1264 A PROSPECTIVE, RANDOMIZED COMPARISON BETWEEN THE HEXAMINOLEVULINATE BLUE LIGHT AND THE STANDARD WHITE LIGHT CYSTOSCOPY CONCERNING THE LONG TERM RECURRENCE RATES IN NON-MUSCLE INVASIVE BLADDER CANCER CASES

Abstract

You have accessJournal of UrologyBladder Cancer: Detection and Screening1 Apr 20121264 A PROSPECTIVE, RANDOMIZED COMPARISON BETWEEN THE HEXAMINOLEVULINATE BLUE LIGHT AND THE STANDARD WHITE LIGHT CYSTOSCOPY CONCERNING THE LONG TERM RECURRENCE RATES IN NON-MUSCLE INVASIVE BLADDER CANCER CASES Bogdan Geavlete, Razvan Multescu, Florin Stanescu, Dragos Georgescu, Marian Jecu, Cristian Moldoveanu, and Petrisor Geavlete Bogdan GeavleteBogdan Geavlete Bucharest, Romania More articles by this author , Razvan MultescuRazvan Multescu Bucharest, Romania More articles by this author , Florin StanescuFlorin Stanescu Bucharest, Romania More articles by this author , Dragos GeorgescuDragos Georgescu Bucharest, Romania More articles by this author , Marian JecuMarian Jecu Bucharest, Romania More articles by this author , Cristian MoldoveanuCristian Moldoveanu Bucharest, Romania More articles by this author , and Petrisor GeavletePetrisor Geavlete Bucharest, Romania More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1596AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A prospective, randomized, long term study was performed aiming to compare the long term recurrence rates provided by the hexaminolevulinate blue light cystoscopy (HAL-BLC) versus the standard white light cystoscopy (WLC) in cases of non-muscle invasive bladder cancer (NMIBC). METHODS A total of 362 NMIBC suspected patients were included in the trial based on positive urinary cytology and/or ultrasonographic suspicion of bladder tumors. The 181 cases of the study group underwent both WLC and HAL-BLC, while patients in the control group benefited from standard cystoscopy alone. A single postoperative mytomicin-C instillation was performed in all resection cases. No additional instillations were used in low risk patients, while adjuvant chemotherapy was applied in intermediate risk cases and BCG immunotherapy for high risk patients. The follow-up protocol consisted of abdominal ultrasound, urinary cytology and WLC, performed every 3 months for a period of 2 years and every 6 months in the third year. RESULTS In the 142 NMIBC patients of the study group, HAL-BLC emphasized significantly improved CIS (95.2% versus 71.4%), pTa (95.3% versus 87.1%) and overall (95.8% versus 85.9%) cases' detection rates. Additional tumors were found by HAL-BLC in a significantly higher proportion of cases (35.2% versus 14.1%). Consequently, the recurrence (16.2% versus 4.9%) and progression (21.1% versus 7%) risk categories of patients changed significantly due to HAL-BLC by comparison to WLC. As a result, the postoperative treatment was modified due to HAL-BLC for a significantly larger proportion of patients (19% versus 6.3%). A total of 115 and respectively 106 NMIBC cases of the two study arms completed the 36 months' evaluation period. The 3 months' recurrence rate was significantly lower in the HAL-BLC series (6.9% versus 15.1%) due to fewer other site recurrences (0.9% versus 6.6%). During the long term follow-up, the overall 1 (20.9% versus 31.1%), 2 (30.4% versus 44.3%) and 3 (35.6% versus 51.9%) years' recurrence rates were significantly reduced in the HAL-BLC study arm. CONCLUSIONS HAL-BLC emphasized superior NMIBC patients' detection rates as well as a significant impact in terms of additional tumors' cases, risk category changes and postoperative treatment modifications. Subsequently, the 3 months', 1, 2 and 3 years' recurrence rates were significantly improved in the HAL-BLC group. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e511-e512 Peer Review Report Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bogdan Geavlete Bucharest, Romania More articles by this author Razvan Multescu Bucharest, Romania More articles by this author Florin Stanescu Bucharest, Romania More articles by this author Dragos Georgescu Bucharest, Romania More articles by this author Marian Jecu Bucharest, Romania More articles by this author Cristian Moldoveanu Bucharest, Romania More articles by this author Petrisor Geavlete Bucharest, Romania More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...