Prognostic impact of non-adherence to follow-up cystoscopy in non-muscle-invasive bladder cancer (NMIBC)

World J Urol. 2019 Oct;37(10):2067-2071. doi: 10.1007/s00345-019-02697-8. Epub 2019 Feb 25.

Abstract

Purpose: To evaluate the underexplored context of cystoscopy adherent versus non-adherent patients in the follow-up of urothelial high-risk non-muscle-invasive bladder cancer (NMIBC).

Methods: We performed a retrospective study (2005-2016) that evaluated patients´ demographical characteristics, histopathological data, recurrence, progression and cancer-specific mortality between adherent and non-adherents patients in the first 3 years of a proposed cystoscopy protocol.

Results: Among the 198 included patients, comparing cystoscopy non-adherent (n = 36, 18%) and adherent patients (n = 162, 82%), there was no demographic or histopathological differences; the rates of disease recurrence, progression and cancer-specific mortality were 15 (41.7%) versus 68 (42.2%), p = 0.58; 12 (33.3%) versus 28 (17.9%), p = 0.014 and 4 (11.1%) versus 19 (11.7%), p = 0.98, respectively. Cystoscopy non-adherence was associated with an inferior number of urinary cytology (p < 0.001) and 2.33 HR for cancer progression, p = 0.014, (95% CI 1.18-4.59).

Conclusions: Non-adherence to follow-up cystoscopy in NMIBC is associated with more than twice progression risk. Future studies are needed to confirm our results and correlate cystoscopy non-adherence to other covariates.

Keywords: Bladder cancer; Cystoscopy; Follow-up; Progression; Recurrence; Survival.

MeSH terms

  • Aged
  • Cystoscopy*
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Patient Compliance*
  • Prognosis
  • Retrospective Studies
  • Urinary Bladder Neoplasms / pathology*