Introduction and Objectives
In this study, we aimed to evaluate the importance of hexaminolevulinate (HAL) blue light cystoscopy (BLC) and transurethral resection of the bladder (BL-TURB) in the treatment of high-risk non-muscle invasive bladder tumors (NMIBT), by comparison to white light cystoscopy (WLC) and white light TURB (WL-TURB).
Material and Methods
Between December 2007 and May 2009, WLC, BLC, BL-TURB and WL-TURB were performed in 155 patients suspected of bladder cancer. After 6 weeks, the 112 cases diagnosed with high-risk NMIBT underwent conventional re-TURB. The control group consisted of 112 patients with the same type of malignancy, which initially benefited only from WLC and WL-TURB, and subsequently re-TURB.
Results
After re-TURB, the recurrence rate in high-risk NMIBT patients was 9% (10 patients) for the study group and 33% (37 cases) for the control group. Recurrence lesions were orthotopic in 23.4% of the cases and heterothopic in 76.6% of the cases. The recurrence rate for G3 tumors was 5% in the study group and 50% in the control group. The G1-G2 multiple or large tumors without CIS lesions emphasized a recurrence rate of 7% in the HAL-BLC series by comparison to 30% in the WLC series, while cases of G1-G2 tumors associated with CIS had a recurrence rate of 21% for the HAL-BLC group and of 54% for the WLC group, respectively.
Conclusions
HAL fluorescence BLC and BL-TURB significantly improve the diagnostic accuracy and treatment efficacy in high-risk NMIBT. Consequently, a more complete endoscopic resection is achieved, thus reducing the tumors’ recurrence rate.
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Identification
Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
