Year: 2023
Type: article
Abstract: To determine whether Xpert bladder cancer monitor, a noninvasive PCR-based biomarker test, can predict the need for 2nd transurethral resection of the bladder (TURB) better than clinical assessment. Patients scheduled for TURB were prospectively screened. After initial TURB, patients were assigned to 2nd TURB or follow-up cystoscopy at 3 months (FU) by clinicians' discretion. Central urine cytology and Xpert monitor tests were performed prior to the 1st TURB and 2nd TURB or FU, respectively. Statistical analysis to compare clinical assessment and Xpert monitor comprised sensitivity (SENS), specificity (SPEC), NPV and PPV. Of 756 screened patients, 171 were included (114 with 2nd TURB, 57 with FU). Residual tumors were detected in 34 patients who underwent 2nd TURB, and recurrent tumors were detected in 2 patients with FU. SENS and SPEC of Xpert monitor were 83.3% and 53.0%, respectively, PPV was 32.6% and NPV was 92.1%. Clinical risk assessment outperformed Xpert monitor. In patients with pTa disease at initial TURB, Xpert monitor revealed a NPV of 96%. Xpert monitor was not superior than clinical assessment in predicting the need for 2nd TURB. It might be an option to omit 2nd TURB for selected patients with pTa disease.
Source: Scientific Reports
Authors: Johannes Breyer, Markus Eckstein, Danijel Sikic, Felix Wezel, Florian Roghmann, Mirco Brehmer, Ralph M. Wirtz, Jonas Jarczyk, Philipp Erben, Veronika Bahlinger, Franziska Goldschmidt, Guido Fechner, Jack Chen, Ellen Paxinos, Michael Bates, Maximilian Haas, Friedemann Zengerling, Christian Bolenz, Maximilian Burger, Arndt Hartmann, Maximilian C. Kriegmair, Johannes Breyer, Markus Eckstein, Danijel Sikic, Felix Wezel, Florian Roghmann, Ralph M. Wirtz, Jonas Jarczyk, Philipp Erben, Veronika Bahlinger, Franziska Goldschmidt, Guido Fechner, Maximilian Haas, Friedemann Zengerling, Christian Bolenz, Maximilian Burger, Arndt Hartmann, Maximilian C. Kriegmair
Institutions: Caritas-Krankenhaus St. Josef, University of Regensburg, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen, University Hospital Ulm, Universitätsklinik Marien Hospital Herne, Ruhr University Bochum, Heidelberg University, Medizinische Fakultät Mannheim, University Hospital Bonn, Cepheid (United States)
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,233
Funder: Universität Regensburg
OpenAlex ID: W4386832518