Urothelial carcinoma is associated with a high rate of recurrence with guidelines recommending rigorous, regular surveillance programs that are invasive and expensive. This study describes a non-invasive urine test with sufficient sensitivity to 'rule out' recurrent urothelial carcinoma, thereby reducing invasive diagnostic evaluations without compromising patient care.
1036 urine samples were prospectively collected from 763 patients undergoing routine surveillance for recurrent urothelial carcinoma of the bladder to develop and validate a test with combined high sensitivity and high negative predictive value. Cxbladder Monitor combines gene expression, clinical and patient data and is designed to rule out the presence of recurrent urothelial carcinoma.
Cxbladder Monitor offers an internally validated sensitivity of 0.93 with a negative predictive value of 0.97 and a test-negative rate of 0.34. Sensitivity is 0.95 for recurrent disease with a high risk of progression (all high-grade disease and low-grade, stage ≥T1 disease) compared with 0.86 for low-grade Ta disease. Subgroup analyses indicated that diagnostic performance was not significantly different within different age groups, gender or tumor stages. The sensitivity was not affected by adjuvant Bacillus Calmette-Guérin treatment within the last 6 months. False-negatives were reported in <1.5% of all samples collected.
The Cxbladder Monitor test offers high sensitivity and high negative predictive value, combined, for ruling out urothelial carcinoma. This test has clinical utility as a confirmatory negative adjunct to cystoscopy, potentially justifying the postponement/avoidance of cystoscopic investigations for monitoring for recurrence patients.
This research output has an Altmetric Attention Score of 145. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 September 2023.
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#318,650
of 28,055,063 outputs
Outputs from The Journal of Urology
#215
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Outputs of similar age
#5,862
of 420,262 outputs
Outputs of similar age from The Journal of Urology
#2
of 341 outputs
Altmetric has tracked 28,055,063 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 19,938 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.4. This one has done particularly well, scoring higher than 98% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 420,262 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 341 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.
