1781 IS IT NECESSARY TO ROUTINELY PERFORM MULTIPLE BIOPSIES FROM NORMAL-APPEARING UROTHELIUM WHEN URINE CYTOLOGY IS POSITIVE IN PATIENTS WITH NON-MUSCLE INVASIVE BLADDER CANCER?

Abstract

You have accessJournal of UrologyBladder Cancer: Superficial (II)1 Apr 20131781 IS IT NECESSARY TO ROUTINELY PERFORM MULTIPLE BIOPSIES FROM NORMAL-APPEARING UROTHELIUM WHEN URINE CYTOLOGY IS POSITIVE IN PATIENTS WITH NON-MUSCLE INVASIVE BLADDER CANCER? Masashi Matsushima, Eiji Kikuchi, Masanori Hasegawa, Kazuhiro Matsumoto, Akira Miyajima, Ken Nakagawa, and Mototsugu Oya Masashi MatsushimaMasashi Matsushima Tokyo, Japan More articles by this author , Eiji KikuchiEiji Kikuchi Tokyo, Japan More articles by this author , Masanori HasegawaMasanori Hasegawa Tokyo, Japan More articles by this author , Kazuhiro MatsumotoKazuhiro Matsumoto Tokyo, Japan More articles by this author , Akira MiyajimaAkira Miyajima Tokyo, Japan More articles by this author , Ken NakagawaKen Nakagawa Tokyo, Japan More articles by this author , and Mototsugu OyaMototsugu Oya Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2871AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The EAU guideline states that if the rest of the bladder mucosa appears normal and if urine cytology is negative, it is not advisable to routinely perform multiple biopsies from normal-appearing urothelium because of the low detection rate and lack of influence on therapeutic decisions. This recommendation is based on the EORTC study. The role of urine cytology performance on CIS detection and the impact on the therapeutic decision on non-muscle invasive bladder cancer (NMIBC) is not fully analyzed in a clinical setting. The purpose of this study was to investigate the clinical significance of bladder biopsy with transurethral resection of bladder tumor (TUR-BT) and the relationship between urine cytology and the biopsy results. METHODS We reviewed a total of 424 patients with NMIBC treated with TUR-BT between 1998 and 2005. Of the total, 293 patients also underwent a bladder biopsy. Biopsies from suspicious-appearing urothelium (N = 59) and those from normal-appearing urothelium (N = 234) were evaluated separately. RESULTS Bladder cancer was observed in 23 (39.0%) patients who underwent a biopsy of suspicious-appearing urothelium and in 26 (11.1%) who underwent a biopsy of normal-appearing urothelium. In the biopsies from suspicious-appearing urothelium, CIS was observed in 13 patients (22.0%). Nine cases with visible tumor resection had CIS only in the biopsies from suspicious-appearing urothelium. Urine cytology was negative in 3 of the 9 cases. In the biopsies from normal-appearing urothelium, CIS was detected in 9 patients (3.8%). Five cases with visible tumors had CIS only in the multiple biopsies from normal-appearing urothelium. Urine cytology was positive in all 5 cases. No upstaging or upgrading cases were found in these patients by the addition of these two types of biopsy. Furthermore, therapy was not altered in these patients. With or without a bladder biopsy was not a significant factor for tumor recurrence in either the univariate analysis or multivariate analysis. CONCLUSIONS In our series, all CIS cases detected only in the multiple biopsies from normal-appearing urothelium had positive cytology results. On the other hand, the positive rate for detecting CIS in biopsies from suspicious-appearing urothelium is significantly higher than that of multiple biopsies from normal-appearing urothelium. Thus, if the patients have suspicious-appearing urothelium or positive cytology results, we believe that bladder biopsy may be useful for detecting CIS because of staging properties. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e732 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Masashi Matsushima Tokyo, Japan More articles by this author Eiji Kikuchi Tokyo, Japan More articles by this author Masanori Hasegawa Tokyo, Japan More articles by this author Kazuhiro Matsumoto Tokyo, Japan More articles by this author Akira Miyajima Tokyo, Japan More articles by this author Ken Nakagawa Tokyo, Japan More articles by this author Mototsugu Oya Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...