Outpatient diode laser treatment of intermediate-risk non-invasive bladder tumors without sedation: efficacy, safety and economic analysis

Hermann, Gregers G.; Mogensen, Karin; Rosthøj, Susanne

doi:10.1080/21681805.2018.1450782

Cited by 19 publications

(16 citation statements)

References 18 publications

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“…Office fulguration is more cost‐effective than any other clinical setting including ambulatory, outpatient hospital, or inpatient hospital TURBT for management of small recurrences. In two European trials using laser photocoagulation techniques under local anaesthesia, savings of up to €2000 per procedure could be realized compared to TURBT . A US‐based cost‐analysis model from the Memorial‐Sloan Kettering Cancer Centre found that, despite a small absolute difference of only $37 per quality‐adjusted life‐years favouring office fulguration over outpatient TURBT, the long‐term follow‐up and protracted course of low‐grade BCa would result in significant overall cost savings .…”

Section: Managementmentioning

confidence: 99%

Risk‐adapted management of low‐grade bladder tumours: recommendations from the International Bladder Cancer Group (IBCG)

et al. 2020

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Objective To provide a contemporary update and recommendations for the diagnosis and management of low‐grade non‐muscle‐invasive bladder cancer (BCa) based on current literature and expert consensus of the International Bladder Cancer Group. Methods We reviewed published trials, guidelines, meta‐analyses and reviews (up to March 2019) and provide recommendations on baseline evaluations, treatment, endpoints, study design and surveillance protocols. Results Low‐grade Ta BCa poses minimal risk to patients in terms of progression and disease‐specific survival. Thus, to minimize patient morbidity, this entity should be managed appropriately. After initial diagnosis of low‐grade Ta tumour, subsequent stable, low‐grade‐appearing recurrences can be managed conservatively with office cystoscopy and fulguration or even followed using an active surveillance protocol. Intravesical therapy other than single‐dose peri‐operative chemotherapy instillation should be used judiciously, and only after assigning appropriate risk points. Routine use of urinary cytology – other than at initial risk stratification, or for patients on active surveillance without therapy – is not recommended; and surveillance cystoscopy may be discontinued after 5 years. Clinical studies in this group of patients should focus on recurrence rates, and time to recurrence, rather than progression events. Conclusions The International Bladder Cancer Group has developed formal recommendations regarding the diagnosis, treatment and surveillance of low‐grade non‐muscle‐invasive BCa to minimize morbidity and encourage uniformity among studies in this disease.

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Section: Managementmentioning

confidence: 99%

Risk‐adapted management of low‐grade bladder tumours: recommendations from the International Bladder Cancer Group (IBCG)

et al. 2020

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“…Local recurrence rates varied between 10–20% at 12 months, which compares well with a predicted 24% risk of recurrence at one year post surgery in this group of patients using the European Organisation for Research and Treatment of Cancer (EORTC) risk tables. Notably, all the studies reported high patient satisfaction, with rates of over 90% …”

Section: The Evidencementioning

confidence: 97%

TULA in recurrent non‐muscle invasive bladder cancer

Sarkar

Mayor²,

Mostafid³

2020

Trends Urol & Men's Health

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“…85,86 In addition, three budget impact models (BIMs) and eighteen CEAs were identified from SLR searches, of which twelve evaluated TURBT, mainly comparing diagnostic imaging during the procedure as well as comparing TURBT to other procedures or procedure setting. [87][88][89][90][91][92][93][94][95][96][97][98] Two studies assessed intravesical therapy; 99,100 four assessed surveillance. [101][102][103][104] Four studies evaluated BCG and/or the impact of its shortage, [105][106][107][108] with one being a CEA that presented AE costs associated with BCG in high-risk patients.…”

Section: Economic Outcomesmentioning

confidence: 99%

<p>Humanistic and Economic Burden of Non-Muscle Invasive Bladder Cancer: Results of Two Systematic Literature Reviews</p>

Lee¹,

Kwon²,

Forsythe³

et al. 2020

CEOR

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Purpose: Non-muscle invasive bladder cancer (NMIBC) is a malignancy restricted to the inner lining of the bladder. Intravesical Bacillus Calmette-Guerin (BCG) following transurethral resection of the bladder tumor is the mainstay first-line treatment for high-risk NMIBC patients. Two systematic literature reviews (SLRs) were conducted to further assess the current evidence on BCG use in NMIBC and the humanistic and economic burden of disease. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, Embase ® and MEDLINE ® were searched using the Ovid platform to identify interventional or real-world evidence studies on the health-related quality of life (HRQoL) and economic burden in NMIBC. Limited evidence was found from initial economic SLR searches in NMIBC, so additional targeted searches for bladder cancer were conducted to expand findings. Results: Fifty-nine publications were included in the HRQoL SLR, of which 23 reported HRQoL and symptoms in NMIBC. At diagnosis, HRQoL was comparable with population norms but worsened considerably 2 years following diagnosis. Maintenance therapy with intravesical BCG was associated with reduced HRQoL, and treatment-related adverse events (AEs) resembled typical NMIBC symptoms. Twenty-two studies reported decreasing BCG compliance over time. Common AEs with BCG were frequent urination, lower urinary tract symptoms, pain, and hematuria. Forty-two publications were included in the economic SLR, of which nine assessed healthcare costs and resource use in NMIBC or bladder cancer. Highrisk disease and high-intensity treatment were associated with increased healthcare costs. Conclusion: NMIBC has a considerable symptomatic, HRQoL, and economic burden. Symptoms persisted and HRQoL worsened despite intravesical BCG treatment. NMIBC is a costly disease, with higher healthcare costs associated with increased risk of disease progression and recurrence. There is a high unmet need for safe and effective treatments that reduce the risk of disease progression and recurrence, provide symptomatic relief, and improve HRQoL for patients.

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Outpatient diode laser treatment of intermediate-risk non-invasive bladder tumors without sedation: efficacy, safety and economic analysis

Abstract: Fluorescence-guided diode lasers provide efficient and almost pain-free treatment of low-grade urothelial cancer in conscious patients and could reduce healthcare costs.

Cited by 19 publications

References 18 publications

Risk‐adapted management of low‐grade bladder tumours: recommendations from the International Bladder Cancer Group (IBCG)

Risk‐adapted management of low‐grade bladder tumours: recommendations from the International Bladder Cancer Group (IBCG)

TULA in recurrent non‐muscle invasive bladder cancer

<p>Humanistic and Economic Burden of Non-Muscle Invasive Bladder Cancer: Results of Two Systematic Literature Reviews</p>

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