The Utility of Urine Cytology in Predicting Recurrence following Intravesical Therapy for Non‐Muscle Invasive Bladder Cancer - Expert Commentary
The authors found that urine cytology detected high- grade disease in 8/15 patients with high-grade disease biopsy results who received induction BCG. In this group, cytology had a sensitivity of 53% (95% CI 27–79%), a specificity of 95% (95% CI 84–99%), a positive predictive value of 80% (95% CI 44–98%), and a negative predictive value of 85% (95% CI 71–94%).In the high grade and suspicious for high grade, urine cytology has a sensitivity of 67% (95% CI 38–88%) and specificity of 88% (95% CI 74–96%).
The authors conclude that while urinary cytology maintains a high specificity following intravesical therapy, it has low sensitivity for high-grade urothelial carcinoma. This study highlights the need for biomarkers that predict recurrences of NMIBC following intravesical BCG. Cell-free DNA technology is a promising developing technology in this space.
Written by: Bishoy M. Faltas, MD, Director of Bladder Cancer Research, Englander Institute for Precision Medicine, Weill Cornell Medicine
References:
1. Gupta M, Milbar N, Tema G, Pederzoli F, Chappidi M, Kates M, VandenBussche CJ, Bivalacqua TJ. Impact of intravesical therapy for non-muscle invasive bladder cancer on the accuracy of urine cytology. World J Urol. 2019 Oct;37(10):2051-2058. DOI: 10.1007/s00345-018-02624-3. Epub 2019 Jan 23.
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