Role of routine transurethral biopsy and isolated upper tract cytology after intravesical treatment of high-grade non-muscle invasive bladder cancer

Andrew J Lightfoot; Henry M Rosevear; Kenneth G Nepple; Michael A O'Donnell

doi:10.1111/j.1442-2042.2012.03089.x

Back

Role of routine transurethral biopsy and isolated upper tract cytology after intravesical treatment of high-grade non-muscle invasive bladder cancer

Journal article

Open access

Peer reviewed

Role of routine transurethral biopsy and isolated upper tract cytology after intravesical treatment of high-grade non-muscle invasive bladder cancer

Andrew J Lightfoot, Henry M Rosevear, Kenneth G Nepple and Michael A O'Donnell

International journal of urology, Vol.19(11), pp.988-993

11/2012

DOI: 10.1111/j.1442-2042.2012.03089.x

PMID: 22762480

Files and links (1)

url

https://doi.org/10.1111/j.1442-2042.2012.03089.xView

Published (Version of record) Open Access

Abstract

To investigate whether random bladder, and prostatic urethral biopsies and individual upper tract cytologies (restaging) provide useful clinical information in addition to cystoscopy and bladder cytology in assessing initial intravesical therapy response for high-grade non-muscle invasive bladder cancer. We retrospectively reviewed records of all patients who underwent restaging at our institution after treatment for high-grade non-muscle invasive bladder cancer (Ta, T1 and Tis) between January 2000 and October 2009. A total of 78 patients undergoing 116 consecutive restagings were included. The presence of intravesical cancer at restaging was assessed by cystoscopy, bladder wash cytology and random bladder biopsies, whereas ureteral and prostatic urethral disease was determined using upper tract barbotage cytology and prostatic urethral biopsies. Indication for intravesical treatment was carcinoma in situ in 86, high-grade T1 in 16 and high-grade Ta in 14 cases. A total of 48 patients had primary disease and 68 had recurrence. Overall, 59 of 116 (50.9%) restagings showed positive bladder or prostatic biopsy and/or a positive cytology localized to the upper tract. Of the total number of recurrences, 12.9% (15 of 116) showed a negative cystoscopy and negative bladder cytology, and would have been missed on routine surveillance. A total of 23 of 116 (19.8%) restagings showed evidence of prostatic urethral and or ureteral disease. Roughly 25% of high-grade non-muscle invasive bladder cancer early recurrences after induction intravesical therapy would go unnoticed without the addition of random and directed prostate biopsies, and isolated upper tract cytologies to standard cystoscopy and bladder cytology.

Administration, Intravesical

Adult

Aged

Aged, 80 and over

Biopsy - methods

Cystoscopy - methods

Female

Humans

Male

Middle Aged

Neoplasm Staging

Retrospective Studies

Treatment Outcome

Urethra - pathology

Urinary Bladder - pathology

Urinary Bladder Neoplasms - drug therapy

Urinary Bladder Neoplasms - pathology

Details

Title: Subtitle: Role of routine transurethral biopsy and isolated upper tract cytology after intravesical treatment of high-grade non-muscle invasive bladder cancer
Creators: Andrew J Lightfoot - University of Iowa
Henry M Rosevear - University of Iowa
Kenneth G Nepple - University of Iowa
Michael A O'Donnell
Resource Type: Journal article
Publication Details: International journal of urology, Vol.19(11), pp.988-993
DOI: 10.1111/j.1442-2042.2012.03089.x
PMID: 22762480
NLM abbreviation: Int J Urol
ISSN: 0919-8172
eISSN: 1442-2042
Language: English
Date published: 11/2012
Academic Unit: Urology
Record Identifier: 9984319986602771

Metrics

14 Record Views

18 Times Cited - Web of Science