Cytophotometry in the monitoring of bladder cancer under intravesical chemotherapy.
OBJECTIVE
We evaluated the DNA cytophotometry in 446 bladder washing samples from 64 patients under mitomycin C after superficial bladder cancer during an observation period of up to 5 years. The aim of the study was to identify patients at high risk of recurrence despite chemotherapy-induced atypical, hence noninformative cytology.


METHODS
The prognostic value of cytology and ploidy during chemotherapy was compared with regard to recurrence rates and the median time to recurrence.


RESULTS
Aneuploidy identified 8 of 10 patients recurring within 12 months out of 17 patients with atypia at first presentation after surgery, whereas no recurrence was seen after atypia and diploid histograms (p = 0.005, mean follow-up period 62 months). Aneuploidy was the most accurate indicator of short-time recurrence (p < 0.001 by multivariate analysis). Follow-up data showed a relative risk of recurrence of 12.7 following histogram shifts towards aneuploidy and of 1.6 for positive shifts in cytology.


CONCLUSIONS
Cytophotometry is superior to cytology in predicting the outcome in patients under chemotherapy for superficial transitional cell cancer of the bladder.
Simak
R
R
Department of Urology, University of Vienna, Austria.
Wiener
H
H
Foeger
A
A
Susani
M
M
Zhang
Z F
ZF
Maier
U
U
Marberger
M
M
D000283:Administration, Intravesical; D000368:Aged; D000782:Aneuploidy; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D003592:Cytophotometry; D004273:DNA, Neoplasm / Q000032:analysis*; D005500:Follow-Up Studies; D006801:Humans; D016685:Mitomycin / Q000008:administration & dosage* / Q000627:therapeutic use; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology / Q000601:surgery
D000903:Antibiotics, Antineoplastic; D004273:DNA, Neoplasm; D016685:Mitomycin