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The AFU has set itself the task of setting up a register of medical practices in order to define possible improvements in the therapeutic management and follow-up of NMIBC. In order to obtain representative data, all urologists who are members of the AFU may be invited to include their patients.
BACKGROUND Non-muscle infiltrating bladder tumors are a cancerous pathology with an estimated incidence of 13,000 new cases/year in France. ¾ of new cases are diagnosed at a stage where the cancer is of limited extension to the urothelial mucosa and/or its underlying chorion (non-muscle-invasive bladder cancer NMIBC). The management and follow-up of NMIBCs are performed according to the best practice recommendations issued by the Cancer Committee of the French Urology Association. The risk of recurrence at 1 and 5 years for NMIBC has been estimated in clinical trials to be between 15%-61% and 31%-78%, respectively, depending on grade, stage, number, size, frequency of previous recurrence and presence of carcinoma in situ. In this context, patients should have regular endoscopic examinations to ensure the absence of tumor lesions inside their bladder. Urine cytology pathology is recommended for the detection of recurrence of NMIBC. However, the negative predictive value of this examination does not allow it to be substituted for bladder endoscopy, as the risk of not recognizing a bladder tumor, especially of low grade, is too high. To date, no urinary biomarker has been shown to be clinically useful and their use is not recommended for the non-invasive detection of endovesical tumor recurrence.
The observational study of the clinical validity of the negative and positive predictive values of urine tests in a population of patients followed for a bladder tumor previously characterized is able to demonstrate the possibility of postponing the realization of the cystoscopy according to the tumoral characteristics and the treatments received by the patients.
OBJECTIVES The main objective of the research will be to evaluate the diagnostic performance of urine tests, which are available in France and which provide a binary result (positive: probable presence of a tumor recurrence; negative: probable absence of a tumor recurrence) to the result of the bladder endoscopy performed as part of the routine care for the follow-up of NMIBC: determination of the negative and positive predictive values of the tests.
The secondary objectives will be to describe the anatomopathological characteristics, the pathological history and the treatments received in the population, as well as analyze demographic and regional disparities in the treatment profiles of these diseases.
MATERIAL AND METHOD When the patient is included in the study, medical data relating to the patient's pathology, including all previous treatments, will be entered into the register, as well as the name and result of the urine test carried out before the resection (biopsy) on urine samples taken as part of routine care. At each follow-up endoscopic examination scheduled in the patient's personalized care plan, the investigating urologist will record its date and endoscopic findings (bladder fibroscopy). The name and result of the urine test will also be recorded by the urologist. The performance of the test will be evaluated from these data by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and by means of an analysis of variance (ANOVA) to explore possible differences within the test by tumor grade and stage, and according to previous endovesical treatments received.
The inclusion target is 8000 patients in France over a 6-year period.
