1648 TREATMENT CHANGES AND LONG-TERM RECURRENCE RATES AFTER HAL FLUORESCENCE CYSTOSCOPY – DOES BLUE LIGHT REALLY MAKE A DIFFERENCE IN THE LONG RUN?

Abstract

You have accessJournal of UrologyBladder Cancer: Superficial1 Apr 20111648 TREATMENT CHANGES AND LONG-TERM RECURRENCE RATES AFTER HAL FLUORESCENCE CYSTOSCOPY – DOES BLUE LIGHT REALLY MAKE A DIFFERENCE IN THE LONG RUN? Bogdan Geavlete, Razvan Multescu, Marian Jecu, Dragos Georgescu, Florin Stanescu, and Petrisor Geavlete Bogdan GeavleteBogdan Geavlete Bucharest, Romania More articles by this author , Razvan MultescuRazvan Multescu Bucharest, Romania More articles by this author , Marian JecuMarian Jecu Bucharest, Romania More articles by this author , Dragos GeorgescuDragos Georgescu Bucharest, Romania More articles by this author , Florin StanescuFlorin Stanescu 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.2011.02.1758AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES This study aimed to evaluate the diagnostic accuracy of hexaminolevulinate blue light cystoscopy (HAL-BLC) and the related treatment changes in cases of non-muscle invasive bladder cancer (NMIBC). A prospective, long term, randomized comparison with a similar series initially diagnosed by white light cystoscopy (WLC) alone with regard to recurrence rates was also performed. METHODS A total of 362 patients suspected of NMIBC were included in the trial, based on positive urinary cytology and ultrasonographic suspicion of bladder tumors. The 181 patients of the BL arm underwent both WLC and BLC. A single postoperative mytomicin-C instillation was performed in all cases, intravesical chemotherapy for intermediate risk patients and BCG instillations for high-risk cases. The follow-up protocol consisting of urinary cytology and WLC was also performed in accordance with the risk category of NMIBC cases for a period of two years. Only first time recurrences after the initial diagnostic were taken into consideration. RESULTS A total of 142 NMIBC patients were diagnosed in the BL arm and 129 in the WL arm. In the BL series, the CIS, pTa, pT1 and overall cases' and tumors' detection rates were significantly improved for BLC. Additional tumors were found by WLC and BLC in 14.1% versus 35.2% of the cases. Consequently, the recurrence and progression risk categories of patients changed in 4.9% and 7% of the cases due to WLC and in 16.2% and 21.1% due to BLC additionally found tumors. The postoperative treatment changed in 6.3% of the cases due to WLC and in 19% due to BLC results. A total of 125 patients of the BL group and 114 of the WL group completed the follow-up protocol. The recurrence rate at 3 months was 15.8% in the WL series versus 7.2% in the BL series. The rates of primary site and other site recurrences in the WL and BL arms were 7.9% versus 5.6% and 6.1% versus 0.8%. The one and two years' recurrence rates were significantly higher in the WLC group by comparison to the BLC group (32.5% versus 21.6% and 45.6% versus 31.2%). CONCLUSIONS HAL-BLC cystoscopy emphasized superior patients' and tumors' detection rates in NMIBC cases, as well as a significant impact in terms of risk category changes and consequent postoperative treatment modifications. At the 3 months' follow-up, significantly improved recurrence rates were determined in the BL arm, mostly due to fewer other site recurrences. The one and two years' recurrence rates confirmed the long term advantages of HAL-BLC. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e661-e662 Advertisement Copyright & Permissions© 2011 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 Marian Jecu Bucharest, Romania More articles by this author Dragos Georgescu Bucharest, Romania More articles by this author Florin Stanescu Bucharest, Romania More articles by this author Petrisor Geavlete Bucharest, Romania More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...