Use of Bladder Epicheck® in the follow-up of non-muscle-invasive bladder cancer: A systematic literature review

Introduction: In recent years, different urinary markers such as the Bladder Epicheck (R) have been developed in an attempt to reduce the number of cystoscopies in the follow-up of non- muscle invasive bladder cancer (NMIBC). Aim: To provide a systematic review of Bladder Epicheck (R) and its current clinical utility in the follow-up and detection of recurrence of NMIBC. Material and methods: Systematic review based on a literature search of PubMed, Web of Science and Scopus databases until October 2023, according to PRISMA and Quadas-2 criteria. Sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of the marker were calculated. Diagnostic performance was evaluated by the area under the curve (AUC). Results: Fifteen studies were analyzed (n = 3761) including 86.7% prospective studies. Of the patient series, 53.2% had received previous intravesical instillations. The mean Se of the biomarker in the detection of recurrence varied according to tumor grade (87.9%-high grade/HG vs. 44.9%-low grade/LG, respectively). Their weighted mean Se and Sp were 71.6% and 84.5%, respectively. The mean recurrence rate was 29.1%. The weighted mean PPV and NPV were 56.4% and 92.8% (97.7% non-LG), respectively. The mean AUC was 85.63%. Conclusion: Bladder Epicheck (R) is a useful urinary marker in the follow-up of NMIBC, with significantly high Se and NPV in the detection of recurrences, especially in cases of HG disease. Its use can reduce the number of cystoscopies required in the follow-up of NMIBC, improving the quality of life of patients and potentially increasing health economic savings. (c) 2024 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.