Prediction of Postoperative Intravesical Recurrence Using Urine DNA Monitoring in Nonmuscular-Invasive Urothelial...

Area of Science:

• Urology
• Oncology
• Molecular Diagnostics

Background:

• Intravesical recurrence is common in bladder urothelial carcinoma (UBC) post-surgery.
• Non-invasive biomarkers are crucial for predicting recurrence and guiding management.
• Current methods like urine cytology have limitations in early detection.

Purpose of the Study:

• To evaluate the utility of urine DNA analysis for detecting and predicting intravesical recurrence in UBC patients.
• To compare the efficacy of urine DNA testing with urine cytology and cystoscopy.

Main Methods:

• Prospective enrollment of patients with primary nonmuscle-invasive UBC post-transurethral surgery.
• Analysis of genomic profiles in tumor tissue and serial urine samples.
• Evaluation of urine DNA, urine cytology, and cystoscopy at 3-month intervals for up to 1 year.

Main Results:

• Urine DNA detected recurrence in all six recurrence cases, preceding cystoscopic or cytologic diagnosis.
• Urine precipitation and supernatant fractions showed similar positivity rates in recurrence cases.
• Four of 13 non-recurrence cases showed positive urine DNA, with three negative after therapy.

Conclusions:

• Urine DNA analysis, using a genomic panel, shows potential for predicting and detecting UBC intravesical recurrence.
• Simultaneous evaluation of urine precipitation and supernatant may improve clinical utility for surveillance.
• Urine DNA offers a promising non-invasive tool for monitoring UBC recurrence.