1268 SIGNIFICANCE OF RANDOM BLADDER BIOPSIES IN PATIENTS UNDERGOING TRANSURETHRAL RESECTION OF NON-MUSCLE INVASIVE BLADDER CANCER

Abstract

You have accessJournal of UrologyBladder Cancer: Detection and Screening1 Apr 20121268 SIGNIFICANCE OF RANDOM BLADDER BIOPSIES IN PATIENTS UNDERGOING TRANSURETHRAL RESECTION OF NON-MUSCLE INVASIVE BLADDER CANCER Masafumi Kumano, Hideaki Miyake, and Masato Fujisawa Masafumi KumanoMasafumi Kumano Kobe, Japan More articles by this author , Hideaki MiyakeHideaki Miyake Kobe, Japan More articles by this author , and Masato FujisawaMasato Fujisawa Kobe, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1600AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Random bladder biopsies, taken from normal areas of urothelium, are widely performed to detect concomitant carcinoma in situ (CIS) in patients undergoing transurethral resection (TUR) of non-muscle invasive bladder cancer. However, there are few reports investigating the outcomes of random bladder biopsies based on the data from large series; thus, the significance of random biopsies remains controversial. The objective of this study was to retrospectively review the clinical outcomes of random bladder biopsies in patients with non-muscle invasive bladder cancer to identify predictive factors significantly associated with the findings of random biopsies. METHODS This study included a total of 451 consecutive patients with histopathologically confirmed non-muscle invasive bladder cancer who underwent TUR and random bladder biopsies. The random biopsies were taken from the seven different sites of normal-appearing urothelium, including right wall, left wall, trigone, dome, posterior wall, anterior wall and prostatic urethra. RESULTS Random biopsies were positive in 72 patients (16.0%), of whom 66 (91.7%) and 6 (8.3%) were diagnosed as Tis and Ta, respectively. The incidence of positive random biopsies was significantly associated with past history of upper urinary tract cancer, urinary cytology before TUR, number of tumors, pathological stage, tumor grade and presence of concomitant CIS. Univariate analysis identified past history of upper urinary tract cancer, urinary cytology before TUR and number of tumors as significant predictors of positive random biopsies, among which only urinary cytology before TUR appeared to be independently associated with positive random bladder biopsies on multivariate analysis. Furthermore, consideration of the preoperative finding of urinary cytology could diagnose concomitant malignant disease by random biopsies with 59.4% sensitivity, 88.8% specificity, 50.0% positive predictive value and 92.0% negative predictive value. CONCLUSIONS These findings suggest that the outcome of urinary cytology before TUR could be a useful predictor of positive biopsies in patients with non-muscle invasive bladder cancer. Accordingly, it would be important to further discuss the indication of random bladder biopsies in patients who were preoperatively diagnosed as negative in urinary cytology in order to avoid unnecessary biopsies. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e513 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Masafumi Kumano Kobe, Japan More articles by this author Hideaki Miyake Kobe, Japan More articles by this author Masato Fujisawa Kobe, Japan More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...