Photodynamic diagnosis-assisted transurethral resection of bladder tumor for high-risk non-muscle invasive bladder cancer improves intravesical recurrence-free survival (BRIGHT study).

Autor: Kawai T; Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.; Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Matsuyama H; Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, Japan.; Department of Urology, JA Yamaguchi Kouseiren Nagato General Hospital, Nagato, Japan., Kobayashi K; Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, Japan., Ikeda A; Department of Urology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan., Miyake M; Department of Urology, Nara Medical University, Kashihara, Japan., Nishimoto K; Department of Uro-Oncology, Saitama Medical University International Medical Center, Hidaka, Japan., Matsushita Y; Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan., Nishiyama H; Department of Urology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan., Fujimoto K; Department of Urology, Nara Medical University, Kashihara, Japan., Oyama M; Department of Uro-Oncology, Saitama Medical University International Medical Center, Hidaka, Japan., Miyake H; Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan.; Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan., Azuma H; Department of Urology, Osaka Medical and Pharmaceutical University Faculty of Medicine, Takatsuki, Japan., Inoue K; Department of Urology, Kochi Medical School, Nankoku, Japan., Mitsui T; Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Chuo, Japan., Kawakita M; Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan., Oyama C; Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan., Mizokami A; Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan., Abe T; Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan., Kuroiwa H; Integrated Center for Advanced Medical Technologies (ICAM-Tech), Kochi Medical School, Nankoku, Japan., Kume H; Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Jazyk: angličtina
Zdroj: International journal of urology : official journal of the Japanese Urological Association [Int J Urol] 2024 Aug; Vol. 31 (8), pp. 906-912. Date of Electronic Publication: 2024 May 02.
DOI: 10.1111/iju.15483
Abstrakt: Objectives: In a primary analysis of data from the BRIGHT study (UMIN000035712), photodynamic diagnosis-assisted transurethral resection of bladder tumor (PDD-TURBT) using oral 5-aminolevulinic acid hydrochloride reduced residual tumors in high-risk non-muscle invasive bladder cancer (NMIBC). We aimed to evaluate the effectiveness of PDD-TURBT for intravesical recurrence after a second transurethral resection for high-risk NMIBC.
Methods: High-risk NMIBC patients initially treated with PDD-TURBT (PDD group) were prospectively registered between 2018 and 2020. High-risk patients with NMIBC who were initially treated with white-light TURBT (WL group) were retrospectively registered. Intravesical recurrence-free survival after the second transurethral resection was compared between the PDD and WL groups using propensity score matching analysis.
Results: In total, 177 patients were enrolled in the PDD group, and 306 patients were registered in the WL group. After propensity score matching (146 cases in each group), intravesical recurrence within 1 year was significantly less frequent in the PDD group than in the WL group (p = 0.004; hazard ratio [HR] 0.44, 95% confidence interval [CI]: 0.25-0.77). In subgroup analysis, PDD-TURBT showed a particularly high efficacy in reducing intravesical recurrence within 1 year, especially in cases of tumors measuring less than 3 cm (p = 0.003; HR 0.31, 95% CI: 0.14-0.67), absence of residual tumor at second transurethral resection (p = 0.020; HR 0.37, 95% CI: 0.16-0.86), and no postoperative intravesical Bacillus Calmette-Guérin therapy (p < 0.001; HR 0.27, 95% CI: 0.13-0.58).
Conclusions: PDD-TURBT may reduce short-term intravesical recurrence in patients with high-risk NMIBC.
(© 2024 The Authors. International Journal of Urology published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Urological Association.)
Databáze: MEDLINE
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