Significance of Random Bladder Biopsies in Superficial Bladder Cancer

Maÿ, F.; Treiber, Uwe; Härtung, R.; Schwaibold, Hartwig

doi:10.1016/s0302-2838(03)00157-x

Cited by 71 publications

(48 citation statements)

References 16 publications

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“…The importance of detecting and locating such highly aggressive tumours is obvious. By contrast with the cited studies on random biopsies [21,22], FC provides high sensitivity for these malignant lesions.…”

Section: Fig 2 Fluorescing Cis When Using Fcmentioning

confidence: 61%

Positive urine cytology but negative white‐light cystoscopy: an indication for fluorescence cystoscopy?

et al. 2009

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OBJECTIVETo evaluate the possible benefit of fluorescence cystoscopy (FC) in detecting cytologically ‘confirmed’ lesions when assessing urothelial carcinoma of the bladder, as negative white‐light cystoscopy in cases of a positive cytological finding represents a diagnostic dilemma.PATIENTS AND METHODSFrom January 1996 to December 2006, 348 patients, who had cystoscopy for surveillance or due to suspicion of urothelial carcinoma, presented with an entirely negative white‐light cystoscopy at our hospital. However, 77 of the 348 patients (22.2%) were diagnosed with a positive cytological finding. All patients had white‐light cystoscopy first and a bladder‐wash cytological specimen was obtained, then FC, followed by cold‐cup biopsies and/or transurethral resection of the bladder tumour.RESULTSIn the 77 patients with a positive cytological specimen FC enabled the detection of the precise site of malignancy within the bladder in 63 (82%). As malignant or premalignant lesions, there were 18 moderate dysplasias, 27 carcinoma in situ (CIS), and 18 pTa‐1/G1‐3 tumours. Moreover using FC, malignant or premalignant lesions were detected in 43 of 271 patients (15.9%) who had a negative cytological specimen (15 moderate dysplasias, six CIS, 22 pTa‐1/G1‐3).CONCLUSIONThis study shows that FC is beneficial in the detection of malignant and premalignant lesions, if there is negative white‐light cystoscopy but positive urine cytology. The immediate identification of the exact site of a malignant lesion during FC enables the physician to diagnose and treat these patients more accurately and with no delay.

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Section: Fig 2 Fluorescing Cis When Using Fcmentioning

confidence: 61%

Positive urine cytology but negative white‐light cystoscopy: an indication for fluorescence cystoscopy?

et al. 2009

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“…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.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of random bladder biopsy in primary T1 bladder cancer

et al. 2018

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Abstract. The clinical significance of random bladder biopsies in primary non-muscle-invasive bladder cancer is unclear. The present study investigated the significance of positive random bladder biopsies in primary T1 NMIBC. The present study retrospectively reviewed the records of 71 patients with primary pT1N0M0 bladder cancer who underwent transurethral resection of the bladder tumor (TURBT) and concomitant random bladder biopsy. A total of 12 patients who received cystectomy immediately following the TURBT were excluded, and the remaining 59 patients were included in the analysis. Random bladder biopsy was defined as a cold-cup biopsy of pre-specified normal-looking areas in the bladder. The association of clinicopathological factors, including random biopsy results, with intravesical recurrence were assessed by univariate and multivariate Cox proportional hazards analyses. Of the 59 patients, 15 (25%) demonstrated carcinoma in situ (CIS) lesions on random bladder biopsy: Five (33%) in biopsy specimens alone and the remaining 10 (67%) in biopsy and TUR specimens. Positive random biopsy was associated with preoperative positive urine cytology (P=0.011) and small size of the main tumor (P=0.008). Multivariate analysis demonstrated positive random biopsy as the sole independent poor prognostic factor for intravesical recurrence (hazard ratio: 4.69, P=0.014). The five patients who had CIS detected in biopsy specimens alone had worse, although non-significantly worse, recurrence-free survival compared with those with CIS detected in biopsy and TUR specimens (P=0.100). In conclusion, positive bladder random biopsy, equivalent to the presence of CIS, was an independent predictor of recurrence in primary T1 bladder cancer. Given that one-third of CIS lesions could not have been detected without biopsy, random bladder biopsy should be considered for patients with T1 tumors.

