Risk for intravesical recurrence of bladder cancer stratified by the results on two consecutive UroVysion fluorescence in situ hybridization tests: a prospective follow-up study in Japan

Abstract

Background A previous comparative study in Japan has demonstrated that the two consecutive UroVysion tests are useful tools to detect the presence of bladder cancer during follow-up after transurethral resection, but they also presented their high rates of false-positive results. Here, we aimed to evaluate the relationship between the UroVysion tests and subsequent intravesical recurrence. Methods In the previous study, patients without bladder cancer during the first analysis showed the same examination set repeated 3 months later as the second analysis. In this follow-up study, 326 patients showed negative findings confirmed on cystoscopy during the second UroVysion test. Recurrence-free survival was assessed using a median follow-up of 27 months. Results In the two consecutive UroVysion tests, 214 patients (65.6%) showed negative UroVysion results in both tests, whereas 91 presented a positive result on either tests and 21 patients presented positive results in both tests. During the follow-up, 40 patients (12.3%) had an intravesical recurrence with non-muscle-invasive bladder cancer. The recurrence rates in patients with negative results in both tests, those with one positive result in either tests, and those with positive results in both tests were 8.4%, 16.5%, and 33.3%, respectively. The multivariate analysis indicated that the history of bladder cancer and the consecutive UroVysion test pattern were independent risk factors for recurrence. Conclusions Our data confirmed the effectiveness of two consecutive UroVysion tests in predicting intravesical recurrence after TURBT. Further prospective studies would help determine an appropriate interval for cystoscopy follow-up.

The Role of Androgens and Androgen Receptor in Human Bladder Cancer

“…Androgen receptor signaling is involved in bladder cancer, although this pathology is not considered sex-related, because the higher associated risk in men versus women may reflect other aspects, nor is the bladder considered an androgen-responsive organ [ 14 , 35 , 84 ]. All the components in AR signaling are studied to understand their participation as biomarkers or as pharmacological targets.…”

“…Suitable treatment of bladder cancer can be indicated after diagnosis following transurethral resection of the tumor with cytoscopy and urine cytology for screening and initial diagnosis and for the monitoring or surveillance of tumor recurrence or its progression; urine-based detection markers (nuclear matrix protein 22, bladder tumor antigen, carcinoembryonic antigen, bladder tumor cell-associated mucins and chromosomal alterations) are also useful tools [ 81 , 82 , 83 , 84 ].…”

UroVysion fluorescence in situ hybridization in urothelial carcinoma: a narrative review and future perspectives

“…UroVysion and urine cytology are not thought to be affected by the presence of erythrocytes or leukocytes compared to the NMP22 test (12). However, the UroVysion test yields false positives due to the presence of umbrella cells, as suggested by the presence of chromosome tetraploidy, or heteroploidy, which appears because of human polyomavirus infection (13)(14)(15). Most papers have compared the UroVysion test to urine cytology or other urinary biomarkers.…”

“…A prospective study comparing urinary biomarkers in a followup of patients with non-muscle invasive BCa with a low grade highlighted the superiority of UroVysion to cytology in terms of sensitivity and specificity (43). Consecutive UroVysion testing was reported as a more reliable method in predicting intravesical recurrence after transurethral resection of bladder tumor (TURBT) (15). In addition, these circumstances might change in the era of high-resolution endoscopes such as narrow band imaging or photodynamic diagnosis (15).…”

“…Consecutive UroVysion testing was reported as a more reliable method in predicting intravesical recurrence after transurethral resection of bladder tumor (TURBT) (15). In addition, these circumstances might change in the era of high-resolution endoscopes such as narrow band imaging or photodynamic diagnosis (15).…”