Abstract
Introduction
The use of urine cytology in the surveillance of non–muscle invasive bladder cancer
(NMIBC) is widely variable in clinical practice. We studied the impact of surveillance
urine cytology on clinical decision making during NMIBC surveillance.
Methods
A retrospective chart review was conducted on patients surveilled for clinical NMIBC
from 2013 to 2020 with at least one follow-up cytology result after diagnosis. Patients
were classified into risk categories according to American Urological Association
(AUA) NMIBC guidelines. Data were obtained regarding tumor recurrence pathology and
the frequency and findings of surveillance cystoscopies and urine cytologies. Positive
(suspicious, malignant) and negative (atypical or negative for malignant cells) cytology
results were correlated with cystoscopy and pathology findings when obtained within
3 months of the cytology specimen to determine if cytology impacted plan of care.
Results
Two hundred fourteen patients with NMIBC were followed for a median of 34 months,
with 1045 urine cytologies collectively obtained over the surveillance period. There
were no positive urine cytologies among patients with low-risk NMIBC; therefore, cytology
did not change management in this cohort. The potential for cytology to escalate management
for patients of any risk group (ie, positive cytology in the absence of positive cystoscopy
or pathology findings) occurred in 30 (2.9%) cases. However, clinical decision making
was only altered in 4 cases (0.4% of all cytologies).
Conclusions
Less than 1% of urine cytology specimens collected during NMIBC surveillance impacted
clinical management, none of whom had low-risk disease. The use of urine cytology
for surveillance of low-risk NMIBC should continue to be strongly discouraged, as
it did not change management in any such cases.
Keywords
Abbreviations:
AUA (American Urologic Association), NMIBC (Non-Muscle Invasive Bladder Cancer), SUO (Society of Urologic Oncology), TURBT (Transurethral Resection of Bladder Tumor), CIS (Carcinoma in Situ), BCG (Bacillus Calmette Guerin)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 23, 2022
Accepted:
December 11,
2022
Received in revised form:
December 8,
2022
Received:
September 20,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
