PPTLBA-02 BLUE LIGHT FLEXIBLE CYSTOSCOPY (BLFC) WITH HEXAMINOLEVULINATE (HAL) AND WHITE LIGHT FLEXIBLE CYSTOSCOPY: A PROSPECTIVE, COMPARATIVE, WITHIN-PATIENT CONTROLLED MULTI-CENTER PHASE 3 STUDY IN THE DETECTION OF BLADDER CANCER DURING SURVEILLANCE

Abstract

You have accessJournal of UrologyPlenary: Prime Time (PPTLBA)1 Apr 2017PPTLBA-02 BLUE LIGHT FLEXIBLE CYSTOSCOPY (BLFC) WITH HEXAMINOLEVULINATE (HAL) AND WHITE LIGHT FLEXIBLE CYSTOSCOPY: A PROSPECTIVE, COMPARATIVE, WITHIN-PATIENT CONTROLLED MULTI-CENTER PHASE 3 STUDY IN THE DETECTION OF BLADDER CANCER DURING SURVEILLANCE Siamak Daneshmand, Sanjay Patel, Yair Lotan, Kamal Pohar, Edouard Trabulsi, Michael Woods, Tracy Downs, William Huang, Jennifer Taylor, Michael O'Donnell, Trinity Bivalacqua, Joel DeCastro, Gary Steinberg, Ashish Kamat, Matthew Resnick, Badrinath Konety, Mark Schoenberg, and Stephen Jones Siamak DaneshmandSiamak Daneshmand More articles by this author , Sanjay PatelSanjay Patel More articles by this author , Yair LotanYair Lotan More articles by this author , Kamal PoharKamal Pohar More articles by this author , Edouard TrabulsiEdouard Trabulsi More articles by this author , Michael WoodsMichael Woods More articles by this author , Tracy DownsTracy Downs More articles by this author , William HuangWilliam Huang More articles by this author , Jennifer TaylorJennifer Taylor More articles by this author , Michael O'DonnellMichael O'Donnell More articles by this author , Trinity BivalacquaTrinity Bivalacqua More articles by this author , Joel DeCastroJoel DeCastro More articles by this author , Gary SteinbergGary Steinberg More articles by this author , Ashish KamatAshish Kamat More articles by this author , Matthew ResnickMatthew Resnick More articles by this author , Badrinath KonetyBadrinath Konety More articles by this author , Mark SchoenbergMark Schoenberg More articles by this author , and Stephen JonesStephen Jones More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.03.075AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES White light (WL) cystoscopy is the current standard of care for bladder cancer surveillance. Multiple studies have demonstrated that blue light cystoscopy (BLC) with HAL in the operating room (OR) improves detection of bladder cancer with reduction in recurrence rates when compared to WL TURBT. The objective of this study was to determine if Blue Light Flexible cystoscopy (BLFC) in the office setting can improve detection of tumors in the surveillance setting when compared to WL cystoscopy alone. METHODS Patients with a high risk of recurrence based on history of multiple tumors, recurrent tumors and/or high grade tumors were included for their first surveillance visit. Patients who had received intravesical therapy within 6 weeks were excluded. In the clinic setting, all patients received intravesical HAL, which was retained for 1 to 3 hours before examination. The bladder was inspected under WL using flexible cystosocpy, and all suspicious lesions were documented. Some patients were randomised to WL only, in order to avoid observational bias. The rest underwent immediate subsequent investigation with BLFC. The first four patients enrolled at each site were training patients and not included in the efficacy analysis. Those suspected of recurrence were referred to the OR within 6 weeks, where WL and BLC were repeated. All suspected lesions underwent biopsy or resection. A panel of independent pathologists blinded to the origin of the specimen achieved a consensus read. The primary endpoint was the proportion of patients with histologically confirmed malignancy which was detected with BLC only. Additional endpoints included false positive rates, detection of CIS and number of additional tumors detected with BLC only. RESULTS Seventeen academic institutions in the US participated in the study and 304 patients were enrolled. Of the 234 non-training patients who proceeded through randomization, 103 patients were referred to the OR with a suspected recurrence for WL and BLC. Approximately 80% of the patients had a history of CIS or HG Ta/T1 tumor. Full results are expected by end of April, 2017. CONCLUSIONS In the surveillance setting, an increase in detection of tumor recurrence using BLFC may provide a significant advantage for patients potentially leading to less extensive and more cost effective management. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e608 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Siamak Daneshmand More articles by this author Sanjay Patel More articles by this author Yair Lotan More articles by this author Kamal Pohar More articles by this author Edouard Trabulsi More articles by this author Michael Woods More articles by this author Tracy Downs More articles by this author William Huang More articles by this author Jennifer Taylor More articles by this author Michael O'Donnell More articles by this author Trinity Bivalacqua More articles by this author Joel DeCastro More articles by this author Gary Steinberg More articles by this author Ashish Kamat More articles by this author Matthew Resnick More articles by this author Badrinath Konety More articles by this author Mark Schoenberg More articles by this author Stephen Jones More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...