The Impact of Frequent Cystoscopy on Surgical Care and Cancer Outcomes Among Patients with Low-risk, Non-muscle-invasive Bladder Cancer

Overview

Journal Cancer

Publisher Wiley

Specialty Oncology

Date 2019 May 24

PMID 31120559

Citations 12

Authors

Florian R Schroeck

Kristine E Lynch

Zhongze Li

Todd A MacKenzie

David S Han

John D Seigne

Douglas J Robertson

Brenda Sirovich

Philip P Goodney

Affiliations

Soon will be listed here.

Abstract

Background: Surveillance recommendations for patients with low-risk, non-muscle-invasive bladder cancer (NMIBC) are based on limited evidence. The objective of this study was to add to the evidence by assessing outcomes after frequent versus recommended cystoscopic surveillance.

Methods: This was a retrospective cohort study of patients diagnosed with low-risk (low-grade Ta (AJCC)) NMIBC from 2005 to 2011 with follow-up through 2014 from the Department of Veterans Affairs. Patients were classified as having undergone frequent versus recommended cystoscopic surveillance (>3 vs 1-3 cystoscopies in the first 2 years after diagnosis). By using propensity score-adjusted models, the authors estimated the impact of frequent cystoscopy on the number of transurethral resections, the number of resections without cancer in the specimen, and the risk of progression to muscle-invasive cancer or bladder cancer death.

Results: Among 1042 patients, 798 (77%) had more frequent cystoscopy than recommended. In adjusted analyses, the frequent cystoscopy group had twice as many transurethral resections (55 vs 26 per 100 person-years; P < .001) and more than 3 times as many resections without cancer in the specimen (5.7 vs 1.6 per 100 person-years; P < .001). Frequent cystoscopy was not associated with time to progression or bladder cancer death (3% at 5 years in both groups; P = .990).

Conclusions: Frequent cystoscopy among patients with low-risk NMIBC was associated with twice as many transurethral resections and did not decrease the risk for bladder cancer progression or death, supporting current guidelines.

Citing Articles

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Lyall V, Ould Ismail A, Haggstrom D, Issa M, Siddiqui M, Tosoian J Urology. 2023; 181:92-97.

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The Role of Novel Bladder Cancer Diagnostic and Surveillance Biomarkers-What Should a Urologist Really Know?.

Malinaric R, Mantica G, Monaco L, Mariano F, Leonardi R, Simonato A Int J Environ Res Public Health. 2022; 19(15).

PMID: 35955004 PMC: 9368399. DOI: 10.3390/ijerph19159648.

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