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Abstract

We completely agree with the editor's comment that the evidence for the benefit of photodynamic diagnostics in the treatment of non–muscle-invasive bladder cancer seems solid. In preparation of the present contribution we were driven by a ubiquitous question in uro-oncological research: when may any innovation be held valid and warrant broader application? We are convinced that it takes a magnitude of data from multiple centers, reflecting various aspects of the novelty and the disease they are set out to manage. We believe that these criteria demand to be met by photodynamic diagnostics. 1 Hungerhuber E. Stepp H. Kriegmair M. et al. Seven years' experience with 5-aminolevulinic acid in detection of transitional cell carcinoma of the bladder. Urology. 2007; 69: 260-264 Abstract Full Text Full Text PDF PubMed Scopus (127) Google Scholar However, we were aware of potential tribulations, as current data are based on 2 different fluorescent agents, namely, 5-aminolevulinic acid and hexaminolevulinate. Consequently, we intended to clarify the comparability of these agents and the transferability of respective data from one substance to another. Thus, we appreciate the editor's view on the purpose of our present contribution. Editorial CommentUrologyVol. 74Issue 6PreviewThe photodynamic agent 5-aminolaevulinic acid (5-ALA) was introduced into urology practice about 15 years ago, followed 5 years later by its hexyl ester derivative hexaminolevulinate (HEX, also referred to as HAL). Robust evidence from various multicenter, prospective, controlled or randomized trials on hundreds of patients reveals that photodynamic diagnosis using these agents improves the detection rate of non–muscle-invasive papillary bladder tumors (Ta-T1 and carcinoma in situ), and decreases the amount of residual cancer following transurethral resection of the bladder (TURB),1 leading to a reduction in rates of tumor recurrence at 9 months. Full-Text PDF Hexaminolevulinate Is Equal to 5-Aminolevulinic Acid Concerning Residual Tumor and Recurrence Rate Following Photodynamic Diagnostic Assisted Transurethral Resection of Bladder TumorsUrologyVol. 74Issue 6PreviewTo compare the outcomes of 5-aminolaevulinic acid (ALA) vs hexaminolaevulinate (HEX) vs white light (WL) transurethral resection of bladder tumors (TURB) to assess transferability of ALA findings to HEX. Extending WL-TURB with photodynamic diagnostic improves outcome. Two fluorescent agents have been commonly used for this. Although numerous and specific data exist on the older substance ALA, considerably less are available on hex, the only agent approved however. To date no such report has been published. Full-Text PDF