Evidence map›Paper›PMID 41184141›Full record

SynthesisInvestigative and clinical urology2025

Evaluating diagnostic performance of urinary biomarkers in the surveillance of non-muscle invasive bladder carcinoma: A systematic review.

Reena Prhiya Ramasamy, Chu Ann Chai, Angelo Cormio, Retnagowri Rajandram, Daniele Castellani, Wei Shen Tan, Vineet Gauhar, See Tong Pang, Paramananthan Mariappan, Jeremy Yuen Chun Teoh and 1 more

Abstract readSystematic Review
In one paragraph

Synthesis in Investigative and clinical urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Reena Prhiya RamasamyUrology Unit, Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia.ORCID 0009-0004-3393-9740
Chu Ann ChaiUrology Unit, Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia. chu.ann@ummc.edu.my.ORCID 0000-0001-8915-3617
Angelo CormioUrology Unit, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy.ORCID 0000-0002-6897-7040
Retnagowri RajandramDepartment of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.ORCID 0000-0001-5247-2817
Daniele CastellaniUrology Unit, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy.ORCID 0000-0001-7354-9190
Wei Shen TanDepartment of Urology, Yale School of Medicine, New Haven, CT, USA.ORCID 0000-0002-6119-4043
Vineet GauharDepartment of Urology, Ng Teng Fong General Hospital, National University Health System, Singapore.ORCID 0000-0002-3740-7141
See Tong PangDivision of Urology, Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.ORCID 0000-0002-2064-0828
Paramananthan MariappanDepartment of Urology, Edinburgh Bladder Cancer Surgery, The University of Edinburgh, Western General Hospital, Edinburgh, UK.ORCID 0000-0001-8221-4640
Jeremy Yuen Chun TeohSH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China.ORCID 0000-0002-9361-2342
Teng Aik OngUrology Unit, Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia.ORCID 0000-0002-0207-8966

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeUrinary biomarkers have been proposed to play an integral role in detecting recurrent non-muscle invasive bladder carcinoma (NMIBC). This review delineates the diagnostic accuracy of such biomarkers and management strategies in the event of discordance between biomarker findings and flexible cystoscopy, the current gold standard for NMIBC surveillance. MATERIALS AND

methodsIn accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement, literature searches were conducted across PubMed, Embase, Scopus, and CENTRAL (Cochrane Central Register of Controlled Trials), focusing on studies comparing urinary biomarkers to cystoscopy. The inclusion criteria were based on the PICOS (Patient Intervention Comparison Outcome Study type) model. The quality of included studies was assessed using the QUADAS-2 tool.

resultsA total of 23 studies were included, encompassing 21 types of urinary biomarkers. The analysis revealed significant variability in diagnostic performance. Sensitivity ranged from 14.8% to 94.3%, specificity from 33.3% to 99.2%, positive predictive value from 9.9% to 100%, and negative predictive value from 35.3% to 98.8%. Heterogeneity was observed across studies, indicating variability in different biomarker performance. Genetic biomarkers demonstrated higher diagnostic accuracy compared to protein-based markers. However, their clinical utility needs further validation.

conclusionsUrinary biomarkers could complement, rather than replace cystoscopy, in the surveillance of NMIBC, potentially reducing the frequency of invasive procedures. In cases of discordance, an algorithm focusing on shared decision-making and tailored surveillance strategies can be undertaken. Large-scale multicentric studies are needed to confirm their efficacy and establish standardized clinical protocols.

Indexed as

Biomarkers, TumorUrinary Bladder NeoplasmsCystoscopyHumansNeoplasm InvasivenessBiomarkers, TumorBiomarkersCystoscopyNon-muscle invasive bladder cancerSystematic reviewUrine

Identifiers

PMID41184141
PMCPMC12599468

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.