Hexyl Aminolevulinate Fluorescence Cystoscopy: A New Diagnostic Tool for Photodiagnosis of Superficial Bladder Cancer—A multicenter study

Jichlinski, Patrice; Guillou, Louis; Karlsen, Steinar J.; Malmström, Per‐Uno; Jocham, Dieter; Brennhovd, Bjørn; Johansson, Eva; Gärtner, Thomas; Lange, Norbert; Bergh, Hubert van den; Leisinger, H.-J.

doi:10.1097/01.ju.0000060782.52358.04

Cited by 236 publications

(172 citation statements)

References 17 publications

Supporting

Mentioning

146

Contrasting

Unclassified

Order By: Relevance

“…Sensitivity and specificity of WLC and PDD are 46%-80% and 76-97%, and 43%-98% and 35-66%, respectively. (Zaak and Hofstetter, 2002;Grimbergen et al, 2003;Jichlinski et al, 2003;Schmidbauer et al, 2004;Fradet et al, 2007;Grossman et al, 2007;Jocham et al, 2008;Stenzl et al, 2008;Geavlete et al, 2012) Now PDD is emerging to diagnose NMIBC or carcinoma in situ. However no studies specifically used PDD for muscle invasive bladder cancer, cystoscopic observation for BCG failure cases or 2nd-TUR cases.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Photodynamic Diagnosis for Challenging TUR-Bt Cases Including Muscle Invasive Bladder Cancer, BCG Failure or 2^nd-TUR

Takai¹,

Inamoto²,

Komura³

et al. 2015

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Background: Despite widely adopted standard methods for follow-up including cystoscopy plus cytology, recurrence rates of non muscle-invasive bladder cancer (NMIBC) have not improved over the past decades, still ranging from 60% through 70%. Hence, widely acceptable surveillance strategies with excellent sensitivity are needed. Early recurrence has led to the development of a novel cystoscopy technique utilizing photodynamic diagnosis (

show abstract

Section: Introductionmentioning

confidence: 99%

Feasibility of Photodynamic Diagnosis for Challenging TUR-Bt Cases Including Muscle Invasive Bladder Cancer, BCG Failure or 2^nd-TUR

Takai¹,

Inamoto²,

Komura³

et al. 2015

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

show abstract

“…For that purpose we instilled rats intravesically with PVP-hypericin (30 µM) or HAL (8, 16 mM) three days after tumor inoculation with concentrations that correspond to the ones typically used in the urological clinic [5,8,9,[28][29][30]. The results show that administration of either of the compounds resulted in an increased uptake (PVP-hypericin) or production (PpIX) of the photosensitizers in normal or malignant urothelium as compared with the deeper tissue layers, i.e.…”

Section: Discussionmentioning

confidence: 97%

Biodistribution of PVP-hypericin and hexaminolevulinate-induced PpIX in normal and orthotopic tumor-bearing rat urinary bladder

Vandepitte

Cleynenbreugel

Hettinger

et al. 2010

Cancer Chemother Pharmacol

View full text Add to dashboard Cite

PurposeIn this preclinical study we examined the biodistribution of hypericin formulated as its watersoluble PVP-hypericin complex in the different layers (urothelium, submucosa, muscle) of a normal rat bladder and a rat bladder bearing a malignant urothelium composed of syngeneic AY-27 tumor cells. The results were compared with the biodistribution of hexaminolevulinate (HAL) induced protoporphyrin IX (PpIX). MethodsFreshly prepared PVP-hypericin and HAL solutions were instilled in both normal as well as tumor bearing rat bladders. Following instillation, bladders were removed and snap frozen in liquid nitrogen. Fluorescence of PVP-hypericin or PpIX induced HAL was measured in the bladder layers and quantified using image analysis software. ResultsThe results of these experiments show that PVP-hypericin (30 µM) accumulated about 3.5-fold more in malignant urothelial tissue as compared to normal urothelium, whereas PpIX accumulated to the same extent in malignant and normal urothelium, both after intra-bladder instillation of 8 or 16 mM HAL. Besides, PVP-hypericin and PpIX accumulated selectively in the urothelium with a tumor-to-muscle ratio of 30.6 for PVP-hypericin and 3.7 to 8.3 for 16 and 8 mM HAL, respectively. ConclusionsThis study shows that PVP-hypericin appears to have great potential as a photodynamic agent against non-muscle invasive bladder cancers after intravesical administration, with a limited risk of affecting the deeper layers of the bladder.

