CYTOPHOTOMETRY IN THE MONITORING OF BLADDER-CANCER UNDER INTRAVESICALCHEMOTHERAPY

Objective: We evaluated the DNA cytophotometry in 446 bladder washing samples from 64 patients under mitomycin C after superficial bladder c ancer during an observation period of up to 5 years. The aim of the st udy was to identify patients at high risk of recurrence despite chemot herapy-induced atypical, hence noninformative cytology. Methods: The p rognostic value of cytology and ploidy during chemotherapy was compare d with regard to recurrence rates and the median time to recurrence. R esults: Aneuploidy identified 8 of 10 patients recurring within 12 mon ths out of 17 patients with atypia at first presentation after surgery , whereas no recurrence was seen after atypia and diploid histograms ( p = 0.005, mean follow-up period 62 months). Aneuploidy was the most a ccurate indicator of short-time recurrence (p < 0.001 by multivariate analysis). Follow-up data showed a relative risk of recurrence of 12.7 following histogram shifts towards aneuploidy and of 1.6 for positive shifts in cytology. Conclusion: Cytophotometry is superior to cytolog y in predicting the outcome in patients under chemotherapy for superfi cial transitional cell cancer of the bladder.