Usefulness of Urine Cytology as a Routine Work-up in the Detection of Recurrence in Patients With Prior Non-Muscle-Invasive Bladder Cancer: Practicality and Cost-Effectiveness.
10.4111/kju.2014.55.10.650
- Author:
Bong Gi OK
1
;
Yoon Seob JI
;
Young Hwii KO
;
Phil Hyun SONG
Author Information
1. Department of Urology, Yeungnam University College of Medicine, Daegu, Korea. sph04@hanmail.net
- Publication Type:Original Article ; Evaluation Studies
- Keywords:
Cytology;
Urinary bladder neoplasms;
Urine
- MeSH:
Aged;
Aged, 80 and over;
Cost-Benefit Analysis;
Cystoscopy/economics;
Cytodiagnosis/economics/methods;
Female;
Health Care Costs/*statistics & numerical data;
Humans;
Male;
Middle Aged;
Neoplasm Recurrence, Local/*diagnosis/economics/pathology;
Neoplasm Staging;
Republic of Korea;
Retrospective Studies;
Sensitivity and Specificity;
Tomography, X-Ray Computed/economics;
Urinalysis/economics/methods;
Urinary Bladder Neoplasms/*diagnosis/economics/pathology/surgery;
Urine/*cytology
- From:Korean Journal of Urology
2014;55(10):650-655
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To investigate the usefulness of urine cytology in the detection of tumor recurrence in terms of practicality and cost-effectiveness. MATERIALS AND METHODS: We retrospectively analyzed 393 patients who underwent transurethral resection of bladder tumor (TURBT) for non-muscle-invasive bladder cancer (NMIBC) from January 2010 to June 2013. All patients underwent cystoscopy, urine cytology, urinalysis, and computed tomography (CT) at 3 and 6 months after TURBT. In 62 cases, abnormal bladder lesions were identified on cystoscopy within 6 months. Suspicious lesions were confirmed pathologically by TURBT or biopsy. Patients were grouped by modalities: group I, urine cytology; group II, CT; group III, urinalysis; group IV, urine cytology plus CT; group V, urine cytology plus urinalysis; group VI, CT plus urinalysis; group VII, combination of all three modalities. Each group was compared by cost per cancer detected. RESULTS: Forty-nine patients were confirmed to have tumor recurrence and 13 patients were confirmed to have inflammation by pathology. The overall tumor recurrence rate was 12.5% (49/393) and recurrent cases were revealed as NMIBC. Sensitivity in group I (24.5%) was lower than in group II (55.1%, p=0.001) and group III (57.1%, p<0.001). However, in group VII (77.6%), the sensitivity was statistically similar to that of group VI (75.5%, p=0.872). Under the Korean insurance system, total cost per cancer detected for group VII was almost double that of group VI (p=0.041). CONCLUSIONS: Routine urine cytology may not be useful for follow-up of bladder cancer in terms of practicality and cost-effectiveness. Application of urine cytology needs to be adjusted according to each patient.
