MP08-15 THE ROLE OF FLEXIBLE BLUE LIGHT CYSTOSCOPY IN SURVEILLANCE OF NON-MUSCLE INVASIVE BLADDER CANCER. RESULTS FROM A NORDIC REGISTRY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP08-15 THE ROLE OF FLEXIBLE BLUE LIGHT CYSTOSCOPY IN SURVEILLANCE OF NON-MUSCLE INVASIVE BLADDER CANCER. RESULTS FROM A NORDIC REGISTRY Karsten Egbert Arnold Zieger, Kristine Young-Halvorsen, and Per-Uno Malmström Karsten Egbert Arnold ZiegerKarsten Egbert Arnold Zieger More articles by this author , Kristine Young-HalvorsenKristine Young-Halvorsen More articles by this author , and Per-Uno MalmströmPer-Uno Malmström More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003223.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bladder cancer is one of the most prevalent cancers in the world. Approximately 75% of bladder cancers are non-muscle invasive (NMIBC) with a high tendency of recurrence and progression. Thus, patients undergo regular surveillance cystoscopies, often life-long. Blue light cystoscopy (BLC) improves the diagnosis of papillary and flat lesions, and may play a role in the surveillance setting by reducing the risk of missing significant lesions, refuting suspicious changes, and strengthening confidence in recurrence-free cystoscopies. This study aims to evaluate the impact of BLC in a surveillance setting. METHODS: The Nordic Blue Light Flexible Cystoscopy (BLFC) registry is a prospective, observational, multi-center study including patients undergoing BLFC for suspicion or surveillance of NMIBC in an outpatient setting. The registry is approved by local ethics committees. Data recorded are patient demographics, bladder cancer history, findings under WLC and BLC, patient preference, discomfort and treatment. RESULTS: We performed 436 BLFC in 319 patients in surveillance of NMIBC. The EAU risk group distribution was 172 (54%) high risk, 136 (43%) intermediate risk and 11 (3%) low risk. 147 (34%) cases underwent adjuvant therapy with BCG or chemotherapy prior to BLFC. 318 (73%) cystoscopies revealed suspicious lesions using white light or blue light. We took biopsies from 452 lesions, showing malignancy in 126/409 (31%) lesions positive for blue light, while 7/43 (16%) lesions negative for blue light. In 86 cases (20%), lesions were identified only by blue light. Pathology showed malignancy in 37/104 biopsies (36%), including 18 CIS. Patients with small recurrences underwent office fulguration, 45 patients (10%) were referred to TURBT, and 82 patients subsequently received adjuvant intravesical therapy. 34 patients expressed discomfort during BLFC, due to bladder distension or the associated biopsy and/or fulguration. Physicians reported benefit of BLC in 367/436 (84%) of the cystoscopies, with a stronger confidence in confirming or refuting a suspicious lesion as the main advantage (28%). CONCLUSIONS: Flexible BLC as an adjunct to white light cystoscopy for surveillance of NMIBC improves the detection of malignant lesions. Furthermore, it improves surgeons’ confidence on identifying clinical important lesions. The combination of BLC with immediate fulguration of tumours in an outpatient setting may positively affect the patients’ burden in NMIBC. The impact on patients overall outcome is target of future evaluations. Source of Funding: Photocure ASA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e100 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Karsten Egbert Arnold Zieger More articles by this author Kristine Young-Halvorsen More articles by this author Per-Uno Malmström More articles by this author Expand All Advertisement PDF downloadLoading ...