Background and Objectives: The limitations, cost and invasiveness of rigid cystoscope generated an increasing interest in noninvasive diagnostic tools for the follow-up of superficial bladder cancer. We evaluated the efficacy and determined the cost-effectiveness of the combination of BTA stat Test (BTA) and bladder wash cytology (BWC) for superficial bladder cancer surveillance.Patients and Methods: From September to October 2002, 40 patients (the majority were TCC patients) undergoing cystoscopy were prospectively included in the study. All patients underwent BTA and BWC as well as a complete evaluation including cystoscopy and transurethral resection of suspicious lesions. Combined sensitivity and specificity values of BTA stat Test and bladder wash cytology were calculated using cystoscopy and bladder wash cytology as the gold standard (which included histopathology when available). Decision trees were built using a 3 month model with linear recurrence and progression assumptions.Results: The sensitivity of BTA, BWC, cystoscopy and a combination of BTA and BWC were 68.75%, 62.5%, 87.5% and 87.5% respectively. The specificity of BTA, BWC, cystoscope and a combination of BTA and BWC were 87.5%, 100%, 100% and 87.5% respectively. The combination test was more cost-effective than cystoscopy.Conclusions: The combination of BTA and BWC was less efficient but more cost-effective than cystoscopy and will produce marginal economic savings if use the newer endoscopic technology that more accurate diagnosis when treatment of superficial cancer.

Archives of Gynecology & Obstetrics ปี 2548, พฤษภาคม ปีที่: 13 ฉบับที่ 0 หน้า