Buenos Aires, Argentina (UroToday.com) Mikio Sugimoto, Professor Kagawa University, Japan, discussed new landscape of biomarkers in order to detect bladder cancer. Bladder cancer has high prevalence, recurrence and lethality once it invades the muscle. BC has the highest incidence among the elderly when compared to all cancer types.
Cytology has high specificity but low sensitivity. There are numerous urine biomarkers but few are approved by FDA. Urovysion (FISH) is used to predict BCG failure with advantages being non-invasive and higher sensitivity (but lower specificity) than urine cytology. However, urine biomarkers are not guideline recommended due to lack of high quality evidence. Cystoscopy has high sensitivity and specificity and represents the gold standard for detection of bladder cancer. Photodynamic therapy increases the sensitivity but reports indicates lower specificity than white light cystoscopy. Fluorescent cystoscopy increases detection of CIS and may decrease recurrence when compared to white light cystoscopy. White light vs narrow band cystoscopy shows significantly improved recurrence free survival in low risk NMIBC patients. Further research and high quality research (level one evidence) as well as cost effectiveness research are needed to determine how we incorporate these biomarkers into detection of NMIBC.
World Urological Oncology Federation Symposium at the SIU Congress 2016 - October 20 - 23, 2016 – Buenos Aires, Argentina
Written By: Stephen B. Williams, M.D., Assistant Professor in Urology, The University of Texas Medical Branch, Galveston, TX. and Ashish Kamat, M.D. Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.