1773 PREDICTION OF RECURRENCE AND PROGRESSION IN THE CONTEXT OF THE CHARLSON COMORBIDITY INDEX IN PATIENTS WITH NON-MUSCLE INVASIVE BLADDER CANCER

Abstract

(83%) were male. Prior NMIBC diagnosis was Ta, T1, and Tis-only in 106 (44%), 91 (37%), and 46 (19%) patients, respectively. 196 (81%) were high grade and 126 (52%) had carcinoma-in-situ (CIS). 155 (64%) patients had a history of any prior intravesical therapy, with 121 (50%) receiving BCG only. Initial FISH results were positive in 103 (42%), uninformative in 64 (26%), and negative in 76 (31%). Recurrence and progression occurred in 97 and 24 patients, with median follow up for survivors of 25 and 17.5 months, respectively. Differences in RFS were statistically significant by FISH result, with three-year recurrence rates of 34%, 43%, and 64% for patients with negative, uninformative, and positive FISH (p 0.001, log rank test). On multivariate analysis, positive FISH result was a significant predictor of recurrence (HR 2.4, 95% CI 1.4, 4.0). Differences in PFS were also significant, with three-year progression rates of 7%, 8%, and 22% for patients with negative, uninformative, and positive results (p 0.024, log rank test). In univariate analysis, positive FISH was also a predictor for progression (HR 3.9, 95% CI 1.3, 11.6). CONCLUSIONS: Urinary FISH is a useful adjunct in the surveillance regimen for NMIBC patients with atypical cytology but negative cystoscopy. For these patients, positive FISH reflects an increased risk of recurrence and may warrant more frequent, long-term cystoscopic follow-up.