Comparison of White Light, Photodynamic Diagnosis, and Narrow-band Imaging in Detection of Carcinoma In Situ or Flat Dysplasia at Transurethral Resection of the Bladder: the DaBlaCa-8 Study

Drejer, Ditte; Beji, Sami; Oezeke, Recep; Nielsen, Anne Ellerup; Høyer, Søren; Johansen, Truls E. Bjerklund; Lam, Gitte Wrist; Jensen, Jørgen Bjerggaard

doi:10.1016/j.urology.2016.11.032

Cited by 34 publications

(21 citation statements)

References 19 publications

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“…Although experienced urologists may be able to point out possible CIS areas on cystoscopy, these lesions may be overlooked without random bladder biopsy. Recent advances in fluorescence cystoscopy and narrow-band imaging may aid in detecting flat CIS lesions, and their results need to be compared with those of random bladder biopsy (21,22).…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of random bladder biopsy in primary T1 bladder cancer

et al. 2018

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Abstract. The clinical significance of random bladder biopsies in primary non-muscle-invasive bladder cancer is unclear. The present study investigated the significance of positive random bladder biopsies in primary T1 NMIBC. The present study retrospectively reviewed the records of 71 patients with primary pT1N0M0 bladder cancer who underwent transurethral resection of the bladder tumor (TURBT) and concomitant random bladder biopsy. A total of 12 patients who received cystectomy immediately following the TURBT were excluded, and the remaining 59 patients were included in the analysis. Random bladder biopsy was defined as a cold-cup biopsy of pre-specified normal-looking areas in the bladder. The association of clinicopathological factors, including random biopsy results, with intravesical recurrence were assessed by univariate and multivariate Cox proportional hazards analyses. Of the 59 patients, 15 (25%) demonstrated carcinoma in situ (CIS) lesions on random bladder biopsy: Five (33%) in biopsy specimens alone and the remaining 10 (67%) in biopsy and TUR specimens. Positive random biopsy was associated with preoperative positive urine cytology (P=0.011) and small size of the main tumor (P=0.008). Multivariate analysis demonstrated positive random biopsy as the sole independent poor prognostic factor for intravesical recurrence (hazard ratio: 4.69, P=0.014). The five patients who had CIS detected in biopsy specimens alone had worse, although non-significantly worse, recurrence-free survival compared with those with CIS detected in biopsy and TUR specimens (P=0.100). In conclusion, positive bladder random biopsy, equivalent to the presence of CIS, was an independent predictor of recurrence in primary T1 bladder cancer. Given that one-third of CIS lesions could not have been detected without biopsy, random bladder biopsy should be considered for patients with T1 tumors.

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Section: Discussionmentioning

confidence: 99%

Clinical significance of random bladder biopsy in primary T1 bladder cancer

et al. 2018

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“…To improve diagnostic accuracy, techniques such as narrow band imaging and blue light cystoscopy with hexylaminolevulinate may improve the detection rate. Nevertheless, at present, their use is limited and has not improved in specificity when compared to traditional white light cystoscopy [11].…”

Section: Clinical Needsmentioning

confidence: 99%

Advanced multimodal laser imaging tool for urothelial carcinoma diagnosis (AMPLITUDE)

et al. 2020

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“…Alternate technologies have been compared to the traditional WL cystoscopy [14][15][16]. Drejer et al compared the use of WL cystoscopy, NBI and PDD in the diagnosis of flat dysplasia and CIS [14]. The authors instilled HVA and then proceeded with WL cystoscopy, followed by NBI and then PDD.…”

Section: Advances In Diagnosis Of Cismentioning

confidence: 99%

“…Photodynamic diagnosis (PDD) and Narrow Band Imaging (NBI) both improve detection of CIS lesions [13]. Multiple phase III studies and meta-analyses have found that PDD and NBI increase CIS detection compared to using WL cystoscopy alone [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

CIS of the Bladder: Significance and Implications for Therapy

Mirabal

Taylor

Lerner

2019

BLC

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Purpose of the review: To review the most recent literature with regards to the pathogenesis, diagnostics, clinical implications and treatment strategies for Carcinoma in Situ (CIS) of the Bladder. Recent findings: There have been advancements in understanding the genetic composition and biochemical behavior of CIS. Technological advancements including Photodynamic Diagnosis (PDD) with Hexaminolevulinate (HVA) better detect CIS compared to traditional white light (WL) cystoscopy. Recently published single and multi-center studies have enabled better understanding of the impact of CIS on clinical and cancer related outcomes, including disease recurrence and patient survival. Alternative intravesical chemotherapeutic and immunotherapies for CIS have been investigated, especially in the setting of Bacillus Calmette-Guerin (BCG) unresponsive disease. While these demonstrate a great deal of promise, they have not garnered much success. Summary: The genetics of CIS is linked to aggressive, and at times resistant disease, with increased cancer progression and associated clinically worse cancer specific outcomes. New technologies have enabled a more effective diagnosis of CIS. The development of a standardized definition for clinical trials and greater disease understanding will enable us to develop better treatment options.

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Comparison of White Light, Photodynamic Diagnosis, and Narrow-band Imaging in Detection of Carcinoma In Situ or Flat Dysplasia at Transurethral Resection of the Bladder: the DaBlaCa-8 Study

Cited by 34 publications

References 19 publications

Clinical significance of random bladder biopsy in primary T1 bladder cancer

Clinical significance of random bladder biopsy in primary T1 bladder cancer

Advanced multimodal laser imaging tool for urothelial carcinoma diagnosis (AMPLITUDE)

CIS of the Bladder: Significance and Implications for Therapy

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