Comparison of outcomes between ultrasonography and cystoscopy in the surveillance of patients with initially diagnosed TaG1-2 bladder cancers: A matched-pair analysis.

PURPOSE: To examine the clinical outcomes of regular use of ultrasonography when compared with those of cystoscopy in the follow-up of patients with TaG1-2 bladder tumors.

PATIENTS AND METHODS: Between 1990 and 2012, 197 patients with TaG1-2 bladder tumors from a retrospective 2-institution cohort were included. We assessed clinical outcomes in 83 patients followed up by ultrasonography, matched for propensity score calculated from clinicopathological variables including age, gender, tumor multiplicity, size, grade, postoperative immediate chemoinstillation, and adjuvant intravesical treatment.

RESULTS: Among the 166 patients identified using the one-to-one propensity score analysis, the 5- and 10-year recurrence-free survival rates were both 63.3% in the cystoscopy group and 69.1% and 58.4%, respectively, in the ultrasonography group (P = 0.762). A total of 54 patients experienced disease recurrence, and 18 patients acquired progressive disease such as tumor grade 3, pT1 tumors, and the appearance of concurrent carcinoma in situ. There were no significant differences in the characteristics of recurrent tumors between both the groups, whereas time to first recurrence in the cystoscopy group was significantly shorter than that in the ultrasonography group (P = 0.021). In a subgroup analysis using 111 patients without adjuvant intravesical treatments, the 5- and 10-year recurrence-free survival rates were both 56.9% in the cystoscopy group and 71.9% and 60.3%, respectively, in the ultrasonography group (P = 0.282).

CONCLUSIONS: This retrospective study suggests that ultrasonography may be one of the follow-up substitutes when considering the management of low-risk bladder tumors such as TaG1-2 bladder tumors.