[et_pb_section fb_built=”1″ _builder_version=”4.16″ custom_padding=”0px|||||” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_row _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” min_height=”446px” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”4_4″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||” theme_builder_area=”post_content”][et_pb_text _builder_version=”4.16″ header_text_color=”#3b8dbf” background_size=”initial” background_position=”top_left” background_repeat=”repeat” global_colors_info=”{}” theme_builder_area=”post_content”]<\/p>\n
Editorial comment by Morgan Roupr\u00eat<\/p>\n
The implementation and advantages of urinary biomarkers<\/strong> for non-muscle-invasive-bladder (NMIBC) were discussed by an international expert panel at the 19th Meeting of the EAU Section of Oncological Urology (ESOU22)<\/strong>, held on 21-23 January 2022 in Madrid, Spain.<\/p>\n The panel consisted of Prof. Morgan Roupr\u00eat<\/strong> (Paris, France), Prof. Fred Witjes<\/strong> (Nijmegen, The Netherlands), Dr. Mario \u00c1lvarez-Maestro<\/strong> (Madrid, Spain) and Dr. Luis Mart\u00ednez-Pi\u00f1eiro<\/strong> (Madrid, Spain).<\/p>\n Dr. Ekaterina Laukhtina<\/strong> presented a case study of an 82-year-old NMIBC patient who underwent a transurethral resection of bladder tumour (TURBT). The pathology report indicated papillary pTa low-grade urothelial carcinoma, no lymphovascular invasion. Dr. Mario \u00c1lvarez-Maestro replied that he has a very good experience with Bladder EpiCheck\u00ae and UroMonitor\u00ae in patients with low-grade tumours. He recommends using a urinary biomarker in elderly patients and not to perform a cystoscopy when the result of the test is negative.<\/strong><\/p>\n Prof. Fred Witjes, agreed with Dr. Mario \u00c1lvarez-Maestro and added that urinary biomarkers became very popular during the COVID-19 pandemic<\/strong> as patients were not allowed or reluctant to come to the hospital. A urine sample can simply be collected and shipped from home to the laboratory and the result can be discussed during a teleconsultation. Prof. Fred Witjes uses Bladder EpiCheck\u00ae in clinical practice, which performs very well in excluding high-grade tumours<\/strong>, in all patients regardless of tumour grade history.<\/p>\n An important remark was made by Prof. Morgan Roupr\u00eat, who noted that urinary markers are currently not recommended for routine use and consequently, not reimbursed. However, alternating a urinary biomarker with cystoscopy in clinical practice is cost effective according to Prof. Fred Witjes<\/strong>, who learned this from practices at his hospital. Especially in an era of COVID-19 outbreak when patients were reluctant to come to the hospital.<\/p>\n Dr. Mario \u00c1lvarez-Maestro pointed out that patients should be properly informed: if you have a negative result, the probability of not having a bladder tumour is 90%.<\/p>\n <\/p>\n Several urinary biomarkers are currently available on the market who differ in the technology (e.g. protein-based, DNA methylation-based) and for whom no head-to-head comparison is available, which can make the choice of marker difficult.<\/p>\n Dr. Mario \u00c1lvarez-Maestro and Prof. Fred Witjes both started using the Bladder EpiCheck\u00ae because of obvious reasons (participation in a clinical trial with Bladder EpiCheck\u00ae, first one available at the hospital), but decided to continue using this marker because they know how to use it, and it performs well.<\/p>\n Dr. Alberto Breda (Barcelona, Spain) from the audience pointed out DNA methylation-based tests such as the Bladder EpiCheck\u00ae are the best according to literature.<\/strong> Additionally, Bladder EpiCheck\u00ae uses 15 DNA methylation biomarkers, while other tests only use 2-3 makers, resulting in a high NPV and sensitivity for Bladder EpiCheck\u00ae.<\/p>\n <\/p>\n In the case study presented by Dr. Ekaterina Laukhtina, the patient refused cystoscopy after 12 months of regular follow-up with cystoscopy, cytology, and a urinary biomarker. In this situation, Dr. Mario \u00c1lvarez-Maestro would prefer a urinary biomarker together with cytology.<\/strong><\/p>\n At 24 months of follow-up, cytology was negative, while the urinary biomarker test was positive. Subsequent cystoscopy showed a 1 cm papillary tumour suggestive of low risk. Due to the age and comorbidities of the patient, active surveillance (cystoscopy + cytology) was chosen as the next step.<\/p>\n [\/et_pb_text][et_pb_video src=”https:\/\/youtu.be\/-7GTrAgnM7E” thumbnail_overlay_color=”rgba(0,0,0,0.6)” _builder_version=”4.16″ width=”70%” module_alignment=”center” global_colors_info=”{}” theme_builder_area=”post_content”][\/et_pb_video][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.16″ global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”4_4″ _builder_version=”4.16″ global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_button button_url=”https:\/\/youtu.be\/-7GTrAgnM7E” button_text=”Watch the expert panel discussion on surveillance here.” button_alignment=”center” _builder_version=”4.16″ custom_button=”on” button_text_color=”#ffffff” button_bg_color=”#3b8dbf” button_border_width=”0px” global_colors_info=”{}” theme_builder_area=”post_content”][\/et_pb_button][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.8.2″ _module_preset=”default” custom_padding=”2px||5px|||” global_module=”303″ saved_tabs=”all” global_colors_info=”{}” theme_builder_area=”post_content”][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":" Clinical case presentation by Dr. Ekaterina Laukhtina (Moscow, Russia) Editorial comment by Morgan Roupr\u00eat The implementation and advantages of urinary biomarkers for non-muscle-invasive-bladder (NMIBC) were discussed by an international expert panel at the 19th Meeting of the EAU Section of Oncological Urology (ESOU22), held on 21-23 January 2022 in Madrid, Spain. The panel consisted of […]<\/p>\n","protected":false},"author":0,"featured_media":204,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[8],"tags":[],"class_list":["post-335","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-lecture"],"_links":{"self":[{"href":"https:\/\/bcamonitor.org\/index.php?rest_route=\/wp\/v2\/posts\/335","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bcamonitor.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/bcamonitor.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/bcamonitor.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=335"}],"version-history":[{"count":1,"href":"https:\/\/bcamonitor.org\/index.php?rest_route=\/wp\/v2\/posts\/335\/revisions"}],"predecessor-version":[{"id":376,"href":"https:\/\/bcamonitor.org\/index.php?rest_route=\/wp\/v2\/posts\/335\/revisions\/376"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bcamonitor.org\/index.php?rest_route=\/wp\/v2\/media\/204"}],"wp:attachment":[{"href":"https:\/\/bcamonitor.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=335"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bcamonitor.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=335"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bcamonitor.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=335"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Dr. Laukhtina raised the question to the expert panel whether non-invasive urinary biomarkers could be routinely used to avoid cystoscopy during surveillance of this patient.<\/p>\nWhich urinary biomarker test to use?<\/h2>\n
What if the patient refuses cystoscopy in follow-up?<\/h2>\n