Cancer - Bladder, Pelvis, Ureter & Others(구연) (E-056) 비근침윤성 방광암에서 경요도 방광종양 절제술 후 즉시 시행된 요세포검사의 임상적 의의 평가 강릉아산병원, 울산대학교 의과대학 비뇨기과학교실 김동수, 남욱, 안동현, 박민욱, 채한규, 김성진, 김한권, 박종연 Purpose: To evaluate the clinical significance of immediate urine cytology (IUC) after transurethral resection of bladder tumors(TURB) in non-muscle-invasive bladder cancer(NMIBC). Materials and Methods: We reviewed the records of 126 patients who underwent TURB for NMIBC with IUC between March 2015 and August 2019. Patients with biopsy proven muscle invasion or metastatic bladder cancer, who had combined upper tract urothelial carcinoma, or who have not been followed up for more than 6 months were excluded. IUC was obtained immediately after TURB and all patients underwent continuous distilled water irrigation after surgery. We analyzed the correlation between IUC results and patient general characteristics, previous NMIBC history, tumor size, multiplicity, pathologic stage, and grade. Multivariate Cox analysis was used to determine the effect of positive IUC results on bladder cancer recurrence. The difference in the effect of BCG therapy on recurrence was assessed according to the IUC results Results: Of 126 patients (median age: 71 yrs(IQR: 64-78), male: 94(74.6%)) who underwent IUC after TURB, 37 (29.4%) patients were positive and 89 (70.6%) negative, and median follow-up period (IQR) was 26.4(16.4-36.6) and 21.6(12.5–36.0), respectively. Pathologic T stages and Tumor grade was significantly worse in Positive IUC patients compared to negative (73.0% vs. 28.1% of pT1, 94.3% vs. 55.1% of high grade). Recurrence of bladder tumor was significantly higher in positive IUC compared to negative in total follow up duration (62.2% vs. 25.8%, p=0.000) and the 2 years recurrence free survival rate was significantly different between positive vs. negative(39.0% vs. 71.1%, p=0.000). Multivariate analyses showed that tumor grade (HR,2.247; P=0.004), multiplicity (HR,2.502; P=0.011), bladder instillation BCG therapy (HR,0.095; P=0.000) and IUC positive (HR,4.766; P=0.000) were significantly associated with recurrence of bladder cancer. Among patients with positive IUC, 20 (54.1%) patients underwent BCG therapy and they had significantly lower bladder cancer recurrence rate than patients who did not receive BCG therapy(35.0% vs. 94.1%, p=0.000). Conclusions: IUC after TURB is significantly associated with recurrence of bladder cancer, and the recurrence rate by BCG treatement was significantly decreased in IUC positive patients compared to IUC negative patients. keywords : Immediate urine cytology, Non-muscle invasive bladder cancer, BCG treatement