Xpert Bladder Cancer Detection in Emergency Setting Assessment (XESA Project): A Prospective, Single-centre Trial

Background and objective: Bladder cancer (BC) represents a significant health care challenge and is frequently detected during evaluations for haematuria in emergency departments (EDs). Our aim was to evaluate the clinical performance and economic implications of the Xpert BC Detection (BCD) test fo...

Full description

Saved in:
Bibliographic Details
Main Authors: Federica Sordelli, Antonio Desai, Filippo Dagnino, Roberto Contieri, Sofia Giuriolo, Marco Paciotti, Vittorio Fasulo, Stefano Mancon, Davide Maffei, Pier Paolo Avolio, Giorgio Da Rin, Federica Maura, Elena Vanni, Davide Federico, Piergiuseppe Colombo, Giovanni Lughezzani, Nicolò Maria Buffi, Paolo Casale, Alberto Saita, Massiomo Lazzeri, Rodolfo Hurle, Antonio Voza
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:European Urology Open Science
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666168324009194
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850277449304113152
author Federica Sordelli
Antonio Desai
Filippo Dagnino
Roberto Contieri
Sofia Giuriolo
Marco Paciotti
Vittorio Fasulo
Stefano Mancon
Davide Maffei
Pier Paolo Avolio
Giorgio Da Rin
Federica Maura
Elena Vanni
Davide Federico
Piergiuseppe Colombo
Giovanni Lughezzani
Nicolò Maria Buffi
Paolo Casale
Alberto Saita
Massiomo Lazzeri
Rodolfo Hurle
Antonio Voza
author_facet Federica Sordelli
Antonio Desai
Filippo Dagnino
Roberto Contieri
Sofia Giuriolo
Marco Paciotti
Vittorio Fasulo
Stefano Mancon
Davide Maffei
Pier Paolo Avolio
Giorgio Da Rin
Federica Maura
Elena Vanni
Davide Federico
Piergiuseppe Colombo
Giovanni Lughezzani
Nicolò Maria Buffi
Paolo Casale
Alberto Saita
Massiomo Lazzeri
Rodolfo Hurle
Antonio Voza
author_sort Federica Sordelli
collection DOAJ
description Background and objective: Bladder cancer (BC) represents a significant health care challenge and is frequently detected during evaluations for haematuria in emergency departments (EDs). Our aim was to evaluate the clinical performance and economic implications of the Xpert BC Detection (BCD) test for patients presenting to the ED with haematuria to address the pressing need for more efficient and accurate diagnostic tools in this setting. Methods: We conducted a prospective single-centre observational study in the ED of a tertiary university hospital. Patients presenting with gross haematuria as the primary reason for their visit were enrolled. Urine samples collected in the ED were analysed using the Xpert BCD test. The primary outcomes were sensitivity, specificity, and a cost analysis for the Xpert BCD test in comparison to standard diagnostic methods such as urine cytology (UC) and white-light cystoscopy (WLC). Key findings and limitations: The Xpert BCD test exhibited superior sensitivity to UC, particularly in identifying high-grade tumours. Importantly, Xpert BCD implementation has the potential to significantly reduce the number of unnecessary WLC procedures and streamline diagnostic pathways. The cost analysis also highlighted potential cost savings for Xpert BCD adoption in the ED setting. Conclusions and clinical implications: Our findings underscore the promise of Xpert BCD for revolutionising the diagnostic approach to BC in the ED for patients with gross haematuria. Its greater sensitivity and efficiency mean that Xpert BCD has the potential to improve patient care, optimise resource use, and alleviate the economic burden associated with unnecessary procedures. Patient summary: Xpert Bladder Cancer Detection is a simple urine test that detects the presence of five genes associated with bladder cancer. We found that for patients visiting the emergency department because of blood in their urine, use of this test could save time and money over urine cell analysis (UCA) for ruling out or diagnosing bladder cancer. The test was also more sensitive in detecting higher-grade cancers. More research is needed to confirm our results.
format Article
id doaj-art-6a3a788af2df43879b8437b8e0051448
institution OA Journals
issn 2666-1683
language English
publishDate 2025-01-01
publisher Elsevier
record_format Article
series European Urology Open Science
spelling doaj-art-6a3a788af2df43879b8437b8e00514482025-08-20T01:49:53ZengElsevierEuropean Urology Open Science2666-16832025-01-017117217910.1016/j.euros.2024.09.001Xpert Bladder Cancer Detection in Emergency Setting Assessment (XESA Project): A Prospective, Single-centre TrialFederica Sordelli0Antonio Desai1Filippo Dagnino2Roberto Contieri3Sofia Giuriolo4Marco Paciotti5Vittorio Fasulo6Stefano Mancon7Davide Maffei8Pier Paolo Avolio9Giorgio Da Rin10Federica Maura11Elena Vanni12Davide Federico13Piergiuseppe Colombo14Giovanni Lughezzani15Nicolò Maria Buffi16Paolo Casale17Alberto Saita18Massiomo Lazzeri19Rodolfo Hurle20Antonio Voza21Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, ItalyEmergency Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Emergency Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyDepartment of Urology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, ItalyLaboratory Medicine, IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyLaboratory Medicine, IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyBusiness Control, IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyDepartment of Pathology, IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Pathology, IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Urology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Urology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Urology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Urology, IRCCS Humanitas Research Hospital, Rozzano, Italy; Corresponding author. Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy.Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Emergency Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, ItalyBackground and objective: Bladder cancer (BC) represents a significant health care challenge and is frequently detected during evaluations for haematuria in emergency departments (EDs). Our aim was to evaluate the clinical performance and economic implications of the Xpert BC Detection (BCD) test for patients presenting to the ED with haematuria to address the pressing need for more efficient and accurate diagnostic tools in this setting. Methods: We conducted a prospective single-centre observational study in the ED of a tertiary university hospital. Patients presenting with gross haematuria as the primary reason for their visit were enrolled. Urine samples collected in the ED were analysed using the Xpert BCD test. The primary outcomes were sensitivity, specificity, and a cost analysis for the Xpert BCD test in comparison to standard diagnostic methods such as urine cytology (UC) and white-light cystoscopy (WLC). Key findings and limitations: The Xpert BCD test exhibited superior sensitivity to UC, particularly in identifying high-grade tumours. Importantly, Xpert BCD implementation has the potential to significantly reduce the number of unnecessary WLC procedures and streamline diagnostic pathways. The cost analysis also highlighted potential cost savings for Xpert BCD adoption in the ED setting. Conclusions and clinical implications: Our findings underscore the promise of Xpert BCD for revolutionising the diagnostic approach to BC in the ED for patients with gross haematuria. Its greater sensitivity and efficiency mean that Xpert BCD has the potential to improve patient care, optimise resource use, and alleviate the economic burden associated with unnecessary procedures. Patient summary: Xpert Bladder Cancer Detection is a simple urine test that detects the presence of five genes associated with bladder cancer. We found that for patients visiting the emergency department because of blood in their urine, use of this test could save time and money over urine cell analysis (UCA) for ruling out or diagnosing bladder cancer. The test was also more sensitive in detecting higher-grade cancers. More research is needed to confirm our results.http://www.sciencedirect.com/science/article/pii/S2666168324009194Bladder cancerCystoscopyUrine cytologyDiagnostic testmRNANon–muscle-invasive bladder cancer
spellingShingle Federica Sordelli
Antonio Desai
Filippo Dagnino
Roberto Contieri
Sofia Giuriolo
Marco Paciotti
Vittorio Fasulo
Stefano Mancon
Davide Maffei
Pier Paolo Avolio
Giorgio Da Rin
Federica Maura
Elena Vanni
Davide Federico
Piergiuseppe Colombo
Giovanni Lughezzani
Nicolò Maria Buffi
Paolo Casale
Alberto Saita
Massiomo Lazzeri
Rodolfo Hurle
Antonio Voza
Xpert Bladder Cancer Detection in Emergency Setting Assessment (XESA Project): A Prospective, Single-centre Trial
European Urology Open Science
Bladder cancer
Cystoscopy
Urine cytology
Diagnostic test
mRNA
Non–muscle-invasive bladder cancer
title Xpert Bladder Cancer Detection in Emergency Setting Assessment (XESA Project): A Prospective, Single-centre Trial
title_full Xpert Bladder Cancer Detection in Emergency Setting Assessment (XESA Project): A Prospective, Single-centre Trial
title_fullStr Xpert Bladder Cancer Detection in Emergency Setting Assessment (XESA Project): A Prospective, Single-centre Trial
title_full_unstemmed Xpert Bladder Cancer Detection in Emergency Setting Assessment (XESA Project): A Prospective, Single-centre Trial
title_short Xpert Bladder Cancer Detection in Emergency Setting Assessment (XESA Project): A Prospective, Single-centre Trial
title_sort xpert bladder cancer detection in emergency setting assessment xesa project a prospective single centre trial
topic Bladder cancer
Cystoscopy
Urine cytology
Diagnostic test
mRNA
Non–muscle-invasive bladder cancer
url http://www.sciencedirect.com/science/article/pii/S2666168324009194
work_keys_str_mv AT federicasordelli xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT antoniodesai xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT filippodagnino xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT robertocontieri xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT sofiagiuriolo xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT marcopaciotti xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT vittoriofasulo xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT stefanomancon xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT davidemaffei xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT pierpaoloavolio xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT giorgiodarin xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT federicamaura xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT elenavanni xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT davidefederico xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT piergiuseppecolombo xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT giovannilughezzani xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT nicolomariabuffi xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT paolocasale xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT albertosaita xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT massiomolazzeri xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT rodolfohurle xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial
AT antoniovoza xpertbladdercancerdetectioninemergencysettingassessmentxesaprojectaprospectivesinglecentretrial