Multicenter evaluation of the role of UroVysion FISH assay in surveillance of patients with bladder cancer: does FISH positivity anticipate recurrence?

Casey Seideman, Daniel Canter, Philip Kim, Billy Cordon, Alon Weizer, Irma Oliva, Jianyu Rao, Brant A. Inman, Michael Posch, Harry Herr, Yair Lotan

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: The significance of a positive UroVysion FISH assay is uncertain in patients with normal cystoscopy. This multicenter study evaluates the clinical significance of a positive FISH assay in patients with no visible tumor and excluding those with a positive cytology. Methods: A multi-institutional, retrospective study of patients with a history of urothelial carcinoma of the bladder identified 664 patients with a FISH assay after excluding those with cystoscopic evidence of a tumor and/or positive cytology. Our primary end point was cancer recurrence, defined by biopsy. Progression was defined as recurrence with a tumor stage ≥T2. Statistical analyses were performed using Fisher’s exact test as a one-tailed test and Chi-square test with significance at 0.05, using SPSS® version 19.0 (SPSS Inc., Chicago, IL, USA). Results: Of the 664 patients in this study, tumor stage was Ta (363, 55 %), T1 (183, 28 %), and CIS (109, 16 %) and most were high grade (440 pts, 66 %). The median follow-up was 26 months (3–104 months), and 277 (41.7 %) patients were recurred. In patients who were FISH positive, mean time to recurrence was 12.6 months, compared to 17.9 months if FISH negative (p = 0.03). In univariate analysis, atypical cytology, positive FISH, cystoscopic findings (atypical vs. normal), and previous intravesical therapy were associated with recurrence (p < 0.05). On multivariate analysis, pathologic stage, cystoscopic findings, and cytology were independently associated with recurrence (p < 0.05). Progression to ≥T2 disease occurred in 34 (5.1 %) patients in this cohort. On multivariate analysis, only initial T stage and FISH result were found to be independent predictors of progression (p < 0.05). Conclusions: Patients with a positive FISH and atypical cytology are more likely to recur even in the absence of visible tumor. FISH positivity may portend a higher risk for progression. These findings require prospective validation.

Original languageEnglish (US)
Pages (from-to)1309-1313
Number of pages5
JournalWorld Journal of Urology
Volume33
Issue number9
DOIs
StatePublished - Sep 2 2015
Externally publishedYes

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Urinary Bladder Neoplasms
Recurrence
Cell Biology
Neoplasms
Multivariate Analysis
Cystoscopy
Chi-Square Distribution
Multicenter Studies
Urinary Bladder
Retrospective Studies
Carcinoma
Biopsy

Keywords

  • Bladder cancer
  • FISH
  • Surveillance

ASJC Scopus subject areas

  • Urology

Cite this

Multicenter evaluation of the role of UroVysion FISH assay in surveillance of patients with bladder cancer : does FISH positivity anticipate recurrence? / Seideman, Casey; Canter, Daniel; Kim, Philip; Cordon, Billy; Weizer, Alon; Oliva, Irma; Rao, Jianyu; Inman, Brant A.; Posch, Michael; Herr, Harry; Lotan, Yair.

In: World Journal of Urology, Vol. 33, No. 9, 02.09.2015, p. 1309-1313.

Research output: Contribution to journalArticle

Seideman, Casey ; Canter, Daniel ; Kim, Philip ; Cordon, Billy ; Weizer, Alon ; Oliva, Irma ; Rao, Jianyu ; Inman, Brant A. ; Posch, Michael ; Herr, Harry ; Lotan, Yair. / Multicenter evaluation of the role of UroVysion FISH assay in surveillance of patients with bladder cancer : does FISH positivity anticipate recurrence?. In: World Journal of Urology. 2015 ; Vol. 33, No. 9. pp. 1309-1313.
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abstract = "Background: The significance of a positive UroVysion FISH assay is uncertain in patients with normal cystoscopy. This multicenter study evaluates the clinical significance of a positive FISH assay in patients with no visible tumor and excluding those with a positive cytology. Methods: A multi-institutional, retrospective study of patients with a history of urothelial carcinoma of the bladder identified 664 patients with a FISH assay after excluding those with cystoscopic evidence of a tumor and/or positive cytology. Our primary end point was cancer recurrence, defined by biopsy. Progression was defined as recurrence with a tumor stage ≥T2. Statistical analyses were performed using Fisher’s exact test as a one-tailed test and Chi-square test with significance at 0.05, using SPSS{\circledR} version 19.0 (SPSS Inc., Chicago, IL, USA). Results: Of the 664 patients in this study, tumor stage was Ta (363, 55 {\%}), T1 (183, 28 {\%}), and CIS (109, 16 {\%}) and most were high grade (440 pts, 66 {\%}). The median follow-up was 26 months (3–104 months), and 277 (41.7 {\%}) patients were recurred. In patients who were FISH positive, mean time to recurrence was 12.6 months, compared to 17.9 months if FISH negative (p = 0.03). In univariate analysis, atypical cytology, positive FISH, cystoscopic findings (atypical vs. normal), and previous intravesical therapy were associated with recurrence (p < 0.05). On multivariate analysis, pathologic stage, cystoscopic findings, and cytology were independently associated with recurrence (p < 0.05). Progression to ≥T2 disease occurred in 34 (5.1 {\%}) patients in this cohort. On multivariate analysis, only initial T stage and FISH result were found to be independent predictors of progression (p < 0.05). Conclusions: Patients with a positive FISH and atypical cytology are more likely to recur even in the absence of visible tumor. FISH positivity may portend a higher risk for progression. These findings require prospective validation.",
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T2 - does FISH positivity anticipate recurrence?

