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Introduction: Urine cytology is routinely used at initial diagnosis and during follow-up of patients with urothelial carcinoma (UC). We hypothesized that urine cytology Results at time of initial diagnosis in UC is representative of the urine cytology when patients recur.
Materials & Methods: A retrospective review of patients newly diagnosed with stage Ta or T1 bladder UC in 2004-2005 was performed. Data were collected from January 2004 to March 2011 regarding demographics, urine cytology, pathology, bladder UC recurrence, and follow-up. 161 patients were evaluated of whom 43 were excluded due to loss to follow-up (17) or unavailable initial cytology in the medical record (26).
Results: 118 patients were evaluated with a mean follow-up of 61.8 months. Positive urine cytology was seen in 46/118 (39%) of patients at initial diagnosis. A total of 76/118 (64%) had recurrent bladder UC with a mean recurrence time of 16 months. In patients with recurrent disease, cytology evaluation had a sensitivity of 76% for detection of recurrence amongst patients who had a history of positive cytology with their initial tumor. However, amongst patients with a history of negative cytology with their initial tumor, cytology only had a sensitivity of 17% during recurrence. Cytology result remained a significant predictor of positive cytology Results with tumor recurrence in multivariate analysis when controlling for grade, tumor size, and multifocality (p<0.0001).
Conclusions: Urine cytology is a useful diagnostic test for follow-up of patients with UC only in those who have a positive result during the first diagnosis of UC.