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Discrepancies between cytology, cystoscopy and biopsy in bladder cancer detection after Bacille Calmette‐Guerin intravesical therapy
Author(s) -
Hara Tomohiko,
Takahashi Mutsuo,
Gondo Toshikazu,
Nagao Kazuhiro,
Ohmi Chietaka,
Sakano Shigeru,
Naito Katsusuke,
Matsuyama Hideyasu
Publication year - 2009
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2008.02200.x
Subject(s) - cystoscopy , medicine , biopsy , cytology , bladder cancer , urine cytology , urology , cancer , urinary system , urinary bladder , radiology , pathology
Objectives: To evaluate discrepancies in the detection of Bacille Calmette‐Guerin (BCG)‐resistant bladder cancer by cystoscopy, bladder biopsy and urinary cytology. Methods: Between January 1992 and August 2006, 127 bladder cancer patients underwent a cycle of eight weekly BCG instillations. Four weeks after the last BCG instillation, urinary cytological analysis and cystoscopy with targeted biopsy in addition to eight–nine selected‐site biopsies were performed. Results: Biopsy‐proven cancer was found in 11/27 (40.7%), 5/42 (11.9%), and 11/58 (19.0%) of positive, suspicious, and negative cytology cases, respectively. Abnormal and normal cystoscopic findings correlated with a biopsy‐proven cancer in 13/53 (24.5%) and 14/74 (18.9%) cases, respectively. The combination of a macroscopic cystoscopic suspicion and a positive cytology missed malignant cases in 15.9% of the cases. In 100 cases without biopsy‐proven cancer, the rates of denuded urothelium at biopsy in the cases with positive and non‐positive cytology were 7/16 (43.8%) and 16/84 (19.0%), respectively Conclusions: According to our study, routine biopsy is recommended in the evaluation of BCG treatment, even if the timing, limitations and disadvantages of the procedure should be taken into account.