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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Institutional variability in the accuracy of urinary cytology for predicting recurrence of transitional cell carcinoma of the bladder
BJU International, Volume 97, No. 5, Year 2006
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Description
OBJECTIVE: To assess the contemporary inter-institutional accuracy of urinary cytology in predicting the recurrence of transitional cell carcinoma (TCC) of the bladder, in a large multi-institutional cohort from four continents, as cystoscopy and urinary cytology represent the 'gold standards' for surveillance of TCC recurrences, but the ability of cytology to predict recurrence varies. PATIENTS AND METHODS: Ten institutions contributed 2542 patients with a history of superficial TCC, of whom 898 had TCC recurrence. Age- and gender-adjusted logistic regression models were used to evaluate the association between urine cytology and TCC recurrence. The predictive accuracy derived from the logistic regression model was tested using the area under the receiver operating characteristic curve. The resulting predictive accuracy estimates were internally validated with 200 bootstrap re-samples. RESULTS: The mean (range across institutions) age of the patients was 65 (48-69) years and 75 (67-87)% were men. Cytology was positive in 19 (10-38)% of patients; recurrence was identified in 35 (27-54)% of patients. The sensitivity was 38-65% across institutions. Urinary cytology varied significantly in its ability to predict recurrence of bladder cancer. Institution-specific predictive accuracy adjusted for gender and age was 0.627-0.893. Stratifying by grade and stage only partly attenuated the discrepancies between centres. CONCLUSIONS: The variability of urinary cytology results was very appreciable among the 10 centres and ranged from poor (63%) to excellent (89%). © 2006 BJU International.
Authors & Co-Authors
I. Karakiewicz, Pierre I.
Canada, Montreal
University of Montreal
Canada, Montreal
Centre Hospitalier de L'universite de Montreal
Benayoun, Serge
Canada, Montreal
University of Montreal
Zippe, Craig
United States, Cleveland
Cleveland Clinic Foundation
Lüdecke, Gerson
Germany, Giessen
Justus-liebig-universität Gießen
Boman, Hans
Unknown Affiliation
Sanchez-Carbayo, Marta
Spain, Salamanca
Hospital Clínico Universitario de Salamanca
Casella, Roberto
Switzerland, Biel
Hospital Center Biel
Mian, Christine
Austria, Vienna
Universität Wien
Friedrich, Martin G.
Germany, Hamburg
Universität Hamburg
Eissa, S.
Egypt, Cairo
Faculty of Medicine - Ain Shams University
Akaza, Hideyuki
Japan, Tsukuba
University of Tsukuba
Huland, Hartwig
Germany, Hamburg
Universität Hamburg
Hedelin, Hans
Unknown Affiliation
Rupesh, Raina
United States, Cleveland
Cleveland Clinic Foundation
Miyanaga, Naoto
Japan, Tsukuba
University of Tsukuba
Sagalowsky, Arthur I.
United States, Richardson
The University of Texas at Dallas
Marberger, Michael Johann
Austria, Vienna
Universität Wien
Shariat, Shahrokh F.
United States, Richardson
The University of Texas at Dallas
Statistics
Citations: 155
Authors: 18
Affiliations: 11
Identifiers
Doi:
10.1111/j.1464-410X.2006.06036.x
ISSN:
14644096
e-ISSN:
1464410X
Research Areas
Cancer
Study Design
Cohort Study
Participants Gender
Male