PD63-12 USE OF CXBLADDER MONITOR DURING THE COVID-19 PANDEMIC TO REDUCE THE FREQUENCY OF SURVEILLANCE CYSTOSCOPY

Abstract

You have accessJournal of UrologyBladder Cancer: Non-invasive III (PD63)1 Sep 2021PD63-12 USE OF CXBLADDER MONITOR DURING THE COVID-19 PANDEMIC TO REDUCE THE FREQUENCY OF SURVEILLANCE CYSTOSCOPY Carissa Chu, Kevin Li, Maxwell Meng, and Sima Porten Carissa ChuCarissa Chu More articles by this author , Kevin LiKevin Li More articles by this author , Maxwell MengMaxwell Meng More articles by this author , and Sima PortenSima Porten More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002107.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic brought unprecedented changes to urologic care in order to minimize risks of transmission. At UCSF, we performed a prospective pilot study of the home-based, mail-in urine CxBladder Monitor (CxM) test to inform the urgency of surveillance cystoscopy in patients with non-muscle invasive bladder cancer (NMIBC). METHODS: From March-June 2020, patients with NMIBC due for surveillance cystoscopy were offered CxM prior to scheduling a clinic visit. Based on prior studies, a CxM score ≥3.5 was used to proceed with cystoscopy while a score below that threshold led to deferring (negative predictive value 97%) cystoscopy. Outcomes of interest included whether in-office cystoscopy was deferred or performed based on CxM and detection of urothelial cancer at immediate or next surveillance cystoscopy. RESULTS: 52 patients (73% men) were included in this study. Median age was 71 (IQR 65-78) years with a median of 4.0 (IQR 2.5-6.1) years since initial bladder cancer diagnosis; 3 (6%) had a history of upper tract urothelial carcinoma (UTUC). By AUA risk stratification criteria, 14 (27%), 17 (33%), and 20 (41%) were low, intermediate, and high-risk, respectively. 50% of patients had experienced recurrence since diagnosis (median 2, IQR 1-4). CxM score was ≥3.5 in 17 (33%) patients. These patients were more likely to have high grade disease at diagnosis (78% vs 64%, p=0.06) but did not differ by age, gender, race, history of UTUC, T stage, or prior recurrences versus patients with CxM results <3.5. 4 patients had tests that could not be resulted and had to be repeated. 14/17 patients (82%) with CxM≥3.5 underwent immediate cystoscopy. 7 (50%) had findings on cystoscopy necessitating biopsy (2 CIS, 2 HG Ta, 2 T2, and 1 subsequently found to have UTUC). In contrast, 35 patients with CxM scores <3.5 deferred cystoscopy to next surveillance at 3 months (63%), 6 months (34%) or 9 months (3%). Of these patients, 32 (91%) have since undergone surveillance cystoscopy (median 4.0 months after) with no suspicious tumor or cytology detected. One patient passed away from unrelated causes. CONCLUSIONS: CxM was feasible and safe for patients on surveillance for NMIBC and decreased frequency of cystoscopy. CxM may be used to further risk stratify patients to deintensify surveillance for NMIBC during the COVID-19 pandemic and beyond. Additional study of patient ease and acceptability is ongoing. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1142-e1142 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Carissa Chu More articles by this author Kevin Li More articles by this author Maxwell Meng More articles by this author Sima Porten More articles by this author Expand All Advertisement PDF downloadLoading ...