The Value of Upper Tract Cytology After Transurethral Resection of Bladder Tumor in Patients With Bladder Transitional Cell Cancer

Sadek, Samih; Soloway, Mark S.; Hook, Sharon; Civantos, Francisco

doi:10.1016/s0022-5347(01)62068-8

Cited by 23 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Notably, two of the present patients required additional treatment for upper tract recurrences. While the proportion of patients diagnosed with NMIBC who go on to develop upper tract TCC is traditionally considered to be < 3% [23][24][25], patients with high-risk superficial disease have been reported to have upper tract recurrence rates of up to 18% after BCG treatment [26,27]. It is difficult to make any inferences without a randomized controlled trial as to whether treatment with intravesical docetaxel positively or negatively altered the risk of upper tract recurrence in the present patients, who were already at increased risk from previous BCG treatment, but our observation indicates the necessity of close surveillance of the upper tract in patients having bladder recurrences after BCG therapy.…”

Section: Discussionmentioning

confidence: 99%

A single‐institution experience with induction and maintenance intravesical docetaxel in the management of non‐muscle‐invasive bladder cancer refractory to bacille Calmette‐Guérin therapy

et al. 2009

View full text Add to dashboard Cite

OBJECTIVE To analyse the durability of response for patients with non‐muscle‐invasive bladder cancer (NMIBC) refractory to bacille Calmette‐Guérin (BCG) therapy and treated with intravesical docetaxel in a combined induction and maintenance regimen. PATIENTS AND METHODS A previous phase I trial showed docetaxel to be safe for intravesical therapy, with no systemic absorption and minimal toxicity after six weekly instillations for patients with BCG‐refractory NMIBC. In that trial, docetaxel gave a 56% complete response (CR) rate at 12 weeks, but the durability was only 22%. Thus a second group of patients was treated with a 6‐week induction and then given monthly maintenance therapy with intravesical docetaxel. Thirteen patients with BCG‐refractory Ta, T1, or Tis transitional cell carcinoma were treated. Induction therapy was administered as six weekly intravesical instillations of 75 mg followed by single‐dose monthly maintenance therapy for nine additional instillations in patients who had a CR. The initial response at 12 weeks from the start of induction therapy was evaluated by cystoscopy with biopsy, and urine cytology. The follow‐up consisted of quarterly cystoscopy with biopsy and cytology, and periodic imaging. RESULTS The median follow‐up was 13 months; 10 of 13 patients had a CR after induction, and six have remained disease‐free during the follow‐up. Of those in who the treatment failed, six had transurethral resection of the tumour and one a cystectomy. All 10 initial responders completed at least three instillations of maintenance therapy to date (median nine instillations), of whom six have remained recurrence‐free. CONCLUSION Monthly maintenance therapy with intravesical docetaxel appears to extend the durability of response to induction treatment for a selected group of patients with BCG‐refractory NMIBC, and might decrease the overall risk of recurrence in high‐risk NMIBC.

show abstract

Section: Discussionmentioning

confidence: 99%

A single‐institution experience with induction and maintenance intravesical docetaxel in the management of non‐muscle‐invasive bladder cancer refractory to bacille Calmette‐Guérin therapy

et al. 2009

View full text Add to dashboard Cite

show abstract

“…Urine cytology has been highly specific but poorly sensitive in diagnosing upper tract urothelial carcinoma (UTUC) . However, patients with a normal UT on imaging or ureteroscopy may be found to have tumor cells in ureteral washing specimens, the significance of which is not well understood . Endoscopic surveillance of UTUC is more feasible with newer instrumentation techniques, but can be technically challenging and may be associated with complications such as ureteral perforation .…”

Section: Introductionmentioning

confidence: 99%

Comparison of urine cytology and fluorescence in situ hybridization in upper urothelial tract samples

