Hexaminolevulinate-induced Fluorescence versus White Light During Transurethral Resection of Noninvasive Bladder Tumor: Does It Reduce Recurrences?
ABSTRACT To evaluate the effect of hexaminolevulinate (HAL)-induced fluorescence during resection of noninvasive bladder cancer on tumor recurrence compared with resection under white light.
Between 2008 and 2010, 102 consecutive patients with suspected bladder cancer were randomized to undergo transurethral resection with either conventional white light or combination of white light and HAL-induced fluorescence. Difference in tumor recurrence rate and recurrence-free survival between the 2 groups was evaluated. Subgroup analysis on recurrence-free survival was performed for different tumor parameters.
Cystoscopy at 3 months revealed tumor recurrence in 6 of 45 (13.3%) patients of the white light group compared with only 1 of 41 patients of the HAL group (2.4%) (P < .001). The recurrence-free rates in white light patients at 12 and 18 months were 56.3% and 50.6%, respectively, compared with 91% and 82.5% in HAL patients (P = .0006). In subgroup analyses, recurrence-free survival was similar between the 2 groups when solitary tumors were treated (P = .3525). However, the HAL group had a favorable recurrence-free survival compared with the white light group when multifocal tumors (P < .001), primary tumors (P = .0237), recurrent tumors (P = .0189), nonaggressive (papillary urothelial neoplasm of low malignant potential and low grade) tumors (P = .0204), or aggressive (high grade and carcinoma in situ) tumors (P = .0134) were treated.
HAL significantly aids resection of non-muscle-invasive bladder cancer with the result of reduction in tumor recurrence rates.
- SourceAvailable from: Lindsay A. Hampson
Urologic Oncology 08/2014; 32(6):735-40. DOI:10.1016/j.urolonc.2014.05.007 · 3.36 Impact Factor
- "5 St. John Hosp, Romania 1 NR HAL FL vs. WL cystoscopy: FL greater number of tumors detected and decreased recurrence rates (12 and 24 mo) Karaolides et al. (2012)  "
- [Show abstract] [Hide abstract]
ABSTRACT: The diagnosis and follow-up of bladder cancer is based on the so-called golden standard of urine cytology and white light endoscopy. In recent years fluorescence endoscopy, also known as photodynamic diagnosis (PDD), of the urinary bladder has become more and more popular. The rising interest in this procedure becomes clear when looking at the current literature. Nowadays, there are studies on PDD from all over Europe and the USA. This article gives an up to date review of these new studies and shows new developments in the outpatient use of PDD.Der Urologe 03/2013; · 0.44 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Die Diagnostik und Nachsorge von Harnblasenkarzinomen basieren seit vielen Jahren auf dem Goldstandard der urinzytologischen Untersuchung in Verbindung mit der Weißlichtzystoskopie. In den letzten Jahren hat die photodynamische Diagnostik (PDD) der Harnblase in Deutschland aber auch in anderen europäischen Ländern zunehmend an Bedeutung gewonnen, was u. a. an der stark gestiegenen Anzahl an Publikationen zu diesem Thema deutlich wird. Unser Beitrag soll nun eine Übersicht über die aktuellen Studienergebnisse rund um die PDD geben sowie mögliche neue Entwicklungen beim Einsatz der PDD aufzeigen.Der Urologe 04/2013; 52(4). DOI:10.1007/s00120-012-3104-2 · 0.44 Impact Factor