Predictive value of Bladder EpiCheck ® in detecting residual tumor before second TUR for non-muscle-invasive bladder cancer.

Purpose: As Bladder EpiCheck ^® (BE) is a promising urinary biomarker for diagnosis and follow up of non-muscle-invasive bladder cancer (NMIBC), there are no studies evaluated this tool for second transurethral resection (TUR) indication. We aim to evaluate the performance of BE in predicting residual tumor before second TUR in NMIBC and its effects on clinical decision making.
Methods: A total of 50 patients who were diagnosed with NMIBC and indicated for a second TUR were included in the study prospectively. The urine sample taken one day before the second TUR operation was evaluated with BE and the results were compared with second TUR pathologies.
Results: The mean age was 65.3 and 45 of the patients were male. Specificity and negative predictive value of BE in primary tumor stage Ta were 100% and 87.5% while in primary tumor stage T1 were 71.4% and 68.2%, respectively. The specificity and negative predictive value of BE were 77.8% and 75%, respectively, in patients with high grade primary tumor. When all NMIBC were evaluated, the specificity and negative predictive value of BE were found to be 78.6% and 73.3% for second TUR, respectively. As an independent predictor of residual tumor in this group, positivity rates of BE were higher in T1 (p < 0.037) and high grade (p < 0.002) tumors.
Conclusions: BE may be useful in detecting residual tumor before second TUR and benefit in clinical decision making with high specificity and negative predictive value. These results encourage the use of BE to reduce number of unnecessary second TUR procedures. It may improve cost effectivity and quality of life as high numbered studies are needed to support these views and to incorporate BE into clinical practice.
Competing Interests: Declarations. Ethics approval: The protocol for this research has been approved by Clinical Research Ethics Commitee of the University of Health Sciences, Istanbul Bagcilar Training and Research Hospital, decision number 2019.10.2.01.074. All methods were carried out in accordance with relevant guidelines and regulations of Helsinki declaration. Consent to participate: Written informed consent was obtained from the participants included in the study. Competing interests: The authors declare no competing interests.
(© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)