Telomerase activity in urine after transurethral resection of superficial bladder cancer and early recurrence

Background: To explore the relationship between telomerase activity in urin e after transurethral resection (TUR) of superficial bladder cancer and ear ly intravesical recurrence. Methods: Urine samples were obtained from 42 patients with superficial blad der cancers prior to TUR and on the postoperative day 1 and day 6. These pa tients were followed-up prospectively by cystoscopy at 3 and 6 months after TUR in combination with urinary cytology and telomerase activity. Telomera se activity in the urine was assessed by the telomeric repeat amplification protocol assay. Results: Urinary telomerase activity prior to TUR was positive in 24 (57%) of the 42 patients. On the postoperative day 1 and day 6, positive urinary telomerase activity was seen in 13 (31%) and nine (21%) patients, respectiv ely Postoperative urinary telomerase activity on either day 1 or day 6 was significantly associated with pre-operative urinary telomerase activity sta tus (P = 0.0024). Fifteen patients showed intravesical tumor recurrence at 3 months cystoscopic check-up and an additional nine had recurred at the 6 months check-up. Recurrence rate within 6 months in patients with pre-opera tive positive urinary telomerase activity was similar to that in those with negative activity (58.3 vs 58.8%). However, recurrence rate at 3 months fo r patients with positive activity was higher than that of those with negati ve activity (50 vs 17.7%), in 23 patients treated only by TUR. Conclusions: Presence of cells positive for telomerase activity in urine af ter TUR of superficial bladder cancer indicates persistently existing cance r cells in the urine. It is, however, not a sole predictor of the early int ravesical recurrence.