AUA 2017: Isolated Red Patches Seen During Endoscopic Surveillance Of Bladder Cancer - How Often Should We Biopsy?
He presented his study assessing the importance of these red patches during BC surveillance and tried to analyze how often they should be biopsied. For this study, 4805 flexible cystoscopy (FC) reports over a 12- month period (January - December 2015) were retrospectively reviewed at a United Kingdom tertiary teaching hospital. Only those undergoing cystoscopic surveillance for BC and found to have solitary red patches at FC were included in the study. Out of all the FC, 241 were performed on 183 patients as part of a surveillance protocol for BC and found to have red patches. A total of 120 individuals who experienced FC (49.8%) had a history of intravesical BCG therapy. Only 85 patients (35.3%) underwent biopsy of the demonstrated red patches. Malignancy was found in 20 of 85 biopsies (23.5%), of which 11 of 20 (55%) were carcinoma in situ. In addition, 16 of 20 of these recurrences had been biopsied previously, of which 11 (68.8%) were benign at last biopsy. Almost 70% of recurrences were found in patients who had been biopsied within the last 12 months. Importantly, no cases of malignancy were identified in those with low-risk BC.
Dr. Mann concluded by recommending a biopsy of all red patches found during endoscopic surveillance of patients with at least an intermediate-to-high-risk BC. It was also emphasized that a biopsy must be performed, especially if no previous biopsy was done within the last 12 months and independently of previous biopsy histology.
Presented By: Gurminder S. Mann, MD, Nottingham, United Kingdom
Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA