A novel bladder cancer surveillance schedule using bladder Cx for patients on annual surveillance

IF 1.6 Q3 UROLOGY & NEPHROLOGY

BJUI compass Pub Date : 2025-01-15 DOI:10.1002/bco2.468

Arjun Guduguntla, Thomas Whish-Wilson, Lauren Chandler, Dennis Gyomber

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Abstract

Objectives

Cx bladder monitor (CxM) is a urine test with a proven high sensitivity and negative predictive value in bladder cancer surveillance. The aim of this retrospective study was to report on the outcomes of our newly implemented bladder cancer surveillance program for patients eligible for yearly cystoscopy, as per the European Association of Urology (EAU) guidelines. In this program, eligible patients alternate between yearly surveillance cystoscopy and CxM, instead of the standard yearly surveillance cystoscopy. Outcomes measures were overall results of CxM and subsequent treatment patterns of patients, impact on waiting lists, cost comparison and patient satisfaction.

Patients and Methods

In 2022, 109 eligible and consenting patients were identified, with 98 commencing on the new surveillance program, starting with CxM instead of cystoscopy. A negative CxM, would result in a planned flexible cystoscopy in 12 months. If a patient had a positive CxM, they proceeded to undergo a cystoscopy, and if required, imaging.

Results

Of the 98 that underwent testing, 90 had a negative CxM test and 8 patients had a positive CxM test. Three of these eight were true positive (PPV 0.375). Seventy negative CxM patients had no recurrence at the time of the next cystoscopy/imaging. Of the remaining 20 negative CxM patients, 11 were found to have a recurrence at subsequent cystoscopy/imaging and 9 did not proceed with further surveillance for various reasons. All of the tumour recurrences diagnosed after a negative CxM were non-invasive, thus there was no progression to muscle-invasive disease. All suitable patients consented to continuing with the CxM protocol. The hospital surveillance cystoscopy waitlist was reduced by approximately 59% and CxM was approximately $850 AUD cheaper than a cystoscopy.

Conclusion

CxM can be safely used in an alternating schedule with Flexible Cystoscopy for patients on annual bladder cancer surveillance.

Abstract Image

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一种新的膀胱癌年度监测方案：膀胱Cx。

目的：Cx膀胱监测（CxM）是一种尿检，在膀胱癌监测中具有高灵敏度和阴性预测价值。这项回顾性研究的目的是报告我们新实施的膀胱癌监测项目的结果，这些患者符合欧洲泌尿外科协会（EAU）的指南，每年进行膀胱镜检查。在这个项目中，符合条件的患者在每年监测膀胱镜检查和CxM之间交替进行，而不是标准的每年监测膀胱镜检查。结果测量是CxM的总体结果和患者的后续治疗模式，对等候名单的影响，成本比较和患者满意度。患者和方法：在2022年，109名符合条件和同意的患者被确定，其中98名开始新的监测项目，从CxM开始，而不是膀胱镜检查。如果x光检查呈阴性，将会在12个月内进行软性膀胱镜检查。如果病人的x光检查呈阳性，他们会继续进行膀胱镜检查，如果需要，还会进行成像。结果：在接受检测的98例患者中，90例CxM检测阴性，8例CxM检测阳性。其中3例为真阳性（PPV 0.375）。70例阴性CxM患者在下次膀胱镜/成像时没有复发。在其余20例阴性CxM患者中，11例在随后的膀胱镜检查/成像中发现复发，9例因各种原因未继续进行进一步监测。所有在x光检查阴性后诊断出的肿瘤复发都是非侵袭性的，因此没有进展为肌肉侵袭性疾病。所有合适的患者都同意继续使用CxM方案。医院膀胱镜检查的等待名单减少了约59%，CxM比膀胱镜检查便宜约850澳元。结论：在膀胱癌年度监测患者中，CxM与柔性膀胱镜交替使用是安全的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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