|The following article features coverage from the American Urological Association (AUA) 2019 meeting. Click here to read more of Renal & Urology News’ conference coverage.|
CHICAGO—In patients with non-muscle invasive bladder cancer (NMIBC), immediate urine cytology after a primary transurethral resection of a bladder tumor (TURBT) can help predict positive biopsy for malignancy at second look cystoscopy 1 month later, according to new study findings presented at the 2019 American Urological Association annual meeting.
Amr Elsawy, MD, of Mansoura University in Egypt, and colleagues studied outcomes among 70 patients with T1 NMIBC undergoing TURBT. A quarter of patients had history of prior TURBT.
During initial cystoscopy, clinicians found solitary tumors in 40 patients, 2 to 7 tumors in 29 patients, and more than 7 tumors in 1 patient. The largest bladder lesion size was a mean 26 mm. Histopathology confirmed stage T1 in all patients. Nine patients had high-grade malignancy. The EORTC risk for recurrence was “intermediate” in all patients and progression risk was “intermediate” or “high” in 19 and 51 patients, respectively. Median EORTC recurrence and progression risk scores were 5 and 9, respectively.
Immediate urine cytology (IUC) performed 48 hours after the first TURBT revealed low-grade malignancy in 31 patients, high-grade malignancy in 7, inflammatory status in 27, and hyperplastic status in 5.
A second-look cystoscopy was performed a mean 36 days after initial cystoscopy. Histopathology revealed 41 patients had cystitis and 29 had non-muscle invasive urothelial tumors.
Among patients with positive IUC, 26 (68.4%) were diagnosed with urothelial carcinoma at the second-look cystoscopy compared to just 3 (9.4%) patients with negative IUC. The sensitivity and specificity of IUC were 89.6% and 70.7%, respectively. The positive predictive and negative predictive values were 64.4% and 90.6%, respectively.
“Immediate urine cytology after TURBT for intermediate recurrence risk NMIBC is significantly associated with positive second-look TURBT for malignancy,” Dr Elsawy told Renal & Urology News. “Immediate urine cytology after TURBT may be a valuable tool in planning further intervention.”
Read more of Renal & Urology News’ coverage of the AUA 2019 meeting by visiting the conference page.
Elsawy A, Kamal F, Harraz A, Ali-El-Dein B. Prospective evaluation of the predictive role of immediate urine cytology (IUC) after transurethral resection of non-muscle invasive bladder cancer. Presented at the 2019 American Urological Association annual meeting held May 3-6 in Chicago. Abstract PD18-06.