title: Prognostic value of urinary cytology and other biomarkers for recurrence and progression in bladder cancer: a prospective study.
abstract: OBJECTIVE
  Urinary cytology (C) and cystoscopy remain the gold standard for the detection and screening of bladder cancer (BC). In this prospective study, we analyzed whether baseline C, ImmunoCyt (I), BTA Stat (B), hemoglobin dipstick (H), and NMP22 BladderChek (N) can predict recurrence and progression.
  
  
  METHODS
  Urinary samples from 91 patients with BC were prospectively collected over an 18-month period. Baseline characteristics of the population included patient demographics, various clinicopathological variables and use of intravesical therapy. Progression and recurrence were then assessed after a median follow-up of 48 months (IQR 23.7-59.5). Univariate and multivariate analyses were performed using COX proportional hazards models.
  
  
  RESULTS
  On univariate analysis, C (HR 1.36; p = 0.26), I (HR 0.89; p = 0.66), B (HR 0.80; p = 0.42), H (HR 0.75; p = 0.30), and N (HR 0.82; p = 0.48) were not associated with recurrence-free survival (RFS). With regard to progression-free survival (PFS), C was significantly prognostic (HR 2.67; p = 0.017), whereas I, B, H, and N were not. On multivariable analysis, NMP22 was the only marker to be independently associated with RFS (HR 0.41, p < 0.01) and PFS (HR 0.32, p = 0.02).
  
  
  CONCLUSIONS
  Based on the results of this study, baseline C, B, I, and H were not independently prognostic. Prognostic impact of NMP22 requires further validation in a multicenter larger study.
authors.affiliation: Department of Surgery (Urology), McGill University, Montreal, QC, Canada.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Bell
authors.affiliation: Department of Surgery (Urology), McGill University, Montreal, QC, Canada.
authors.forename: Faysal A
authors.initials: FA
authors.lastname: Yafi
authors.affiliation: Department of Surgery (Urology), McGill University, Montreal, QC, Canada.|Division of Pathology, McGill University Health Center, Montreal, QC, Canada.
authors.forename: Fadi
authors.initials: F
authors.lastname: Brimo
authors.affiliation: Department of Surgery (Urology), McGill University, Montreal, QC, Canada.
authors.forename: Jordan
authors.initials: J
authors.lastname: Steinberg
authors.affiliation: Department of Surgery (Urology), McGill University, Montreal, QC, Canada.
authors.forename: Armen G
authors.initials: AG
authors.lastname: Aprikian
authors.affiliation: Department of Surgery (Urology), McGill University, Montreal, QC, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Tanguay
authors.affiliation: Department of Surgery (Urology), McGill University, Montreal, QC, Canada. wassim.kassouf@muhc.mcgill.ca.
authors.forename: Wassim
authors.initials: W
authors.lastname: Kassouf
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000652:urine; D002170:Canada / Q000453:epidemiology; D003558:Cystoscopy; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000652:urine*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016482:Urinalysis; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000652:urine*
chemical_list: D014408:Biomarkers, Tumor
keywords: Bladder cancer; Progression; Recurrence; Urinary biomarkers; Urinary cytology