Urine Cytology with FISH as surveillance for bladder cancer – pro

Surveillance refers to the process of ongoing followup that can identify cancer recurrence earlier and presumably to improve prognosis with earlier treatment. Surveillance methods must be highly predictive, have few false positive and there must be a recognized benefit to early intervention. Urine cytology testing with FISH is lacking on these parameters. In an early study by Yoder et al. Approximately 27% of patients under bladder carcinoma surveillance without immediate evidence of tumor recurrence will have a positive FISH result, defining the anticipatory positive subset. In about 65% of this anticipatory positive group, recurrent bladder urothelial carcinoma developed within 29 months. This is a fairly low predictive value. Using FISH in an attempt to increase sensitivity is also not well studied. The review by Anastasiadis says: “At the present time, the additional use and utility of urine-based molecular markers in the follow-up of patients remains unclear and we have to rely on cystoscopic evaluation adapted to risk group classification.” The values of this test with FISH needs to be prospectively validated (Seideman et al).

 

REFERENCES:

 

 

  1. Yoder BJ, Skacel M, Hedgepeth R, Babineau D, Ulchaker JC, Liou LS, Brainard JA, Biscotti CV, Jones JS, Tubbs RR. Reflex UroVysion testing of bladder cancer surveillance patients with equivocal or negative urine cytology: a prospective study with focus on the natural history of anticipatory positive findings. Am J Clin Pathol. 2007 Feb;127(2):295-301.

 

  1. Anastasios Anastasiadis, Ernesto Cordeiro, Mieke Tj Bus, Gerasimos Alivizatos, Jean Jmch de la Rosette, Theo M de Reijke. Expert Review of Anti-infective Therapy 09/2012; 12(9):1229-41. ·Follow-up procedures for non-muscle-invasive bladder cancer: an update.

 

Seideman, Casey (Dallas, TX); Canter, Daniel; Kim, Phillip; Cordon, Billy; Weizer, Alon; Oliva, Irma; Rao, Jianyu; Inman, Brant; Posch, Michael; Lakowske, Margaret; Herr, Harry; Lotan, Yair, Multicenter Evaluation of the Role of Urovysion FISH Assay in Surveillance of Patients with Bladder Cancer: Does FISH Positivity Anticipate Recurrence? AUA,  https://www.auanet.org/university/abstract_detail.cfm?id=391&meetingID=13SAN

Abstract: 391
Date & Time: May 5, 2013 10:30 AM
Session Title: Urothelial Cancer: Natural History, Markers & Pathophysiology

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