Reynolds

Voss

Kipp

et al. 2014

Cancer Cytopathology

View full text Add to dashboard Cite

BACKGROUND:The cytologic diagnosis of urothelial carcinoma (UC) of the upper urothelial tract (UT) is challenging.Using the UroVysion probe set adds diagnostic value for the detection of bladder cancer in voided urine. In instrumented Biopsy confirmation of UTUC in 21 patients was considered the gold standard. RESULTS: Cytology alone was found to be poorly sensitive (38%) but highly specific (89%) for the detection of UTUC. FISH was found to increase the sensitivity of cytology and decrease specificity. Tetrasomy FISH resulted in many false-positive cases. Other false-positive FISH results were likely due to the presence of bladder cancer cells contaminating the UT specimen. CONCLUSIONS: Caution should be used when evaluating instrumented urine specimens of the UT from patients with a previous history of bladder carcinoma, and tetrasomy FISH results should not be interpreted as abnormal because it significantly lowers the specificity of the test. The combination of cytology and FISH appears to have good specificity while maintaining good sensitivity in evaluating UTUC when using modified scoring criteria for the appropriate patient population. Cancer (Cancer Cytopathol) 2014;122:459-67.

show abstract

“…In a more recent study, the use of cytologic analysis and ImmunoCyt together gave the best results, with 100% sensitivity and specificity 15 . However, as reported by Sadek et al 8 . in the case of concomitant bladder cancer, tumor cells obtained by retrograde catheterization of the UT do not necessarily represent UT‐TCC but are probably a contamination by malignant cells from the bladder entering into the UT during manipulation.…”

Section: Discussionmentioning

confidence: 86%

“…In an attempt to monitor the UT by cytology, urologists may obtain urine from each UT by ureteral catheterization. However, as reported by Sadek et al 8 . in the case of concomitant bladder cancer, tumor cells obtained by retrograde catheterization of the UT do not necessarily represent UT‐TCC.…”

Section: Introductionmentioning

confidence: 82%

Value of selective upper tract cytology for recognition of upper tract tumors after treatment of superficial bladder cancer

et al. 2003

View full text Add to dashboard Cite

Background : The value of selective upper urinary tract (UT) cytology in patients who are asymptomatic and tumor free at control cystoscopy after being treated for superficial bladder carcinoma has not been studied. The present study was performed to evaluate the value of selective UT cytology in patients who are tumor free at control cystoscopy after being treated for superficial bladder cancer. Methods : Forty-seven consecutive patients who had undergone definitive surgical treatment for superficial bladder cancer at least 24 months prior and were tumor free at control cystoscopy were evaluated with bladder wash for cytology as well as selective UT urine cytology by catheterization of both ureteral orifices. Of the 47 patients, disease was stage Ta in 30 (63.8%), T1 in 15 (31.9%) and Ta/Tcis in 2 (4.3%). Primary tumor was unifocal in 24 (51.1%) and multifocal in 23 (48.9%) patients. The time elapsed from the initial diagnosis to the last evaluation ranged from 2 to 21 years (mean 5.39). Results : UT cytology was positive in 2 cases. Although, excretory urography (IVP) revealed mild pelvicalicectasis in 1 of these 2 patients, ureterorenoscopy (URS) revealed no abnormality. In the other patient with normal IVP and retrograde pyelography (RGP), URS revealed a ureteral tumor 5 mm in diameter. Although the UT cytology was normal in the remaining 45 patients, IVP revealed right hydronephrosis in 1 patient and URS revealed multiple ureteral tumors. Conclusion : Given the normal appearance of the UT, it is highly unlikely that these patients have tumor in the UT. Thus, during the follow-up of patients with superficial bladder cancer, it is not useful to perform UT select cytology in the absence of any identifiable filling defects in the upper urinary tract.

show abstract

The Value of Upper Tract Cytology After Transurethral Resection of Bladder Tumor in Patients With Bladder Transitional Cell Cancer

Cited by 23 publications

References 23 publications

A single‐institution experience with induction and maintenance intravesical docetaxel in the management of non‐muscle‐invasive bladder cancer refractory to bacille Calmette‐Guérin therapy

A single‐institution experience with induction and maintenance intravesical docetaxel in the management of non‐muscle‐invasive bladder cancer refractory to bacille Calmette‐Guérin therapy

Comparison of urine cytology and fluorescence in situ hybridization in upper urothelial tract samples

Value of selective upper tract cytology for recognition of upper tract tumors after treatment of superficial bladder cancer

Contact Info

Product

Resources

About