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Considering the Effects of Modern Point-of-Care Urine Biomarker Assays in Follow-Up of Patients with High-Risk Non-muscle-Invasive Bladder Cancer

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Urothelial Carcinoma

Part of the book series: Methods in Molecular Biology ((MIMB,volume 2684))

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Abstract

Background: Although a plethora of urine markers for diagnosis and follow-up of patients with bladder cancer (BC) has been developed and studied, the clinical impact of urine testing on patient management remains unclear. The goal of this manuscript is to identify scenarios for a potential use of modern point-of-care (POC) urine marker assays in the follow-up of patients with high-risk non-muscle-invasive BC (NMIBC) and estimate potential risks and benefits.

Methods: To permit comparison between different assays, the results of 5 different POC assays studied in a recent prospective multicenter study including 127 patients with suspicious cystoscopy undergoing TURB were used for this simulation. For the current standard of care (SOC), a “marker-enforced” procedure, and a combined strategy sensitivity (Se), estimated number of cystoscopies, and the numbers needed to diagnose (NND) over a 1-year follow-up period were calculated.

Results: For regular cystoscopy (SOC), a Se of 91.7% and a NND of 42.2 repetitive office cystoscopies (WLCs) for 1 recurrent tumor at 1 year were calculated. For the “marker-enforced” strategy, marker sensitivities between 94.7% and 97.1% were observed. The “combined” strategy yielded for markers with a Se exceeding 50% an overall Se at 1 year similar or superior to the current SOC. Savings regarding the number of cystoscopies in the “marker-enforced” strategy vs. the SOC were small, while, depending on the marker, up to 45% of all cystoscopies may be saved using the “combined” strategy.

Conclusions: Based on the results of this simulation, a marker-supported follow-up of patients with high-risk (HR) NMIBC is safe and offers options to significantly reduce the number of cystoscopies without compromising the Se. Further research focusing on prospective randomized trials is needed to finally find a way to include marker results into clinical decision-making.

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Author information

Author notes

  1. Thorsten H. Ecke and Natalya Benderska-Söder contributed equally with all other contributors.

Authors and Affiliations

  1. Department of Urology, Helios Hospital, Bad Saarow, Germany

    Thorsten H. Ecke

  2. Department of Urology, Universitätsmedizin Berlin Charité, Berlin, Germany

    Thorsten H. Ecke

  3. German Study Group of Bladder Cancer (DFBK e.V.), Munich, Germany

    Thorsten H. Ecke

  4. Urologie 24, Nürnberg, Germany

    Natalya Benderska-Söder, Ekkehardt Bismarck & Bernd J. Schmitz-Dräger

  5. Department Surgical Oncology (Urology), Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    Bas W. G. van Rhijn

  6. Department of Urology, University of Regensburg, Caritas-Hospital St. Josef, Regensburg, Germany

    Bas W. G. van Rhijn

  7. Studienpraxis Urologie, Nürtingen, Germany

    Tilman Todenhöfer

  8. Medical Faculty, University of Tübingen, Tübingen, Germany

    Tilman Todenhöfer

  9. Department of Urology, Friedrich-Alexander University, Erlangen, Germany

    Bernd J. Schmitz-Dräger

Authors
  1. Thorsten H. Ecke
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  2. Natalya Benderska-Söder
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  3. Ekkehardt Bismarck
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  4. Bas W. G. van Rhijn
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  5. Tilman Todenhöfer
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  6. Bernd J. Schmitz-Dräger
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Corresponding author

Correspondence to Thorsten H. Ecke .

Editor information

Editors and Affiliations

  1. Department of Urology, Medical Faculty and University Hospital, Heinrich-Heine-University Duesseldorf, Düsseldorf, Germany

    Michèle J. Hoffmann

  2. Institute of Pathology, University Hospital, RWTH Aachen University, Aachen, Germany

    Nadine T. Gaisa

  3. Department of Urology, University Hospital Rechts der Isar, Technical University Munich, Munich, Germany

    Roman Nawroth

  4. Department of Urology, Helios Hospital, Bad Saarow, Germany

    Thorsten H. Ecke

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© 2023 The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature

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Ecke, T.H., Benderska-Söder, N., Bismarck, E., van Rhijn, B.W.G., Todenhöfer, T., Schmitz-Dräger, B.J. (2023). Considering the Effects of Modern Point-of-Care Urine Biomarker Assays in Follow-Up of Patients with High-Risk Non-muscle-Invasive Bladder Cancer. In: Hoffmann, M.J., Gaisa, N.T., Nawroth, R., Ecke, T.H. (eds) Urothelial Carcinoma. Methods in Molecular Biology, vol 2684. Humana, New York, NY. https://doi.org/10.1007/978-1-0716-3291-8_12

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  • DOI: https://doi.org/10.1007/978-1-0716-3291-8_12

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  • Publisher Name: Humana, New York, NY

  • Print ISBN: 978-1-0716-3290-1

  • Online ISBN: 978-1-0716-3291-8

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