PMID- 21396845
OWN - NLM
STAT- MEDLINE
DCOM- 20130725
LR  - 20211020
IS  - 1873-2496 (Electronic)
IS  - 1078-1439 (Print)
IS  - 1078-1439 (Linking)
VI  - 30
IP  - 6
DP  - 2012 Nov-Dec
TI  - The role of FISH and cytology in upper urinary tract surveillance after radical 
      cystectomy for bladder cancer.
PG  - 821-4
LID - S1078-1439(10)00222-X [pii]
LID - 10.1016/j.urolonc.2010.08.006 [doi]
AB  - OBJECTIVES: Cytology and fluorescence in situ hybridization (FISH) (Urovysion) 
      assay are often used during upper urinary tract surveillance in patients 
      following radical cystectomy with urinary diversion, without much available data 
      regarding efficacy in this population. Here, we evaluate the value of FISH and 
      cytology in detecting upper tract recurrence in the face of a urinary diversion. 
      MATERIALS AND METHODS: A review of our cystectomy database revealed 270 patients 
      who had at least one FISH and/or cytology assay performed during surveillance 
      after radical cystectomy. Workup included upper tract imaging in all patients and 
      upper tract endoscopy as indicated. A total of 163 FISH assays and 474 urinary 
      cytology examinations were included in the analysis. Sensitivity, specificity, 
      positive predictive value (PPV), and negative predictive value (NPV) of FISH and 
      cytology were assessed. RESULTS: Ten patients (3.4%) developed upper tract 
      recurrence after a median follow-up time of 31 months (2-202). All but 1 patient 
      presented either with gross hematuria or positive finding on imaging; 6 had 
      positive FISH and cytology, and 2 had positive cytology only (no FISH done). For 
      detection of upper tract recurrence, sensitivity, specificity, PPV, and NPV of 
      cytology were 80.0%, 85.6%, 10.7%, and 99.5%, respectively; and that for FISH 
      were 85.7%, 86.5%, 23.1%, and 99.2%, respectively. CONCLUSIONS: The FISH assay 
      and urinary cytology both demonstrate high rates of false positivity and are 
      useful mainly for their negative predictive ability in patients with a urinary 
      diversion. Unless prospective trials show otherwise, both-or at least the more 
      expensive test-can be omitted from surveillance strategies.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Fernandez, Mario I
AU  - Fernandez MI
AD  - Department of Urology, The University of Texas M. D. Anderson Cancer Center, 
      Houston, TX 77030, USA.
FAU - Parikh, Sahil
AU  - Parikh S
FAU - Grossman, H Barton
AU  - Grossman HB
FAU - Katz, Ruth
AU  - Katz R
FAU - Matin, Surena F
AU  - Matin SF
FAU - Dinney, Colin P N
AU  - Dinney CP
FAU - Kamat, Ashish M
AU  - Kamat AM
LA  - eng
GR  - P50 CA091846/CA/NCI NIH HHS/United States
GR  - 5P50CA091846-03/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20110310
PL  - United States
TA  - Urol Oncol
JT  - Urologic oncology
JID - 9805460
SB  - IM
MH  - Carcinoma, Transitional Cell/*diagnosis/urine
MH  - Cystectomy
MH  - Endoscopy
MH  - Humans
MH  - *In Situ Hybridization, Fluorescence
MH  - Neoplasm Grading
MH  - Neoplasm Recurrence, Local/*diagnosis
MH  - Neoplasm Staging
MH  - Sensitivity and Specificity
MH  - Urinalysis
MH  - Urinary Bladder Neoplasms/*diagnosis/urine
PMC - PMC3931457
MID - NIHMS524063
EDAT- 2011/03/15 06:00
MHDA- 2013/07/26 06:00
PMCR- 2014/02/21
CRDT- 2011/03/15 06:00
PHST- 2010/06/30 00:00 [received]
PHST- 2010/08/10 00:00 [revised]
PHST- 2010/08/10 00:00 [accepted]
PHST- 2011/03/15 06:00 [entrez]
PHST- 2011/03/15 06:00 [pubmed]
PHST- 2013/07/26 06:00 [medline]
PHST- 2014/02/21 00:00 [pmc-release]
AID - S1078-1439(10)00222-X [pii]
AID - 10.1016/j.urolonc.2010.08.006 [doi]
PST - ppublish
SO  - Urol Oncol. 2012 Nov-Dec;30(6):821-4. doi: 10.1016/j.urolonc.2010.08.006. Epub 
      2011 Mar 10.