Reflex fluorescence in situ hybridization assay for suspicious urinary cytology in patients with bladder cancer with negative surveillance cystoscopy Journal Article


Authors: Kim, P. H.; Sukhu, R.; Cordon, B. H.; Sfakianos, J. P.; Sjoberg, D. D.; Hakimi, A. A.; Dalbagni, G.; Lin, O.; Herr, H. W.
Article Title: Reflex fluorescence in situ hybridization assay for suspicious urinary cytology in patients with bladder cancer with negative surveillance cystoscopy
Abstract: Objective To assess the ability of reflex UroVysion fluorescence in situ hybridization (FISH) testing to predict recurrence and progression in patients with non-muscle-invasive bladder cancer (NMIBC) with suspicious cytology but negative cystoscopy. Patients and Methods Patients under NMIBC surveillance were followed with office cystoscopy and urinary cytology every 3-6 months. Between March 2007 and February 2012, 500 consecutive patients with suspicious cytology underwent reflex FISH analysis. Clinical and pathological data were reviewed retrospectively. Predictors for recurrence, progression and findings on subsequent cystoscopy (within 2-6 months after FISH) were evaluated using univariate and multivariate Cox regression. Results In all, 243 patients with suspicious cytology also had negative surveillance cystoscopy. Positive FISH was a significant predictor of recurrence (hazard ratio [HR] = 2.35, 95% confidence interval [CI]: 1.42-3.90, P = 0.001) in multivariate analysis and for progression (HR = 3.01, 95% CI: 1.10-8.21, P = 0.03) in univariate analysis, compared with negative FISH. However, positive FISH was not significantly associated with evidence of tumour on subsequent surveillance cystoscopy compared with negative FISH (odds ratio = 0.8, 95% CI: 0.26-2.74, P = 1). Conclusions Positive FISH predicts recurrence and progression in patients under NMIBC surveillance with suspicious cytology but negative cystoscopy. However, there was no association between the FISH result and tumour recurrence in the immediate follow-up period. Reflex FISH testing for suspicious cytology might have limited ability to modify surveillance strategies in NMIBC. © 2013 The Authors. BJU International © 2013 BJU International.
Keywords: adult; aged; human cell; major clinical study; clinical feature; cancer recurrence; cancer growth; cancer staging; follow up; cancer grading; cytology; progression free survival; retrospective study; fluorescence in situ hybridization; cystoscopy; cancer classification; surveillance; recurrence free survival; disease surveillance; urine cytology; diagnostic kit; non-muscle-invasive bladder cancer; non muscle invasive bladder cancer; human; male; female; priority journal; article; reflex fluorescence in situ hybridization
Journal Title: BJU International
Volume: 114
Issue: 3
ISSN: 1464-4096
Publisher: Wiley Blackwell  
Date Published: 2014-09-01
Start Page: 354
End Page: 359
Language: English
DOI: 10.1111/bju.12516
PROVIDER: scopus
PMCID: PMC3988266
PUBMED: 24128299
DOI/URL:
Notes: Export Date: 1 October 2014 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Guido Dalbagni
    250 Dalbagni
  2. Oscar Lin
    231 Lin
  3. Daniel D. Sjoberg
    138 Sjoberg
  4. Harry W Herr
    401 Herr
  5. Philip Hyunwoo Kim
    39 Kim
  6. Abraham Ari Hakimi
    129 Hakimi
  7. Billy Hamilton Cordon
    3 Cordon
  8. Ranjit   Sukhu
    5 Sukhu