AU - Seideman, Casey

AU - Canter, Daniel

AU - Kim, Philip

AU - Cordon, Billy

AU - Weizer, Alon

AU - Oliva, Irma

AU - Rao, Jianyu

AU - Inman, Brant A.

AU - Posch, Michael

AU - Herr, Harry

AU - Lotan, Yair

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Y1 - 2015/9/2

N2 - Background: The significance of a positive UroVysion FISH assay is uncertain in patients with normal cystoscopy. This multicenter study evaluates the clinical significance of a positive FISH assay in patients with no visible tumor and excluding those with a positive cytology. Methods: A multi-institutional, retrospective study of patients with a history of urothelial carcinoma of the bladder identified 664 patients with a FISH assay after excluding those with cystoscopic evidence of a tumor and/or positive cytology. Our primary end point was cancer recurrence, defined by biopsy. Progression was defined as recurrence with a tumor stage ≥T2. Statistical analyses were performed using Fisher’s exact test as a one-tailed test and Chi-square test with significance at 0.05, using SPSS® version 19.0 (SPSS Inc., Chicago, IL, USA). Results: Of the 664 patients in this study, tumor stage was Ta (363, 55 %), T1 (183, 28 %), and CIS (109, 16 %) and most were high grade (440 pts, 66 %). The median follow-up was 26 months (3–104 months), and 277 (41.7 %) patients were recurred. In patients who were FISH positive, mean time to recurrence was 12.6 months, compared to 17.9 months if FISH negative (p = 0.03). In univariate analysis, atypical cytology, positive FISH, cystoscopic findings (atypical vs. normal), and previous intravesical therapy were associated with recurrence (p < 0.05). On multivariate analysis, pathologic stage, cystoscopic findings, and cytology were independently associated with recurrence (p < 0.05). Progression to ≥T2 disease occurred in 34 (5.1 %) patients in this cohort. On multivariate analysis, only initial T stage and FISH result were found to be independent predictors of progression (p < 0.05). Conclusions: Patients with a positive FISH and atypical cytology are more likely to recur even in the absence of visible tumor. FISH positivity may portend a higher risk for progression. These findings require prospective validation.

AB - Background: The significance of a positive UroVysion FISH assay is uncertain in patients with normal cystoscopy. This multicenter study evaluates the clinical significance of a positive FISH assay in patients with no visible tumor and excluding those with a positive cytology. Methods: A multi-institutional, retrospective study of patients with a history of urothelial carcinoma of the bladder identified 664 patients with a FISH assay after excluding those with cystoscopic evidence of a tumor and/or positive cytology. Our primary end point was cancer recurrence, defined by biopsy. Progression was defined as recurrence with a tumor stage ≥T2. Statistical analyses were performed using Fisher’s exact test as a one-tailed test and Chi-square test with significance at 0.05, using SPSS® version 19.0 (SPSS Inc., Chicago, IL, USA). Results: Of the 664 patients in this study, tumor stage was Ta (363, 55 %), T1 (183, 28 %), and CIS (109, 16 %) and most were high grade (440 pts, 66 %). The median follow-up was 26 months (3–104 months), and 277 (41.7 %) patients were recurred. In patients who were FISH positive, mean time to recurrence was 12.6 months, compared to 17.9 months if FISH negative (p = 0.03). In univariate analysis, atypical cytology, positive FISH, cystoscopic findings (atypical vs. normal), and previous intravesical therapy were associated with recurrence (p < 0.05). On multivariate analysis, pathologic stage, cystoscopic findings, and cytology were independently associated with recurrence (p < 0.05). Progression to ≥T2 disease occurred in 34 (5.1 %) patients in this cohort. On multivariate analysis, only initial T stage and FISH result were found to be independent predictors of progression (p < 0.05). Conclusions: Patients with a positive FISH and atypical cytology are more likely to recur even in the absence of visible tumor. FISH positivity may portend a higher risk for progression. These findings require prospective validation.

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