Prognostic Significance Of Nondiagnostic Molecular Changes In Urine Detected By UroVysion FISH During Surveillance For Bladder Cancer

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology
Article Date: 12 Jan 2009 - 2:00 PDT

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UroToday.com - Non-diagnostic fluorescence in situ hybridization (FISH) (ie, <4 gains of chromosomes 3, 7, or 17 in
A positive result is defined as a gain of >/=2 chromosomes (3, 7, or 17) in 4 cells, isolated loss of 9p21 in 12 cells, or isolated gains of only 1 chromosome in >/=10% of cells. Most FISH-positive patients will develop recurrent urothelial carcinoma within 1 year. The authors compared the data from 149 patients with a non-diagnostic FISH result and >/=30 months of follow-up with the data from patients with a negative FISH result from the same period. The time to conversion to a positive FISH result or the development of a bladder tumor was recorded. Patients with non-diagnostic FISH results had significantly greater rates of progression to positive FISH findings or the development of a bladder tumor than did patients with negative FISH findings. Most progression occurred within 1 year. Patients with non-diagnostic FISH results and concurrent negative cytology and cystoscopy had a very low risk of developing recurrent disease, similar to that found with truly negative FISH results.

The authors concluded that non-diagnostic FISH results are related to a greater risk of progression to positive FISH results and tumor recurrence than those with negative FISH findings. However, after controlling for negative cytologic and cystoscopic status, a non-diagnostic FISH result does not appear to be an independent predictor of disease recurrence, and aggressive investigation is not warranted.

Nguyen CT, Litt DB, Dolar SE, Ulchaker JC, Jones JS, Brainard JA
Urology. 2008 Nov 19. Epub ahead of print
doi:10.1016/j.urology.2008.09.042

Written by UroToday.com Contributing Editor David P. Wood, MD

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