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| Measure | Description | Time Frame |
|---|---|---|
| Recurrence-Free Survival | New bladder cancer (Whether NMIBC or MIBC). | 5 years |
| Performance of urine tests (biomarkers) | To evaluate the diagnostic performance of urine tests (biomarkers) available in France, and providing a binary result (positive: probable presence of a tumor recurrence; negative: probable absence of a tumor recurrence) correlated to the result of the bladder endoscopy performed as part of the routine care for the follow-up of NMIBC: determination of the negative and positive predictive values of biomarkers. | 5 years |
| Measure | Description | Time Frame |
|---|---|---|
| Progression-Free Survival | New bladder cancer (MIBC). | 5 years |
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Inclusion Criteria:
Exclusion Criteria:
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Patient being monitored for a non-muscle-invasive bladder tumor and having undergone a urinary test (biomarker) prior to their resection (biopsy) diagnosis or recurrence
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yann Neuzillet | Contact | +33145480609 | registres@afu.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hopital Prive de Provence | Recruiting | Aix-en-Provence | 13080 | France |
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| CHU Angers | Recruiting | Angers | 49933 | France |
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| Hopital Privé Arras les Bonnettes | Recruiting | Arras | 62000 | France |
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| Centre hospitalier Privé Montgradé | Recruiting | Aubergenville | 78410 | France |
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| Centre Hospitalier Beauvais Simone Veil | Recruiting | Beauvais | France |
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| CHU Caen | Recruiting | Caen | France |
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| Hôpital Privé de Sévigné | Recruiting | Cesson-Sévigné | France |
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| Clinique des Cèdres | Recruiting | Cornebarrieu | France |
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| GH Eaubonne-Montmorency Hopital Simone Veil | Recruiting | Eaubonne | 95602 | France |
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| CHD Vendée | Recruiting | La Roche-sur-Yon | France |
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| CHU Kremlin Bicêtre APHP | Recruiting | Le Kremlin-Bicêtre | France |
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| Pôle Santé Sud | Recruiting | Le Mans | 72016 | France |
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| Clinique Bon Secours | Recruiting | Le Puy-en-Velay | France |
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| Hopital Franco-Britannique Cognac Jay | Recruiting | Levallois-Perret | France |
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| Clinique Mutualiste de la porte de l'Orient | Recruiting | Lorient | 56100 | France |
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| Clinique de la Sauvegarde | Recruiting | Lyon | France |
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| Hopital Edouard Heriot | Recruiting | Lyon | France |
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| Hopital Lyon Sud | Recruiting | Lyon | France |
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| Clinique de la Région Mantaise | Recruiting | Mantes-la-Jolie | France |
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| Hôpital privé Européen - Marseille | Recruiting | Marseille | France |
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| Centre Hospitalier Martigues | Recruiting | Martigues | France |
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| Grand Hôpital de l'Est-Francilien | Recruiting | Meaux | France |
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| Clinique Beau Soleil | Recruiting | Montpellier | France |
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| CHU Nimes | Recruiting | Nîmes | France |
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| CH Saint-Louis APHP | Recruiting | Paris | 75010 | France |
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| GH Paris Saint Joseph | Recruiting | Paris | 75014 | France |
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| Hôpital Européen Georges Pompidou APHP | Recruiting | Paris | 75015 | France |
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| GH Pitié-Salpêtrière APHP | Recruiting | Paris | France |
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| CH Perpignan | Recruiting | Perpignan | 66000 | France |
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| GHT Novo - CH René Dubos Pontoise | Recruiting | Pontoise | France |
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| Centre Hospitalier Annecy Genevois | Recruiting | Pringy | France |
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| Clinique la Croix du Sud | Recruiting | Quint-Fonsegrives | France |
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| Clinique Mathilde | Recruiting | Rouen | France |
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| Clinique Saint Hilaire | Recruiting | Rouen | France |
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| Clinique Pasteur | Recruiting | Royan | France |
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| Clinique Saint Germain en laye | Recruiting | Saint-Germain-en-Laye | France |
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| Hopital Privé Saint Grégoire | Recruiting | Saint-Grégoire | 35760 | France |
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| Clinique Santé Atlantique | Recruiting | Saint-Herblain | 44800 | France |
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| Clinique de l'Union | Recruiting | Saint-Jean | France |
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| Polyclinique de l'Europe | Recruiting | Saint-Nazaire | 44600 | France |
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| Centre Hospitalier de Saintonge | Recruiting | Saintes | 17100 | France |
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| Hopital Foch | Recruiting | Suresnes | France |
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| Polyclinique de l'Ormeau | Recruiting | Tarbes | 65000 | France |
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| Clinique Pasteur | Recruiting | Toulouse | 31076 | France |
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| ID | Term |
|---|---|
| D000093284 | Non-Muscle Invasive Bladder Neoplasms |
| D001749 | Urinary Bladder Neoplasms |
| D012008 | Recurrence |
| ID | Term |
|---|---|
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D014571 | Urologic Neoplasms |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D001745 | Urinary Bladder Diseases |
| D014570 | Urologic Diseases |
| D052801 | Male Urogenital Diseases |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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