AFU Registry of the Therapeutic Management and Follow-up of Non-Muscle-Invasive Bladder Cancer
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- This is an observational study: the protocol does not assign a study treatment.
- Who it may be relevant to
- Registry conditions: Non-Muscle-Invasive Bladder Cancer. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- France
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
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.
Detailed description
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.
Primary outcome measures
- Recurrence-Free Survival [Time frame: 5 years]
- Performance of urine tests (biomarkers) [Time frame: 5 years]
Secondary outcome measures (1)
- Progression-Free Survival [Time frame: 5 years]
Eligibility criteria
Inclusion criteria
- 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,
- AND adult (equal to or > 18 years old),
- AND affiliated with a social security scheme in France,
- AND whose monitoring will be carried out at the recruiting center.
Exclusion criteria
- Patient being monitored for a non-urothelial bladder tumor
- Patient refusing follow-up
- Opposition to participation in the study
- Adult protected by law
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Case-only
Study locations
France · 44 centers
- Hopital Prive de Provence — Aix-en-Provence
- CHU Angers — Angers
- Hopital Privé Arras les Bonnettes — Arras
- Centre hospitalier Privé Montgradé — Aubergenville
- Centre Hospitalier Beauvais Simone Veil — Beauvais
- CHU Caen — Caen
- Hôpital Privé de Sévigné — Cesson-Sévigné
- Clinique des Cèdres — Cornebarrieu
- … and 36 more centers
Identifiers
NCT: NCT05002556 · Registry TVNIM-AFU