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“…Además, no se trata de un procedimiento inocuo, pudiendo ocasionar sangrados, perforación vesical y riesgo de implante de célu-las tumorales en las áreas donde se realizó la biopsia [20][21][22] .…”

Section: Discussionunclassified

¿Cuál es el valor de la biopsia aleatoria en el seguimiento del carcinoma uroterial superficial de vejiga?

et al. 2005

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RESUMEN¿CUÁL ES EL VALOR DE LA BIOPSIA ALEATORIA EN EL SEGUIMIENTO DEL CARCINOMA UROTERIAL SUPERFICIAL DE VEJIGA? Introducción: Los pacientes con tumor de vejiga de tipo Carcinoma de Células Transicionales (CCT) presentan enfermedad generalizada de todo el urotelio. El seguimiento de los pacientes con diagnóstico de CCT superficial es sumamente importante por la potencialidad de progresión tumoral. Algunos servicios de urología defienden la biopsia aleatoria de forma rutinaria, sin embargo, otros servicios juzgan ese método innecesario y utilizan la cistoscopia asociada a la citología urinaria como método de seguimiento.Materiales y Métodos: Fueron analizados, retrospectivamente, 49 pacientes portadores de tumor superficial de vejiga (pTa y pT1), en el periodo de 10 años. El seguimiento de este grupo se realizó a través de exámenes de cistoscopia, trimestrales en el primer año, semestrales en el segundo y tercer año, y anuales en el cuarto y quinto año. Durante las cistoscopias se realizaron análisis de citología de la orina y lavado vesical, biopsias de áreas sospechosas y biopsias aleatórias.Resultados: En el grupo de biopsias aleatorias (total de 1.489) se observaron 15 biopsias positivas (1%) y en el grupo de biopsias de áreas sospechosas (total de 38) hubo 4 biopsias positivas (10,5%). Los resultados se consideraron positivos en presencia de tumor urotelial y carcinoma in situ. La citología y/o el lavado vesical se presentaron positivas en 50 (17,4%) de las 288 cistoscopias realizadas. La sensibilidad de la biopsia, incluyendo las aleatorias y las dirigidas, fue de 31%, y su especificidad, de 85,2%, mientras que la asociación de la citología y el lavado urinario obtuvieron sensibilidad de 48% y especificidad de 86,5%.Conclusión: La biopsia aleatoria no demostró mayor eficiencia en el diagnóstico de recidiva tumoral de CCT superficiales cuando fue comparada a la citología urinaria y el lavado vesical, los cuales presentan buenas tasas de sensibilidad y especificidad.Palabras clave: Tumor de vejiga. Carcinoma de células transicionales. Biopsias aleatorias. Recidiva tumoral. Citología. ABSTRACT IS THERE A PLACE FOR RANDOMIZED BIOPSIES IN THE FOLLOW UP OF SUPERFICIAL TRANSITIONAL CELLCARCINOMA OF THE URINARY BLADDER? Introduction: Transitional cell carcinoma of the bladder represents a disease of entire urothelial tract. The follow up is very important to detect any lesion that might represent a progression or a local recurrence. Some authors recommend randomized biopsies as a routine workup, others recommend cystoscopies and urinary cytology as the main part of superficial bladder cancer follow up.Patients and Methods: Forty nine patients with superficial bladder cancer were followed up during a ten-year period. Randomized biopsies and urinary cytology were harvested according to the international cancer protocol on bladder cancer.Results: 15 (1%) out of 1.489 randomized biopsies found to be positive to transitional cell carcinoma. Four out (10.5%) of 35 biopsies targeted to suspicious areas were positive to t...

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Significance of Random Bladder Biopsies in Superficial Bladder Cancer

Cited by 71 publications

References 16 publications

Positive urine cytology but negative white‐light cystoscopy: an indication for fluorescence cystoscopy?

Positive urine cytology but negative white‐light cystoscopy: an indication for fluorescence cystoscopy?

Clinical significance of random bladder biopsy in primary T1 bladder cancer

¿Cuál es el valor de la biopsia aleatoria en el seguimiento del carcinoma uroterial superficial de vejiga?

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