MP08-07 THE IMPACT OF BLUE-LIGHT CYSTOSCOPY ON RESPONSE TO INDUCTION BCG IN PATIENTS WITH HIGH-GRADE NON-MUSCLE- INVASIVE BLADDER CANCER

Abstract

You have accessJournal of UrologyBladder Cancer: Non-invasive I1 Apr 2018MP08-07 THE IMPACT OF BLUE-LIGHT CYSTOSCOPY ON RESPONSE TO INDUCTION BCG IN PATIENTS WITH HIGH-GRADE NON-MUSCLE- INVASIVE BLADDER CANCER Nina Mikkilineni, Samuel Antoine, Ashley Alford, Gen Li, Sven Wenske, G. Joel Decastro, James McKiernan, and Christopher Anderson Nina MikkilineniNina Mikkilineni More articles by this author , Samuel AntoineSamuel Antoine More articles by this author , Ashley AlfordAshley Alford More articles by this author , Gen LiGen Li More articles by this author , Sven WenskeSven Wenske More articles by this author , G. Joel DecastroG. Joel Decastro More articles by this author , James McKiernanJames McKiernan More articles by this author , and Christopher AndersonChristopher Anderson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.312AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The use of blue light cystoscopy (BLC) during transurethral resection of bladder tumor (TURBT) is known to improve the detection of bladder cancer and reduce long-term recurrence rates. Intravesical Bacillus Calmette-Guerin (BCG) therapy is the standard of care for the treatment of high-grade non-muscle-invasive bladder cancer (NMIBC), and is associated with complete response rates of approximately 70%. We performed a retrospective study to investigate if response to induction BCG is affected by the use of BLC during pre-treatment TURBT in patients found with high-grade NMIBC. METHODS We retrospectively reviewed the charts of 148 patients with high-grade NMIBC at our institution who received induction BCG from 2014 to 2016. The primary exposure was white light cystoscopy (WLC) or BLC during the TURBT prior to induction BCG. Of the 148 patients, 103 patients had 3-month follow up with a cystoscopy with or without biopsy following completion of induction BCG. Disease recurrence was defined as visible or biopsy-proven tumor or positive urine cytology at 3 months. We used multivariate logistic regression to examine the association between type of cystoscopy and 3 month recurrence rate. Model covariates included stage, history of NMIBC, and prior intravesical therapy. RESULTS We identified 33 patients who had a BLC TURBT and 70 patients who had a WLC TURBT prior to induction BCG. Patients in the BLC group were more likely to have carcinoma in situ (67% vs. 47%, p=0.10), prior NMIBC (42% vs. 30%, p=0.31), and prior intravesical therapy (36% vs. 11%, p=0.007). At first cystoscopy after BCG induction, 13 patients (39%) in the BLC group and 24 (34%) in the WLC group had recurrent disease (p=0.78). On multivariate logistic regression, BLC did not have a lower recurrence rate compared to WLC (OR = 1.11, [95% CI 0.42, 2.93]; p=0.83). CONCLUSIONS There was no significant difference in 3 month recurrence rates after BCG induction for patients with BLC or WLC. The selection criteria for BLC differed from WLC, although our conclusion was unchanged after adjusting for confounding factors. BLC has been shown to improve detection of certain high risk tumors, but it is unclear if there is a therapeutic benefit to BLC for patients with known or suspected high risk disease. Further study is required to determine the value of BLC in improving response rates to intravesical BCG in patients with high grade NMIBC. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e98 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Nina Mikkilineni More articles by this author Samuel Antoine More articles by this author Ashley Alford More articles by this author Gen Li More articles by this author Sven Wenske More articles by this author G. Joel Decastro More articles by this author James McKiernan More articles by this author Christopher Anderson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...