Multiple Mucosal Biopsies and Postoperative Urinary Cytology in
Patients with Bladder Cancer

Gil-Salom, Manuel; Sánchez, Miguel Ángel García; Chuan, Pascual; Clar, F.; Santamarı́a, Javier Gutiérrez; García-Sisamón, Francisco

doi:10.1159/000480134

Cited by 10 publications

(5 citation statements)

References 9 publications

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“…Several reports have suggested that bladder biopsy provokes implantation of tumor cells in biopsy sites[6,7,10,14-17]. Levi et al reported that cold-cup bladder biopsy was highly associated with CIS recurrence compared to hot wire loop biopsy, and thus concluded that bladder biopsy provokes implantation of neoplastic cells[15].…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, an EAU guideline suggested that routine random biopsy is not advised if bladder mucosa has a normal aspect and urine cytology is negative. Furthermore, other investigators have suggested the possibility that bladder biopsies induce implantation of tumor cells at the biopsied mucosal site[6,7,10,14-17]. Still, there seems to be no consensus concerning taking bladder biopsies during TUR-BT[2,4,10].…”

Section: Introductionmentioning

confidence: 99%

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Clinical impact of bladder biopsies with TUR-BT according to cytology results in patients with bladder cancer: a case control study

et al. 2010

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BackgroundThere seems to be no consensus concerning taking bladder biopsies during transurethral resection of bladder tumor (TUR-BT). We investigate the clinical significance of bladder biopsy with TUR-BT and the relationship between urinary cytology and the biopsy results.MethodsWe reviewed a total of 424 patients with non-muscle invasive bladder cancer treated with TUR-BT between 1998 and 2005. Of the total, 293 patients also underwent a bladder biopsy. Biopsies from suspicious-appearing urothelium (N = 59) and those from normal-appearing urothelium (N = 234) were evaluated separately.ResultsBladder cancer was observed in 23 cases (39.0%) who underwent a biopsy of suspicious-appearing urothelium. Among these 23 cases, 9 cases with visible tumor resection had carcinoma in situ (CIS) only in the biopsies from suspicious-appearing urothelium. Urinary cytology was negative in 3 of the 9 cases. Bladder cancer was observed in 26 cases (11.1%) who underwent a biopsy of normal-appearing urothelium. Of them, 5 cases with visible tumors had CIS only in the multiple biopsies from normal-appearing urothelium. Urinary cytology was positive in all of the 5 cases. No upstaging or upgrading cases were found in these patients by the addition of these two types of biopsy. Furthermore, therapy was not altered in these patients. With or without bladder biopsy was not a significant factor for tumor recurrence in either the univariate or multivariate analysis.ConclusionsBased on the results, it is concluded the multiple biopsies from normal-appearing urothelium are not necessary in patients with negative cytology results because of the low detection rate and lack of influence on therapeutic decisions. Meanwhile, biopsy of suspicious-appearing urothelium is needed in patients with negative cytology results in order to detect CIS due to staging properties. This result supports a recent EAU guideline.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical impact of bladder biopsies with TUR-BT according to cytology results in patients with bladder cancer: a case control study

et al. 2010

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“…So far, indications of multiple biopsies have not been determined. It has been reported that abnormal biopsy results are associated with tumor grade and stage 15 . However, it is difficult to know the precise tumor grade and stage at the time of surgery.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2003

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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.

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“…Conversely, the results are less impressive with low-grade disease. Most studies report the sensitivity of cytology in these cases as between 35 and 65% [20,21]. Confounding factors in cytologic evaluation of the urine include tumor load and sampling error.…”

Section: Soluble Tumor Markersmentioning

confidence: 99%

Bladder tumor markers: from hematuria to molecular diagnostics – where do we stand?

Shirodkar¹,

Lokeshwar²

2008

Expert Review of Anticancer Therapy

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Bladder cancer is a common malignancy in the USA. Currently, the detection of initial tumors and recurrent disease is based on evaluation of voided urinary specimens, often followed by cystoscopy. With the high rate of recurrence, cystoscopies are regularly repeated with the aim of halting progression of the disease. For patients, this process is fraught with anxiety, pain and high cost. As a result, intense work is being done in the field of bladder tumor markers with the goal of identifying bladder cancer earlier, both in the initial diagnosis and in recurrences of known tumor. The possibility of identifying a marker that could noninvasively differentiate benign and malignant causes of hematuria, and identify recurrences prior to their pathologic progression is the objective of this area of research. Currently, a large number of tumor markers exist, each scrutinized in both the laboratory and in clinical trials. Here we present many of the most widely used and tested markers. Background details are provided as to the mechanism of detection of malignant cells, the results of recent trials and future directions of study. Some novel modalities for tumor detection are also presented. The next few years will no doubt bring newer markers and lead to the elimination of others. Studies continue to refine the role of these markers in clinical practice, but their ultimate efficacy will need to be borne out in large-scale clinical trials in a multitude of settings.

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Multiple Mucosal Biopsies and Postoperative Urinary Cytology in Patients with Bladder Cancer

Cited by 10 publications

References 9 publications

Clinical impact of bladder biopsies with TUR-BT according to cytology results in patients with bladder cancer: a case control study

Clinical impact of bladder biopsies with TUR-BT according to cytology results in patients with bladder cancer: a case control study

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

Bladder tumor markers: from hematuria to molecular diagnostics – where do we stand?

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