Urine cytology in monitoring recurrence in urothelial carcinoma after radical cystectomy and urinary diversion Journal Article


Authors: Chen, H; Liu, L; Pambuccian, S. E.; Barkan, G. A.; Quek, M. L.; Wojcik, E. M.
Article Title: Urine cytology in monitoring recurrence in urothelial carcinoma after radical cystectomy and urinary diversion
Abstract: BACKGROUND: After radical cystectomy and urinary diversion (RC-UD), upper urinary tract and urethral recurrences of urothelial carcinoma (UCa) are reported to occur in 2% to 17% of patients. The objective of the current study was to determine the performance of urinary cytology (UCy) in the diagnosis of recurrences in the remnant urothelium (RRU) after RC-UD. METHODS: The authors retrospectively identified all patients who underwent RC-UD for UCa at the study institution from January 2002 to April 2014, and collected data from all available follow-up UCy and biopsies. Cytologies were classified as unsatisfactory, negative, suspicious, positive for malignancy, or atypical urothelial cells (AUC). The authors calculated the sensitivity, specificity, positive predictive value, and negative predictive value of suspicious or positive UCy for the diagnosis of histologically confirmed RRU. RESULTS: Of the 222 patients who underwent RC-UD for UCa of the urinary bladder during the study period, 111 had at least 1 follow-up UCy performed at the study institution, for a total of 477 UCy samples. During a mean follow-up interval of 40.8 months (range, 3-155 months), the RRU rate was 9.9% (11 of 111 patients). Positive/suspicious UCy results were noted in 12 of 111 patients, 9 of whom had RRU. A diagnosis of AUC was made in 8.6% of samples from 29 patients (41 of 477 samples). The sensitivity, specificity, positive predictive value, and negative predictive value of UCy for RRU were 82%, 97%, 75%, and 98%, respectively. Six of the 28 patients with diagnoses of AUC (21.4%) were eventually diagnosed with RRU. CONCLUSIONS: In the current series, UCy demonstrated good sensitivity and high specificity for the detection of disease recurrence of UCa after RC-UD. Cancer Cytopathol 2016;124:273-8. (c) 2015 American Cancer Society.
Keywords: Pathology; Recurrence; urothelial carcinoma; urine cytology; monitoring; radical cystectomy and urinary diversion
Journal Title: Cancer cytopathology
Volume: 124
Issue: 4
ISSN: 1934-6638; 1934-662X
Publisher: American Cancer Society  
Journal Place: United States
Date Published: 2016
Start Page: 273
End Page: 278
Language: eng
DOI/URL:
Notes: CI: (c) 2015; JID: 101499453; OTO: NOTNLM; 2015/10/06 [received]; 2015/10/20 [revised]; 2015/10/23 [accepted]; 2015/11/13 [aheadofprint]; ppublish