Recurrence of non-muscle invasive bladder carcinoma after transurethral resection with hexaminolevulinate photodynamic diagnosis or regular cystoscopy
DOI:
https://doi.org/10.2340/sju.v58.10160Keywords:
Cystoscopy, Bladder Cancer, Fluorescence Imaging, Recurrence, 5-aminolevulinic acidAbstract
Objectives: To compare the recurrence of non-muscle invasive bladder carcinoma (NMIBC) after transurethral resection employing cystoscopy with hexaminolevulinate-based photodynamic diagnosis (PDD) or with standard white light.
Patients and methods: We included patients with newly suspected NMIBC in this retrospective cohort study and compared those undergoing transurethral resection by white light cystoscopy (WLC) (2008–2010) and PDD (2010–2012). All patients were treated following established criteria for good quality resection. The primary outcome was the difference in the recurrence rate after 60 months’ follow-up, but we also stratified recurrence by risk groups, as set by the European Organization for Research and Treatment of Cancer. The mean recurrence-free survival was compared between the cohorts. Odds ratios or hazard ratios are reported with their 95% confidence intervals.
Results: The WLC and PDD cohorts comprised 124 and 91 subjects, respectively. There were no significant differences in recurrence rates between the cohorts at 6 months (recurrence rate 9/123; 7.3%), 12 months (17/118; 14.4%) or 60 months (39/102; 38.2%), with odds ratios of 1.23 (CI 0.48–3.25), 1.32 (CI 0.67–2.62) and 1.12 (CI 0.70–1.79), in favour of WLC, respectively. Further analysis showed no significant effect of PDD on either recurrence by risk group or on mean recurrence-free survival (hazard ratio, 1.12 [CI 0.70–1.79]).
Conclusion: We found no relevant differences in the recurrence of NMIBC after the introduction of PDD with hexaminolevulinate compared to standard WLC when used for transurethral resection in our single institution.
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Babjuk M, Burger M, Compérat EM, et al. European Association of Urology guidelines on non-muscle-invasive bladder cancer (TaT1 and Carcinoma In Situ) – 2019 Update. Eur Urol. 2019;76(5): 639–657. https://doi.org/10.1016/j.eururo.2019.08.016 DOI: https://doi.org/10.1016/j.eururo.2019.08.016
Sylvester RJ, Van Der Meijden APM, Oosterlinck W, et al. Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: A combined analysis of 2596 patients from seven EORTC trials. Eur Urol. 2006;49(3):466–475. https://doi.org/10.1016/j.eururo.2005.12.031 DOI: https://doi.org/10.1016/j.eururo.2005.12.031
Herr HW, Donat SM. Reduced bladder tumour recurrence rate associated with narrow-band imaging surveillance cystoscopy. BJU Int. 2011; 107(3):396–398. https://doi.org/10.1111/j.1464-410X.2010.09547.x DOI: https://doi.org/10.1111/j.1464-410X.2010.09547.x
Jocham D, Witjes F, Wagner S, et al. Improved detection and treatment of bladder cancer using hexaminolevulinate imaging: a prospective, phase III multicenter study. J Urol. 2005;174(3):862–866. https://doi.org/10.1097/01.ju.0000169257.19841.2a DOI: https://doi.org/10.1097/01.ju.0000169257.19841.2a
di Stasi SM, de Carlo F, Pagliarulo V, et al. Hexaminolevulinate hydrochloride in the detection of nonmuscle invasive cancer of the bladder. Ther Adv Urol. 2015;7(6):339–350. https://doi.org/10.1177/1756287215603274 DOI: https://doi.org/10.1177/1756287215603274
Burger M, Grossman HB, Droller M, et al. Photodynamic diagnosis of non-muscle-invasive bladder cancer with hexaminolevulinate cystoscopy: a meta-analysis of detection and recurrence based on raw data. Eur Urol. 2013;64(5):846–854. https://doi.org/10.1016/j.eururo.2013.03.059 DOI: https://doi.org/10.1016/j.eururo.2013.03.059
Shen P, Yang J, Wei W, et al. Effects of fluorescent light-guided transurethral resection on non-muscle-invasive bladder cancer: a systematic review and meta-analysis. BJU Int. 2012;110(6b):E209–E215. https://doi.org/10.1111/j.1464-410X.2011.10892.x DOI: https://doi.org/10.1111/j.1464-410X.2011.10892.x
Yuan H, Qiu J, Liu L, et al. Therapeutic outcome of fluorescence cystoscopy guided transurethral resection in patients with non-muscle invasive bladder cancer: a meta-analysis of randomized controlled trials. PLoS One. 2013;8(9):1–8. https://doi.org/10.1371/journal.pone.0074142 DOI: https://doi.org/10.1371/journal.pone.0074142
Chou R, Selph S, Buckley DI, et al. Review article comparative effectiveness of fluorescent versus white light cystoscopy for initial diagnosis or surveillance of bladder cancer on clinical outcomes: systematic review. J Urol. 2017;197(3):548–558. https://doi.org/10.1016/j.juro.2016.10.061 DOI: https://doi.org/10.1016/j.juro.2016.10.061
Maisch P, Koziarz A, Vajgrt J, Narayan V, Kim MH, Dahm P. Blue vs white light for transurethral resection of non-muscle-invasive bladder cancer: an abridged Cochrane Review. BJU Int. 2022;130(6):730-740. https://doi.org/10.1002/14651858.CD014887.pub2 DOI: https://doi.org/10.1111/bju.15723
Veeratterapillay R, Gravestock P, Nambiar A, et al. Time to turn on the blue lights: a systematic review and meta-analysis of photodynamic diagnosis for bladder cancer. Eur Urol Open Sci. 2021;31:17–27. https://doi.org/10.1016/j.euros.2021.06.011 DOI: https://doi.org/10.1016/j.euros.2021.06.011
Gallagher KM, Gray K, Anderson CH, et al. ‘Real-life experience’: recurrence rate at 3 years with Hexvix®photodynamic diagnosis-assisted TURBT compared with good quality white light TURBT in new NMIBC—a prospective controlled study. World J Urol. 2017; 35(12):1871–1877. https://doi.org/10.1007/s00345-017-2077-6 DOI: https://doi.org/10.1007/s00345-017-2077-6
Mariappan P, Rai B, El-Mokadem I, et al. Real-life experience: Early recurrence with Hexvix photodynamic diagnosis-assisted transurethral resection of bladder tumour vs good-quality white light TURBT in new non-muscle-invasive bladder cancer. Urology. 2015;86(2): 327–331. https://doi.org/10.1016/j.urology.2015.04.015 DOI: https://doi.org/10.1016/j.urology.2015.04.015
Ipsen Limited. Guideline on Summary of Product Characteristics Hexvix [Internet]. Electronic Medicines Compendium; 2004, p. 1. Available from: https://www.medicines.org.uk/emc/product/4313/smpc [cited 29 April 2023].
Heer R, Lewis R, Vadiveloo T, et al. A randomized trial of PHOTOdynamic surgery in non–muscle-invasive bladder cancer. NEJM Evid. 2022; 1(10):1–10. https://doi.org/10.1056/EVIDoa2200092 DOI: https://doi.org/10.1056/EVIDoa2200092
D’Agostino RB. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med. 1998;17(19):2265–2281. https://doi.org/10.1002/(SICI)1097-0258(19981015)17:19%3C2265::AID-SIM918%3E3.0.CO;2-B DOI: https://doi.org/10.1002/(SICI)1097-0258(19981015)17:19<2265::AID-SIM918>3.0.CO;2-B
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