Photodynamic diagnosis-assisted transurethral resection using oral 5-aminolevulinic acid decreases residual cancer and improves recurrence-free survival in patients with non-muscle-invasive bladder cancer

Taoka, Rikiya; Matsuoka, Yuki; Yamasaki, Mari; Kani, Naoya; Honda, Tomoko; Harada, Satoshi; Tohi, Yoichiro; Kato, Takuma; Okazoe, Homare; Tsunemori, Hiroyuki; Ueda, Nobufumi; Sugimoto, Mikio

doi:10.1016/j.pdpdt.2022.102838

Cited by 15 publications

(11 citation statements)

References 22 publications

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“…Photodynamic diagnosis can distinguish normal and cancerous tissues. 5-aminolevulinic acid (5-ALA) is a second-generation photosensitizer, which is advantageous due to lower photosensitivity toxicity, hypoallergenic reaction, and longer imaging time compared with the first-generation photosensitizer, Hematoporphyrinderivative (HPD) ( 36 ). 5-ALA-mediated PDD (5-ALA-PDD) is widely used in the diagnosis and treatment of NMIBC.…”

Section: Discussionmentioning

confidence: 99%

Global research trends in non-muscle invasive bladder cancer: Bibliometric and visualized analysis

et al. 2022

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BackgroundBladder cancer is one of the most common urological cancers. Non-muscle invasive bladder cancer (NMIBC) accounts for about 75-85% of all newly diagnosed bladder cancers. Globally, there are many NMIBC-related publications. However, a bibliometric analysis of these publications has not been performed.ObjectiveThis study aims to systematically analyze and visualize NMIBC-related publications through bibliometrics, and to reveal identified topics, hotspots, and knowledge gaps in related fields.MethodsBased on the Web of Science core collection database, we firstly analyzed the quantity and quality of publications in the field of NMIBC, secondly profiled the publishing groups in terms of country, institution, author’s publication and cooperation network, and finally sorted out and summarized the hot topics of research.ResultsThis bibliometric analysis was conducted from 2001 to 2022. The analysis identified 2,185 articles and reviews, which were published in 402 journals. The number of publications and citations on NMIBC-related research has steadily increased over the last two decades. Furthermore, academic institutions in Europe and the United States play a leading role in NMIBC research. The country, institution, journal, and author with the most publications were the United States (559), Radboud University Nijmegen (88), Urologic oncology: Seminars and Original Investigations (141), and Witjes J (74), respectively. The most frequently used keywords were Bladder cancer (793), Recurrence (671), Urothelial carcinoma (593), Progression (523), Bacillus-calmette-guerin (411), Transitional-cell carcinoma (401), Carcinoma (366), Risk (297), Transurethral resection (286), and Non-muscle-invasive bladder cancer (280).ConclusionMore and more scholars are devoted to the research of related NMIBC. This bibliometric analysis revealed that the main research topics and hotspots in NMIBC included pathological staging, clinical diagnosis and treatment, and bladder perfusion.

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Section: Discussionmentioning

confidence: 99%

Global research trends in non-muscle invasive bladder cancer: Bibliometric and visualized analysis

et al. 2022

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Section: Discussionmentioning

confidence: 99%

“…The beneficial effect of PDD‐TURBT on the BC recurrence rate in NMIBC patients has been proven in several randomized control trials (RCTs), retrospective studies, and systematic reviews and meta‐analyses. 4 , 5 , 6 , 7 , 11 , 12 , 20 , 21 , 22 In contrast, evidence regarding the positive effect of this treatment on c‐progression and related mortality is limited. One RCT demonstrated a reduction in both bladder recurrence and c‐progression risk with PDD‐TURBT as compared to with WL‐TURBT (HR 0.56, 95% CI 0.39–0.80, P = 0.001 and HR 0.33, 95% CI 0.12–0.91, P = 0.031, respectively), whereas the OS and cancer‐specific survival rates remained similar.…”

Section: Discussionmentioning

confidence: 99%

Additional oncological benefit of photodynamic diagnosis with blue light cystoscopy in transurethral resection for primary non‐muscle‐invasive bladder cancer: A comparative study from experienced institutes

et al. 2023

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Objectives: The objective of this work is to evaluate the additional oncological benefit of photodynamic diagnosis (PDD) using blue-light cystoscopy in transurethral resection (TURBT) for primary non-muscle-invasive bladder cancer (NMIBC) based on the International Bladder Cancer Group (IBCG)-defined progression and the subsequent pathological pathways.Patients and Methods: We reviewed 1578 consecutive primary NMIBC patients undergoing white-light TURBT (WL-TURBT) or PDD-TURBT during 2006-2020.One-to-one propensity score-matching was performed using multivariable logistic regression to obtain balanced groups. IBCG-defined progression of NMIBC included stage-up and grade-up as well as conventional definitions such as the development of muscle-invasive BC or metastatic disease. Nine oncological endpoints were evaluated. Sankey diagrams were generated to visualize follow-up pathological pathways after the initial TURBT.Results: Comparison of event-free survival between the matched groups revealed that PDD use decreased the bladder cancer recurrence risk and IBCG-defined progression risk, whereas no significant difference was noted in conventionally defined

