The utilisation of ADXBLADDER to reduce the frequency of follow up cystoscopies for recurrence in low grade, low stage non muscle invasive bladder cancer
BAUS ePoster online library. Dudderidge T. 06/22/21; 318999; p10-10
Disclosure(s): Paid Consultant of Arquer Diagnostics Ltd
Tim Dudderidge
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Abstract
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INTRODUCTION:
Frequent follow-up cystoscopies are required in patients diagnosed with non-muscle invasive bladder cancer (NMIBC) to detect recurrence/progression. Recently it was reported that lower intensity follow-up schedules demonstrate no risk of progression/death, therefore it may be possible to reduce cystoscopic surveillance. Our aim was to determine how a less intensive surveillance schedule, utilising ADXBLADDER in a predictive tool, could enable a reduction in unnecessary follow-up cystoscopies.
MATERIALS & METHODS
A secondary analysis of 1416 NMIBC patients in follow-up was conducted. Uni and multivariable logistic regression models were fit for all recurrences and HG/CIS recurrences. Using multivariate logistic regression models, nomograms estimating probability of recurrence and HG/CIS recurrence were generated. Decision curve analyses (DCA) examined the net benefit of the models and calculated the net reduction in unnecessary cystoscopies.
RESULTS:
ADXBLADDER status was the only significant variable in the multivariable analysis for HG/CIS recurrence. The probability of an ADXBLADDER negative patient having a HG/CIS recurrence is 0.7%(NPV 99.3%) versus 4.8% in ADXBLADDER positive patients. DCA determined that for HG/CIS recurrence threshold probabilities between 0-0.048, there is a net benefit for using ADXBLADDER in deciding to do a cystoscopy during follow-up (vs. cystoscopy in all patients), leading to a net reduction of 19-60 cystoscopies per 100 patients.
CONCLUSIONS:
Where risk of HG/CiS recurrence is low (i.e. pTaLG patients (no CIS) at the previous visit) incorporation of ADXBLADDER into the follow-up surveillance schedule could lead to a reduction of up to 60% of unnecessary cystoscopies during follow-up, improving patient quality-of-life and decreasing costs.
Frequent follow-up cystoscopies are required in patients diagnosed with non-muscle invasive bladder cancer (NMIBC) to detect recurrence/progression. Recently it was reported that lower intensity follow-up schedules demonstrate no risk of progression/death, therefore it may be possible to reduce cystoscopic surveillance. Our aim was to determine how a less intensive surveillance schedule, utilising ADXBLADDER in a predictive tool, could enable a reduction in unnecessary follow-up cystoscopies.
MATERIALS & METHODS
A secondary analysis of 1416 NMIBC patients in follow-up was conducted. Uni and multivariable logistic regression models were fit for all recurrences and HG/CIS recurrences. Using multivariate logistic regression models, nomograms estimating probability of recurrence and HG/CIS recurrence were generated. Decision curve analyses (DCA) examined the net benefit of the models and calculated the net reduction in unnecessary cystoscopies.
RESULTS:
ADXBLADDER status was the only significant variable in the multivariable analysis for HG/CIS recurrence. The probability of an ADXBLADDER negative patient having a HG/CIS recurrence is 0.7%(NPV 99.3%) versus 4.8% in ADXBLADDER positive patients. DCA determined that for HG/CIS recurrence threshold probabilities between 0-0.048, there is a net benefit for using ADXBLADDER in deciding to do a cystoscopy during follow-up (vs. cystoscopy in all patients), leading to a net reduction of 19-60 cystoscopies per 100 patients.
CONCLUSIONS:
Where risk of HG/CiS recurrence is low (i.e. pTaLG patients (no CIS) at the previous visit) incorporation of ADXBLADDER into the follow-up surveillance schedule could lead to a reduction of up to 60% of unnecessary cystoscopies during follow-up, improving patient quality-of-life and decreasing costs.
INTRODUCTION:
Frequent follow-up cystoscopies are required in patients diagnosed with non-muscle invasive bladder cancer (NMIBC) to detect recurrence/progression. Recently it was reported that lower intensity follow-up schedules demonstrate no risk of progression/death, therefore it may be possible to reduce cystoscopic surveillance. Our aim was to determine how a less intensive surveillance schedule, utilising ADXBLADDER in a predictive tool, could enable a reduction in unnecessary follow-up cystoscopies.
MATERIALS & METHODS
A secondary analysis of 1416 NMIBC patients in follow-up was conducted. Uni and multivariable logistic regression models were fit for all recurrences and HG/CIS recurrences. Using multivariate logistic regression models, nomograms estimating probability of recurrence and HG/CIS recurrence were generated. Decision curve analyses (DCA) examined the net benefit of the models and calculated the net reduction in unnecessary cystoscopies.
RESULTS:
ADXBLADDER status was the only significant variable in the multivariable analysis for HG/CIS recurrence. The probability of an ADXBLADDER negative patient having a HG/CIS recurrence is 0.7%(NPV 99.3%) versus 4.8% in ADXBLADDER positive patients. DCA determined that for HG/CIS recurrence threshold probabilities between 0-0.048, there is a net benefit for using ADXBLADDER in deciding to do a cystoscopy during follow-up (vs. cystoscopy in all patients), leading to a net reduction of 19-60 cystoscopies per 100 patients.
CONCLUSIONS:
Where risk of HG/CiS recurrence is low (i.e. pTaLG patients (no CIS) at the previous visit) incorporation of ADXBLADDER into the follow-up surveillance schedule could lead to a reduction of up to 60% of unnecessary cystoscopies during follow-up, improving patient quality-of-life and decreasing costs.
Frequent follow-up cystoscopies are required in patients diagnosed with non-muscle invasive bladder cancer (NMIBC) to detect recurrence/progression. Recently it was reported that lower intensity follow-up schedules demonstrate no risk of progression/death, therefore it may be possible to reduce cystoscopic surveillance. Our aim was to determine how a less intensive surveillance schedule, utilising ADXBLADDER in a predictive tool, could enable a reduction in unnecessary follow-up cystoscopies.
MATERIALS & METHODS
A secondary analysis of 1416 NMIBC patients in follow-up was conducted. Uni and multivariable logistic regression models were fit for all recurrences and HG/CIS recurrences. Using multivariate logistic regression models, nomograms estimating probability of recurrence and HG/CIS recurrence were generated. Decision curve analyses (DCA) examined the net benefit of the models and calculated the net reduction in unnecessary cystoscopies.
RESULTS:
ADXBLADDER status was the only significant variable in the multivariable analysis for HG/CIS recurrence. The probability of an ADXBLADDER negative patient having a HG/CIS recurrence is 0.7%(NPV 99.3%) versus 4.8% in ADXBLADDER positive patients. DCA determined that for HG/CIS recurrence threshold probabilities between 0-0.048, there is a net benefit for using ADXBLADDER in deciding to do a cystoscopy during follow-up (vs. cystoscopy in all patients), leading to a net reduction of 19-60 cystoscopies per 100 patients.
CONCLUSIONS:
Where risk of HG/CiS recurrence is low (i.e. pTaLG patients (no CIS) at the previous visit) incorporation of ADXBLADDER into the follow-up surveillance schedule could lead to a reduction of up to 60% of unnecessary cystoscopies during follow-up, improving patient quality-of-life and decreasing costs.
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