DOES VOIDED URINE CYTOLOGY HAVE BIOLOGICAL SIGNIFICANCE

Objective To (i) define any correlation between the result of voided u rine cytology (VUC) at presentation and the biological behaviour of Ta /T1 transitional cell carcinoma (TCC) of the bladder; and (ii) observe the natural history of Ta/T1 bladder cancer in relation to new progno stic groupings. Patients and methods The study comprised 109 patients with newly diagnosed Ta/T1 TCC of the bladder, all of whom had VUC ass essed at presentation. Information on the number of tumours at present ation and the subsequent tumour recurrence rate during clinical follow -up was compared with the outcome of VUC. Results Of the 109 patients, 67 (61%) had Ta and 42 (39%) had T1 tumours. At presentation, there w ere 75 (69%) solitary (Ta=50, T1=25) and 34 (31%) multifocal (Ta=17, T 1=17) tumours. At presentation, VUC was negative in 71 (65%), suspicio us in 22 (20%) and positive for urothelial carcinoma in 16 (15%) patie nts. During follow-up, 58% of patients with Ta tumours and 83% of pati ents with T1 tumours developed recurrences (median follow-up 43.5 mont hs, P=0.01), although there was no significant difference in the recur rence rate between these groups (P=0.096). In addition, for those pati ents with Ta tumours that were multifocal at presentation, there was a significantly higher recurrence rate (P=0.003). Although there was no correlation between the result of VUC and the number of tumours at pr esentation, there was a significantly higher tumour recurrence rate fo r those patients with suspicious/positive VUC than for those whose VUC was negative (P<0.05). Conclusion This study shows the impact of tumo ur multifocality at presentation on subsequent tumour recurrence rate. In addition, the VUC result at presentation correlated with tumour re currence in patients with Ta/T1 TCC of the bladder.