Blue versus white light for transurethral resection of non-muscle invasive bladder cancer

Maisch, Philipp; Koziarz, Alex; Vajgrt, Jon; Narayan, Vikram M.; Kim, Myung Ha; Dahm, Philipp

doi:10.1002/14651858.cd013776.pub2

Cited by 15 publications

(14 citation statements)

References 115 publications

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“…Relatively few higher‐quality systematic reviews exist on this topic, but those do not fulfil the rigorous Cochrane methodology including a study protocol, a comprehensive literature search, the application of GRADE for rating the quality of evidence and a focus on patient‐centred outcomes [20].…”

Section: Discussionmentioning

confidence: 99%

“…We added a post hoc subgroup analysis for HAL vs 5‐ALA with regard to time to disease recurrence and time to disease progression. Additional methodological details for this systematic review and meta‐analysis can be found in the published Cochrane review [24].…”

Section: Methodsmentioning

confidence: 99%

“…This systematic review and meta‐analysis was based on a published protocol [20]. Our research question was asked according to the PICO (population, intervention, comparator, outcome) format.…”

Section: Methodsmentioning

confidence: 99%

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Blue vs white light for transurethral resection of non‐muscle‐invasive bladder cancer: an abridged Cochrane Review

et al. 2022

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Objectives To assess the effects of blue‐light (BL)‐enhanced transurethral resection of bladder tumour (TURBT) compared to white‐light (WL)‐based TURBT in the treatment of non‐muscle‐invasive bladder cancer (NMIBC). Methods Based on a published protocol, we performed a systematic search of multiple databases from their inception to March 2021. We included randomized controlled trials (RCTs) comparing blue‐light (BL) TURBT to white‐light (WL) TURBT. Our meta‐analysis was based on a random‐effects model. We assessed the quality of evidence on a per‐outcome basis according to the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Results We included 16 RCTs involving a total of 4325 participants in this review. BL TURBT may reduce the risk of disease recurrence over time (hazard ratio [HR] 0.66, 95% confidence interval [CI] 0.54–0.81; low‐certainty evidence) depending on baseline risk. For participants with low‐, intermediate‐ and high‐risk NMIBC, this corresponded to 48 (66 fewer to 27 fewer), 109 (152 fewer to 59 fewer) and 147 (211 fewer to 76 fewer) fewer recurrences per 1000 participants when compared to WL TURBT, respectively. BL TURBT may also reduce the risk of disease progression over time (HR 0.65, 95% CI 0.50–0.84; low‐certainty evidence) depending on baseline risk. For participants with low‐, intermediate‐ and high‐risk NMIBC, this corresponded to 1 (1 fewer to 0 fewer), 17 (25 fewer to 8 fewer), and 56 (81 fewer to 25 fewer) fewer progressions per 1000 participants when compared to WL TURBT, respectively. Conclusions Our findings suggest a favourable impact of BL TURBT on the risk of disease recurrence and progression; however, whether this risk reduction is clinically relevant greatly depends on the baseline risk of patients. We did not find an increase in severe surgical complications with BL cystoscopy, and we did not find any trial evidence on other, non‐surgical adverse events.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Blue vs white light for transurethral resection of non‐muscle‐invasive bladder cancer: an abridged Cochrane Review

et al. 2022

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“…Technical and qualitative disparities in TURBT procedure among centers have long been noted, and affect oncological outcomes. Mostafid et al 4 emphasized the importance and necessity of offering attendees TURBT techniques in international conferences as an activity of the Urological Association. They also gave an opinion that the rate of innovation containing PDD-TURBT pales in comparison with the frequency of the procedure.…”

Section: Angelo Nasellimentioning

confidence: 99%

“…This could avoid potential non‐useful procedures, avoiding additional patient's morbidity and hospitalization. On the other hand, the favorable impact on risk of disease recurrence over time, recently confirmed in a recent metanalysis involving 16 randomized controlled trials comparing PDD‐TURBT vs WL‐TURBT, 4 would be maintained.…”

mentioning

confidence: 93%

Editorial Comment from Dr Naselli and Dr Pirola to Bladder cancer prospective cohort study on high‐risk non‐muscle invasive bladder cancer after photodynamic diagnosis‐assisted transurethral resection of the bladder tumor (BRIGHT study)

Naselli

Pirola

2022

Int J of Urology

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