Multiple biopsies of normal‐looking urothelium in patients with superficial bladder cancer: Are they necessary?

Abstract

Background : The objective of the study presented here was to assess the usefulness and indications of multiple biopsies of normal-appearing urothelium in patients with superficial bladder cancer. Methods : Between December 1996 and December 2002, multiple biopsies of normal-appearing bladder mucosa were performed in 100 patients with superficial bladder transitional cell carcinoma. Biopsy specimens were taken from seven different sites in females and nine different sites in males. Results : In eight of 100 patients, bladder cancers were detected in the biopsy specimens. Three cases were Ta and five were Tis. All of the five patients with carcinoma in situ (CIS) in their biopsy specimens had multiple papillary broad-base tumors and positive urinary cytology. The detection ratio of CIS in patients with these findings was 17.9% (5/28). No concomitant CIS was detected in the 72 patients who had a solitary tumor, pedunculated tumor(s), or negative urinary cytology. Conclusion : Multiple mucosal biopsies of normal-appearing urothelium are not necessary for all patients with superficial bladder cancer. They are, however, necessary for patients with multiple papillary broad-base tumors and positive urinary cytology.

Clinical significance of random bladder biopsy in primary T1 bladder cancer

“…Thus, the indications of random bladder biopsies needs to be carefully optimized. Previous studies have reported that random bladder biopsy has demonstrated positive results in 5 to 30% of the patients with all-risk NMIBC, and in as high as 60% of the patients with high-risk NMIBC (8)(9)(10)(11)(12). However, prognostic significance of random bladder biopsy in primary NMIBC has not been well defined.…”

Significance of Random Bladder Biopsies in Non-Muscle Invasive Bladder Cancer

“…Of the 100 patients who were diagnosed as low risk NMIBC, including low grade, small size and solitary tumors, concomitant urothelial cancer was detected in 10 (10%) patients by the random biopsies. To date, various proportions of patients showing positive findings of random bladder biopsies have been reported [4,5,6,7,8,9,10]. For example, May et al [5] reported that 12.4% of patients with high- or intermediate-risk NMIBC had urothelial cancer in random biopsies, while in a study conducted by the European Organization for Research and Treatment of Cancer (EORTC), there were no abnormal findings of the random biopsies in 95.6% of patients with low-risk NMIBC and 88.4% of patients with high- and intermediate-risk NMIBC [4].…”

“…To date, there have been few studies investigating the significance of random bladder biopsies for patients with NMIBC, and their findings on the indication of this procedure were controversial [4,5,6,7,8,9,10]. For example, van der Meijden et al [4] reported that random bladder biopsies contributed to neither the staging nor the selection of adjuvant therapy following TUR of NMIBC, while May et al [5] showed the strong impact of random biopsies on the decision to undertake post-TUR therapy for patients with NMIBC.…”

Diagnóstico fotodinámico (PDD) en el cáncer vesical no músculo-invasivo: Revisión bibliográfica

“…En este caso, el lector inicialmente puede opinar que no debemos emplear la PDD, ya que teniendo citologías negativas la posibilidad de hallar lesión plana de alto grado es remota, y ni tan siquiera en condiciones normales realizaríamos biopsias aleatorias 16,43 Tabla 10 -Repercusión del empleo de PDD (HAL) en el gasto sanitario en un año suponiendo diferentes capacidades de disminución de la tasa de recidivas 40 calidad, ya que la PDD es capaz de detectar un mayor número de lesiones 19,20 ; de una baja tasa de residuales 27 ; estamos favoreciendo la presentación de una falsa recidiva temprana y a largo plazo le privaremos de una supervivencia libre de recidiva mayor [23][24][25][26] .…”