MP22-11 POSITIVE URINE MARKERS PREDICT RECURRENCE IN PATIENTS WITH NEGATIVE CYSTOSCOPY DURING SURVEILLANCE FOR BLADDER CANCER
2014-03-28

You have accessJournal of UrologyBladder Cancer: Detection & Screening1 Apr 2014MP22-11 POSITIVE URINE MARKERS PREDICT RECURRENCE IN PATIENTS WITH NEGATIVE CYSTOSCOPY DURING SURVEILLANCE FOR BLADDER CANCER Tilman Todenhöfer, Jörg Hennenlotter, Philipp Guttenberg, Valentina Gerber, Ursula Kühs, Stefan Aufderklamm, Georgios Gakis, Arnulf Stenzl, and Christian Schwentner Tilman TodenhöferTilman Todenhöfer More articles by this author , Jörg HennenlotterJörg Hennenlotter More articles by this author , Philipp GuttenbergPhilipp Guttenberg More articles by this author , Valentina GerberValentina Gerber More articles by this author , Ursula KühsUrsula Kühs More articles by this author , Stefan AufderklammStefan Aufderklamm More articles by this author , Georgios GakisGeorgios Gakis More articles by this author , Arnulf StenzlArnulf Stenzl More articles by this author , and Christian SchwentnerChristian Schwentner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.859AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The role of urine markers in the surveillance of bladder cancer (BC) is discussed controversely. Evidence exists that positive urine markers may precede visible tumor recurrence. To date, little evidence on the ability of urine markers and their combinations to predict tumour recurrence in patients with negative cystoscopy exists. The present study is the first systematic approach to address this issue. METHODS 113 patients who underwent urine marker testing during surveillance for non-muscle-invasive BC (NMIBC) and had no evidence of tumor in cystoscopy at time of urine marker testing were included. For all patients cytology, Fluorescence-in-situ-hybridization (FISH), immunocytology and Nuclear matrix protein 22 (NMP22) enzyme linked immunosorbent assay (ELISA) were performed as urine markers. All patients had a cystoscopic and clinical follow-up of at least 24 months. Results of urine markers and their combinations were correlated with recurrence and progression by Cox-proportional hazard analyses. RESULTS 34 of 112 (30.3%) patients experienced disease recurrence within 24 months of follow-up. The median time to recurrence was 11.5 months. 11 of 112 (9.8%) patients had disease progression during follow-up. Median time to progression was 14.0 months. Recurrence rates in patients with positive vs. negative cytology, immunocytology, FISH and NMP22 were 48.7% vs. 21.3% (OR=3.5; 95% CI 1.5-8.3; p=0.003), 45.5% vs 20.6% (OR 3.2; 1.4-7.5; p=0.005), 42.5% vs. 23.6% (OR 2.4; 1.1-5.5; p=0.03) and 38.7% vs. 18.3% (OR 2.8; 1.2-7.1; p=0.01). Odds Ratios for progression in patients with positive vs. negative cytology, immunocytology, FISH and NMP22 were 6.9 (95 % CI 1.8-33.4; p=0.003), 5.1 (1.4-24.4; p=0.01), 6.1 (1.6-29.5; p=0.006) and 2.3 (0.6-10.8; p=0.22). In multivariable analysis adjusted for other risk factors, cytology and immunocytology remained independent predictors of recurrence and progression. Rates of recurrence and progression in patients with all urine tests positive vs. those with all tests negative were 76.9% vs. 11.5% (OR 25.6, 5.0-182.6, p<0.001) and 46.2% vs. 3.4% (OR 25.0, 3.4-522.1, p<0.0001). CONCLUSIONS The present study shows, that positive urine markers in patients with negative cystoscopy and history of NMIBC are highly predictive for tumor recurrence. The application of urine markers as an adjunct to cystoscopy enables improved prediction of recurrence and progression in patients undergoing surveillance of NMIBC. Thereby, urine markers might contribute to individualize surveillance of patients with NMIBC. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e238 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Tilman Todenhöfer More articles by this author Jörg Hennenlotter More articles by this author Philipp Guttenberg More articles by this author Valentina Gerber More articles by this author Ursula Kühs More articles by this author Stefan Aufderklamm More articles by this author Georgios Gakis More articles by this author Arnulf Stenzl More articles by this author Christian Schwentner More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...