Abstract
The study was aimed to evaluate the accuracy of combined urine cytology and cystoscopy for the detection of the recurrence of superficial urothelial carcinoma of urinary bladder without bladder biopsy. A total 60 patients [males 48, females 12; age range 41-80 years (mean age- 63.15 years)] were included. Urine cytology as well as cystoscopy were done with a targeted biopsy taken from any apparently visible growth in the bladder. The systematic biopsy was taken where there was no growth. Reports of the cytology and cystoscopy were compared with the histopathology reports. It was found that 18 patients were cytology positive (false positive 2) and 42 patients were cytology negative (false negative 10) with sensitivity 61.5% and specificity 94%. During cystoscopy 24 patients were found recurrent growth in the bladder (false positive 3) and 36 patients were negative (false negative 5) with sensitivity 80.7% and specificity 91%. But when combined urine cytology and cystoscopic findings evaluated, the sensitivity and specificity were found 100% and 91% respectively. In conclusion, combined urine cytology and cystoscopy can be used for the detection of recurrence of superficial urothelial carcinoma of urinary bladder.
Highlights
Urothelial carcinoma of the bladder is the most common malignancy of the genitourinary tract
Superficial type accounts for 70% of the urothelial carcinoma that has a high probability of recurrence (48–71%) within 5 years of initial diagnosis and treatment
Seventy percent of patients who present with the superficial bladder carcinoma have a low-grade superficial tumor and the initial treatment should be the complete clearance by transurethral resection.[1]
Summary
Urothelial carcinoma of the bladder is the most common malignancy of the genitourinary tract. Seventy percent of patients who present with the superficial bladder carcinoma have a low-grade superficial tumor and the initial treatment should be the complete clearance by transurethral resection.[1]. Cystoscopic biopsy is the most accurate technique in diagnosing the recurrence of such tumors.[3] Once superficial urothelial carcinoma with a poor prognosis or high-risk (high-grade tumor T1, multiple location, recurrence) has been diagnosed, the adjuvant treatment is given either by intravesical chemotherapy or intravesical immunotherapy (Bacillus CalmetteGuérin, BCG).[4] After BCG treatment, high-risk tumor is cured in the long-term in one-third of the cases, with recurrence in the same form in another one-third of the cases, and as infiltrating tumor in the remaining one-third.[5]
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