding patient demographics, original histology, dates of procedures, follow-up time, recurrence, progression, and complications were recorded. Results A total of 199 procedures were performed on 97 patients (mean age of 83.56), 73 (75.3%) of which originally had low-grade (G1 or G2) tumours. Overall, 55 (56.7%) patients developed tumour recurrence at long-term follow-up (mean 5.36 years), and only 9 (9.3%) patients had tumour progression to a higher stage or grade, but there was no progression to muscle-invasive disease. The median recurrence-free, progression-free and overall survival times were 1.69 years (95% CI 1.20-2.25), 5.70 years (95% CI 4.10-7.60) and 7.60 years (95% CI 4.90-8.70), respectively. No patients required emergency inpatient admission after laser ablation for any associated complications. Conclusions Office-based Holmium: YAG laser ablation is an oncologically-safe method of managing recurrent low-grade non-muscle-invasive bladder cancer in the long-term, with no patients progressing to muscle-invasive disease. Furthermore, the procedure is safe, and no significant complications were seen in this elderly and co-morbid population.

Discrepancy between German S3 Guideline Recommendations and Daily Urologic Practice in the Management of Nonmuscle Invasive Bladder Cancer: Results of a Binational Survey

2021 ◽  
pp. 1-11
Author(s):  
Julian P. Struck ◽  
Martin J.P. Hennig ◽  
Marie C. Hupe ◽  
Nadim Moharam ◽  
Pia Paffenholz ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urine Cytology ◽  
Invasive Bladder Cancer ◽  
Guideline Recommendation ◽  
Adherence Rate ◽  
Routine Practice ◽  
Daily Routine ◽  
Low Grade ◽  
Second Resection ◽  
Nonmuscle Invasive Bladder Cancer

<b><i>Introduction:</i></b> Guideline recommendations are meant to help minimize morbidity and to improve the care of nonmuscle invasive bladder cancer (NMIBC) patients but studies have suggested an underuse of guideline-recommended care. The aim of this study was to evaluate the level of adherence of German and Austrian urologists to German guideline recommendations. <b><i>Methods:</i></b> A survey of 27 items evaluating diagnostic and therapeutic recommendations (15 cases of strong consensus and 6 cases of consensus) for NMIBC was administered among 14 urologic training courses. Survey construction and realization followed the checklist for reporting results of internet e-surveys and was approved by an internal review board. <b><i>Results:</i></b> Between January 2018 and June 2019, a total of 307 urologists responded to the questionnaire, with a mean response rate of 71%. The data showed a weak role of urine cytology (54%) for initial diagnostics although it is strongly recommended by the guideline. The most frequently used supporting diagnostic tool during transurethral resection of the bladder was hexaminolevulinate (95%). Contrary to the guideline recommendation, 38% of the participants performed a second resection in the case of pTa low-grade NMIBC. Correct monitoring of Bacille Calmette-Guérin (BCG) response with cystoscopy and cytology was performed by only 34% of the urologists. <b><i>Conclusions:</i></b> We found a discrepancy between certain guideline recommendations and daily routine practice concerning the use of urine cytology for initial diagnostics, instillation therapy with a low monitoring rate of BCG response, and follow-up care with unnecessary second resection after pTa low-grade NMIBC in particular. Our survey showed a moderate overall adherence rate of 73%. These results demonstrate the need for sharpening awareness of German guideline recommendations by promoting more intense education of urologists to optimize NMIBC care thus decreasing morbidity and mortality rates.

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