Poster session 8: Bladder cancer, Urinary diversion and Pediatric urology| Volume 8, ISSUE 8, P697, September 2009

C120 Recurrence rates in high-risk non-muscle invasive bladder tumors – the real impact of HAL blue light fluorescence cystoscopy and TURB

      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.


      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.


      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.