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“…PDD-assisted TURBT using ALA is becoming increasingly popular in Japan, and its usefulness has been reported in several studies (3,4,6,7). Moreover, several recent systematic reviews revealed that TURBT with PDD could reduce BC recurrence and resulted in a progression risk reduction compared to conventional TURBT with WL (13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

Poor Prognosis With Intravesical Bacillus Calmette-Guérin History After Photodynamic Diagnosis-assisted Transurethral Resection Using 5-Aminolevulinic Acid

Makino

Ofude

Kawahara

et al. 2022

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Background/Aim: Diagnostic efficacy and treatment outcome of orally administered 5 aminolevulinic acid (ALA) assessment for photodynamic diagnosis (PDD) in transurethral resection for non-muscle-invasive bladder cancer (NMIBC) in clinical practice. Patients and Methods: A retrospective analysis was performed of 105 patients who underwent PDD transurethral resection using orally administered ALA and were pathologically diagnosed with Ta, T1, or Tis at the Ishikawa Prefectural Central Hospital from December 2018 to May 2022. Results: Fluorescent light had a significantly higher sensitivity but a lower specificity in detecting carcinoma compared to white light (91.7% vs. 77.1%; p<0.05 and 43.0% vs. 85.2%; p<0.05, respectively), as well as in detecting carcinoma in situ lesions (80.4% vs. 28.6%; p<0.05 and 23.3% vs. 84.5%; p<0.05, respectively). The cumulative frequency of recurrence and progression 1 year after treatment were 26.3% and 12.3%, respectively. Multivariate analyses indicated that a Bacillus Calmette-Guérin (BCG) history instillation was an independent predictive factor for intravesical recurrence (hazard ratio=4.439; p=0.002) and disease progression (hazard ratio=8.534; p=0.005). The 1-year cumulative recurrence rates were 66.2% and 16.5%, respectively (p<0.001), and progression rates for patients with and without prior BCG intravesical instillation were 50.4% and 3.5%, respectively (p<0.001). Conclusion: Sufficient diagnostic accuracy and relatively good treatment outcome was shown in PDDtransurethral resection using ALA. However, prior BCG intravesical instillation for NMIBC patients was a poor prognostic factor of cancer recurrence and progression, and may be useful for clinicians in their postoperative follow-up.Transurethral resection of bladder tumor (TURBT) by intraoperative cancer detection under white light (WL) (1) is the standard therapy for non-muscle-invasive bladder cancer (NMIBC) in clinical practice, which accounts for approximately 70% of bladder cancers (BCs). However, about 50% of NMIBCs recur, and BC invades the muscle layer in the recurrence process in 15%-30% of cases (2). Therefore, improving TURBT quality and increasing the complete tumor resection rate is essential to reduce the recurrence risk. The protoporphyrin IX precursor called 5aminolevulinic acid (ALA) is attracting attention as a new generation photosensitive material for photodynamic diagnosis (PDD). PDD assisted TURBT using orally administered ALA has demonstrated clear advantages in Japan in terms of increased tumor detection and improved oncological outcome (3-7). Clinical data originating from Japan are not yet sufficient, although ALA was made available under the Japanese public medical insurance system in 2017.Recently, the Bacillus Calmette-Guérin (BCG) unresponsive disease concept was advocated; a group of diseases that recur despite adequate BCG intravesical therapy and are considered ineffective for reintroduction of BCG intravesical therapy (8, 9). However, it is unclear how prior BCG intravesical treatme...

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Photodynamic diagnosis-assisted transurethral resection using oral 5-aminolevulinic acid decreases residual cancer and improves recurrence-free survival in patients with non-muscle-invasive bladder cancer

Cited by 15 publications

References 22 publications

Global research trends in non-muscle invasive bladder cancer: Bibliometric and visualized analysis

Global research trends in non-muscle invasive bladder cancer: Bibliometric and visualized analysis

Additional oncological benefit of photodynamic diagnosis with blue light cystoscopy in transurethral resection for primary non‐muscle‐invasive bladder cancer: A comparative study from experienced institutes

Poor Prognosis With Intravesical Bacillus Calmette-Guérin History After Photodynamic Diagnosis-assisted Transurethral Resection Using 5-Aminolevulinic Acid

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