IBCN 2018: A Non-Invasive Diagnostic Urine Assay to Safely Reduce the Need for Diagnostic Cystoscopy in Patients Presenting with Hematuria

Rotterdam, The Netherlands (UroToday.com) Kim E.M. van Kessel assessed the accuracy to detect bladder cancer of a previously developed molecular assay in a large prospective cohort of patients referred for hematuria. They prospectively included 1003 patients referred to the urology clinic for hematuria who received a cystoscopy. Mutation status of the FGFR3, TERT and HRAS genes and methylation of the OTX1, ONECUT2 and TWIST1 genes were determined. The predictive capacity of the urine assay, potential confounders and the association between potentially predictive variables and the detection of bladder cancer were determined via logistic regression analyses.

Of all patients, 59% were male and 41% female, 55% presented with macroscopic hematuria compared to 45% with microscopic hematuria. A total of 115 patients was diagnosed with urothelial cancer. The assay resulted in an AUC of 0.95 and a sensitivity of 93%, a specificity of 81% and a NPV of 99%. All 4 upper tract tumors were identified. 

In summary, patients referred for hematuria the urine assay was able to predict the absence of bladder cancer, especially in the microhematuria patient population, with very high accuracy. This assay may be implemented clinically to select patients for diagnostic cystoscopy.

Presented by: Kim E.M. van Kessel, Erasmus MC Cancer Institute, Erasmus Medical Center, Rotterdam

Written by: Stephen B. Williams, M.D., Associate Professor, Division of Urology, The University of Texas Medical Branch, Galveston, TX. and Ashish M. Kamat, M.D. Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX at the 16th Annual Meeting of the International Bladder Cancer Network (IBCN) October 11-13, 2018 - the Inntel Hotels Rotterdam Centre, Rotterdam, The Netherlands