Follow-up of superficial bladder cancer: how to spare cystoscopies?

To study the efficacy, specificity and sensitivity of ultrasonography, cytology and phospholipid/fatty acid quotient (PL/FA) in the detection of recurrences in patients with superficial bladder cancer we performed these three examinations simultaneously with cystoscopy. In over 405 cystoscopies, 348 were negative and 57 were positive for tumor. Sensitivity, the most important parameter, was 73% for the three examinations together. Each method separately had the following sensitivity: ultrasound 26%; cytology 14%, and PL/FA 47%. Considering that there were only 15 false-negatives, with this follow-up scheme we save the patient from a lot of cystoscopies, avoiding their inherent morbidity.