show abstract

“…10 Hexaminolevulinate, a second generation drug, made fluorescence cystoscopy practical by requiring a much shorter exposure time (1 hour) to achieve good quality fluorescence. 1 Multi-institutional studies of fluorescence cystoscopy with either 5-aminolevulinic acid or hexaminolevulinate have demonstrated increased detection of both carcinoma in situ and papillary bladder cancer. 6,11 While it is reasonable to hypothesize that better visualization of bladder cancer results in more complete resection and improved disease free interval, conflicting data from different studies have made this conclusion controversial.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] In this technique, hexaminolevulinate is administered intravesically 1 hour prior to cystoscopy and bladder tumor resection. The drug is converted locally to porphyrins that selectively accumulate in malignant cells.…”

Section: Introductionmentioning

confidence: 99%

957 Long-term reduction in bladder cancer recurrence with hexaminolevulinate enabled fluorescence cystoscopy

Burger¹,

Stenzl²,

Mynderse³

et al. 2012

European Urology Supplements

View full text Add to dashboard Cite

Purpose-We assessed the impact that hexaminolevulinate fluorescence cystoscopic detection of papillary, non-muscle invasive bladder cancer has on long-term recurrence rates.Materials and Methods-Long-term follow-up was assessed in 551 participants enrolled in a prospective, randomized study of fluorescence cystoscopy for Ta or T1 urothelial bladder cancer. In the original study, 280 patients in the white light cystoscopy group and 271 in the fluorescence cystoscopy group were followed with cystoscopy for 3, 6, and 9 months following the initial resection or until recurrence. A study extension protocol obtained long-term follow-up of these patients.Results-Follow-up information was obtained for 261 of the 280 (93%) participants in the white light group and 255 of the 271 (94%) participants in the fluorescence group. Median follow-up in the white light and fluorescence groups were 53.0 and 55.1 months, respectively. In the white light and fluorescence groups, 83 (31.8%) and 97 (38%) of the participants remained tumor free, respectively. The median recurrence free survival was 9.6 months in the white light group and 16.4 months in the fluorescence group, p = 0.04. The rates of intravesical therapy were similar in the white light (46%) and fluorescence groups (45%). Cystectomy was performed in 22/280 (7.9%) in the white light group and 13/271 (4.8%) in the fluorescence group, p = 0.16.Conclusions-Hexaminolevulinate fluorescence cystoscopy significantly improves long-term bladder cancer recurrence free survival with a trend towards improved bladder preservation. NIH Public Access

show abstract

Hexyl Aminolevulinate Fluorescence Cystoscopy: A New Diagnostic Tool for Photodiagnosis of Superficial Bladder Cancer—A multicenter study

Abstract: HAL fluorescence cystoscopy is a new, sensitive, promising diagnostic procedure that showed improved detection of bladder tumors, in particular CIS. The procedure is well tolerated and can easily be implemented in current clinical practice.

Cited by 236 publications

References 17 publications

Feasibility of Photodynamic Diagnosis for Challenging TUR-Bt Cases Including Muscle Invasive Bladder Cancer, BCG Failure or 2^nd-TUR

Feasibility of Photodynamic Diagnosis for Challenging TUR-Bt Cases Including Muscle Invasive Bladder Cancer, BCG Failure or 2^nd-TUR

Biodistribution of PVP-hypericin and hexaminolevulinate-induced PpIX in normal and orthotopic tumor-bearing rat urinary bladder

957 Long-term reduction in bladder cancer recurrence with hexaminolevulinate enabled fluorescence cystoscopy

Contact Info

Product

Resources

About

Hexyl Aminolevulinate Fluorescence Cystoscopy: A New Diagnostic Tool for Photodiagnosis of Superficial Bladder Cancer—A multicenter study

Abstract: HAL fluorescence cystoscopy is a new, sensitive, promising diagnostic procedure that showed improved detection of bladder tumors, in particular CIS. The procedure is well tolerated and can easily be implemented in current clinical practice.

Cited by 236 publications

References 17 publications

Feasibility of Photodynamic Diagnosis for Challenging TUR-Bt Cases Including Muscle Invasive Bladder Cancer, BCG Failure or 2nd-TUR

Feasibility of Photodynamic Diagnosis for Challenging TUR-Bt Cases Including Muscle Invasive Bladder Cancer, BCG Failure or 2nd-TUR

Biodistribution of PVP-hypericin and hexaminolevulinate-induced PpIX in normal and orthotopic tumor-bearing rat urinary bladder

957 Long-term reduction in bladder cancer recurrence with hexaminolevulinate enabled fluorescence cystoscopy

Contact Info

Product

Resources

About

Feasibility of Photodynamic Diagnosis for Challenging TUR-Bt Cases Including Muscle Invasive Bladder Cancer, BCG Failure or 2^nd-TUR

Feasibility of Photodynamic Diagnosis for Challenging TUR-Bt Cases Including Muscle Invasive Bladder Cancer, BCG Failure or 2^nd-TUR