UroVysion testing can lead to early identification of intravesical therapy failure in patients with high risk non-muscle invasive bladder cancer.
OBJECTIVE
In this study, we investigated the ability of UroVysion to assess response to intravesical therapy in patients with high risk superficial bladder tumors.


METHODS
We performed a retrospective review of patients undergoing intravesical therapy for high risk superficial bladder tumors. Urine specimens were collected for UroVysion analysis before and immediately after a course of intravesical therapy. Cytology and cystoscopy were performed six weeks after treatment, using either a positive cytology or visible abnormality on cystoscopy as a prompt for biopsy. The operating characteristics of the UroVysion test were then determined.


RESULTS
41 patients were identified in whom 47 cycles of induction and 41 cycles of maintenance intravesical therapy were given during the study period. This yielded a total of 88 treatment and evaluation cycles. Median follow-up was 9 months per induction (range 1-21 months) and 13 months per patient (range 1-25 months). A total of 133 urine samples were collected for UroVysionTM of which 40 were positive. Based upon standard clinical evaluation, 41 biopsies were performed which detected 20 recurrences. UroVysionTM testing performed immediately upon completion of therapy for the 41 patients undergoing biopsy yielded a sensitivity, specificity, and accuracy of 85%, 61%, and 71%.


CONCLUSIONS
The use of UroVysionTM following intravesical therapy for high-risk superficial bladder tumors helps to identify patients at high risk of refractory or recurrent disease who should undergo immediate biopsy under anesthesia.
Whitson
Jared M
JM
Department of Urology, University of California San Francisco, San Francisco, California, USA. jwhitson@urology.ucsf.edu
Berry
Anna B
AB
Carroll
Peter R
PR
Konety
Badrinath R
BR
D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001706:Biopsy; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D017211:Treatment Failure; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D014556:Urine / Q000166:cytology
D000970:Antineoplastic Agents