title: Does voided urine cytology have biological significance?
abstract: OBJECTIVE
  To (i) define any correlation between the result of voided urine cytology (VUC) at presentation and the biological behaviour of Ta/T1 transitional cell carcinoma (TCC) of the bladder; and (ii) observe the natural history of Ta/T1 bladder cancer in relation to new prognostic groupings.
  
  
  METHODS
  The study comprised 109 patients with newly diagnosed Ta/T1 TCC of the bladder, all of whom had VUC assessed at presentation. Information on the number of tumours at presentation and the subsequent tumour recurrence rate during clinical follow-up was compared with the outcome of VUC.
  
  
  RESULTS
  Of the 109 patients, 67 (61%) had Ta and 42 (39%) had T1 tumours. At presentation, there were 75 (69%) solitary (Ta=50, T1=25) and 34 (31%) multifocal (Ta=17, T1=17) tumours. At presentation, VUC was negative in 71 (65%), suspicious in 22 (20%) and positive for urothelial carcinoma in 16 (15%) patients. During follow-up, 58% of patients with Ta tumours and 83% of patients with T1 tumours developed recurrences (median follow-up 43.5 months, P=0.01), although there was no significant difference in the recurrence rate between these groups (P=0.096). In addition, for those patients with Ta tumours that were multifocal at presentation, there was a significantly higher recurrence rate (P=0.003). Although there was no correlation between the result of VUC and the number of tumours at presentation, there was a significantly higher tumour recurrence rate for those patients with suspicious/positive VUC than for those whose VUC was negative (P<0.05).
  
  
  CONCLUSIONS
  This study shows the impact of tumour multifocality at presentation on subsequent tumour recurrence rate. In addition, the VUC result at presentation correlated with tumour recurrence in patients with Ta/T1 TCC of the bladder.
authors.affiliation: Department of Urology, University of Newcastle upon Tyne, Newcastle, UK.
authors.forename: V M
authors.initials: VM
authors.lastname: Tut
authors.forename: A J
authors.initials: AJ
authors.lastname: Hildreth
authors.forename: M
authors.initials: M
authors.lastname: Kumar
authors.forename: J K
authors.initials: JK
authors.lastname: Mellon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000652:urine*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D001749:Urinary Bladder Neoplasms / Q000652:urine*; D014556:Urine / Q000166:cytology