Simulation of the effects of molecular urine markers in follow-up of patients with high-risk non-muscle invasive bladder cancer

被引：1

作者：

Benderska-Soder, Natalya ^{[1
]}

Ecke, Thorsten ^{[2
,3
]}

Kleinlein, Lisa ^{[1
]}

Roghmann, Florian ^{[4
]}

Bismarck, Ekkehardt ^{[1
]}

van Rhijn, Bas W. G. ^{[5
,6
]}

Stenzl, Arnulf ^{[7
]}

Witjes, Johannes Alfred ^{[8
]}

Todenhoefer, Tilman ^{[9
]}

Hakenberg, Oliver W. ^{[10
]}

Grimm, Marc Oliver ^{[11
]}

Goebell, Peter J. ^{[12
]}

Burger, Maximilian ^{[6
]}

Jensen, Jorgen Bjerggaard ^{[13
]}

Schmitz-Draeger, Bernd J. ^{[1
,9
]}

机构：

[1] St Theresienkrankenhaus, Urol 24, Nurnberg, Germany

[2] HELIOS Klin, Dept Urol, Bad Saarow Pieskow, Germany

[3] Charite Univ Med Berlin, Dept Urol, Berlin, Germany

[4] Ruhr Univ Bochum, Marien Hosp Herne, Dept Urol, Bochum, Germany

[5] Antoni Leeuwenhoek Hosp, Netherlands Canc Inst, Dept Surg Oncol Urol, Amsterdam, Netherlands

[6] Univ Regensburg, Caritas Hosp St Josef, Dept Urol, Regensburg, Germany

[7] Eberhard Karls Univ Tubingen, Dept Urol, Tubingen, Germany

[8] Radboud Univ Nijmegen, Med Ctr, Dept Urol, Nijmegen, Netherlands

[9] Studienpraxis Urol, Nurtingen, Germany

[10] Univ Rostock, Dept Urol, Rostock, Germany

[11] Univ Jena, Dept Urol, Jena, Germany

[12] Friedrich Alexander Univ, Dept Urol, Erlangen, Germany

[13] Univ Aarhus, Dept Urol & Clin Med, Aarhus, Denmark

来源：

UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS | 2024年 / 42卷 / 08期

关键词：

Urinary tumor markers; Bladder cancer; High grade; Follow-up; Surveillance; Disease management; PHOTODYNAMIC DIAGNOSIS; COST-EFFECTIVENESS; VOIDED-URINE; CYSTOSCOPY; CYTOLOGY;

D O I：

10.1016/j.urolonc.2024.01.025

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

A plethora of urine markers for the management of patients with bladder cancer has been developed and studied in the past. However, the clinical impact of urine testing on patient management remains obscure. The goal of this manuscript is to identify scenarios for the potential use of molecular urine markers in the follow-up of patients with high -risk non -muscle -invasive BC (NMIBC) and estimate potential risks and benefits. Information on the course of disease of patients with high -risk NMIBC and performance data of a point -of -care test (UBC rapid (TM)), an MCM-5 directed ELISA (ADXBLADDER (TM)), and 2 additional novel assays targeting alterations of mRNA expression and DNA methylation (Xpert bladder cancer monitor (TM), Epicheck (TM)) were retrieved from high -quality trials and/or meta -analyses. In addition, the sensitivity of white light cystoscopy (WLC) and the impact of a urine marker result on the performance of WLC were estimated based on fluorescence cystoscopy data and information from the CeFub trial. This information was applied to different scenarios in patient follow-up and sensitivity, estimated number of cystoscopies, and the numbers needed to diagnose were calculated. The sensitivity of guideline -based regular follow-up (SOC) at 1 year was calculated at 96%. For different marker -supported strategies sensitivities ranging from 77% to 97.9% were estimated. Calculations suggest that several strategies are effective for the SOC. While for the SOC 24.6 WLCs were required to diagnose 1 tumor recurrence (NND), this NND dropped below 5 in some marker -supported strategies. Based on the results of this simulation, a marker -supported follow-up of patients with HR NMIBC is safe and offers the option to significantly reduce the number of WLCs. Further research focusing on prospective randomized trials is needed to finally find a way to implement urine markers into clinical decision -making. (c) 2024 Published by Elsevier Inc.

引用

页码：229 / 235

页数：7

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