Skip to main content

Advertisement

SpringerLink
Log in

Value of Fluorescence Cystoscopy in High Risk Non-muscle Invasive Bladder Cancer

  • Urothelial Cancer (A Sagalowsky, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Photodynamic Diagnosis (PDD), an adjunct to white light cystoscopy, has been shown to improve detection and thoroughness of resection of bladder cancer by enhancing visualisation of malign lesions during transurethral resection of bladder tumours (TURBT) compared to the sole use of standard white light cystoscopy. The PDD also has been shown to improve recurrence of free survival in non-muscle invasive bladder cancer. Little data on its impact on outcome in non-muscle invasive bladder cancer of high risk of progression is available however. The few trials and studies available demonstrate improved accuracy of diagnosis especially of flat malign lesions. In addition, improved recurrence rates have been suggested without an impact on progression rates in early invasive bladder cancer indicating little influence of thoroughness of resection on the tumour biology in those tumour stages. While no specific and larger data on impact of PDD on cancer specific survival exist to date and the few long-term data suggest little impact, improved accuracy of diagnosis is suggested to be beneficial for clinical decision making and thus a value of PDD is postulated in the management of high-risk non-muscle invasive bladder cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as:•• Of major importance

  1. Jocham D, Baumgartner R, Fuchs N, Lenz H, Stepp H, Unsöld E. Fluorescence diagnosis of porphyrin-marked urothelial tumors. Status of experimental development. Urologe A. 1989;28(2):59–64.

    PubMed  CAS  Google Scholar 

  2. Kriegmair M, Baumgartner R, Knuechel R, Steinbach P, Ehsan A, Lumper W, Hofstadter F, Hofstetter A. Fluorescence photodetection of neoplastic urothelial lesions following intravesical instillation of 5-aminolevulinic acid. Urology. 1994;44(6):836–41.

    Article  PubMed  CAS  Google Scholar 

  3. •• Jocham D, Witjes F, Wagner S, et al. Improved detection and treatment of bladder cancer using hexaminolevulinate imaging: a prospective, Phase III multicenter study. J Urol. 2005;174(3):862–6.

    Article  PubMed  Google Scholar 

  4. Stenzl A, Burger M, Fradet Y, et al. Hexaminolevulinate guided fluorescence cystoscopy reduces recurrence in patients with nonmuscle invasive bladder cancer. J Urol. 2010;184(5):1907–13.

    Article  PubMed  Google Scholar 

  5. Denzinger S, Burger M, Walter B, Knuechel R, Roessler W, Wieland WF, Filbeck T. Clinically relevant reduction in risk of recurrence of superficial bladder cancer using 5-aminolevulinic acid-induced fluorescence diagnosis: 8-year results of prospective randomized study. Urology. 2007;69(4):675–9. doi:10.1016/j.urology.2006.12.023.

    Article  PubMed  Google Scholar 

  6. Riedl CR, Daniltchenko D, Koenig F, Simak R, Loening SA, Pflueger H. Fluorescence endoscopy with 5-aminolevulinic acid reduces early recurrence rate in superficial bladder cancer. J Urol. 2001;165(4):1121–3.

    Article  PubMed  CAS  Google Scholar 

  7. Babjuk M, Soukup V, Petrík R, Jirsa M, Dvorácek J. 5-aminolaevulinic acid-induced fluorescence cystoscopy during transurethral resection reduces the risk of recurrence in stage Ta/T1 bladder cancer. BJU Int. 2005;96(6):798–802.

    Article  PubMed  CAS  Google Scholar 

  8. Daniltchenko DI, Riedl CR, Sachs MD, Koenig F, Daha KL, Pflueger H, Loening SA, Schnorr D. Long-term benefit of 5-aminolevulinic acid fluorescence assisted transurethral resection of superficial bladder cancer: 5-year results of a prospective randomized study. J Urol. 2005;174(6):2129–33. doi:10.1097/01.ju.0000181814.73466.14. discussion 2133.

    Article  PubMed  CAS  Google Scholar 

  9. Kriegmair M, Zaak D, Rothenberger KH, Rassweiler J, Jocham D, Eisenberger F, Tauber R, Stenzl A, Hofstetter A. Transurethral resection for bladder cancer using 5-aminolevulinic acid induced fluorescence endoscopy versus white light endoscopy. J Urol. 2002;168(2):475–8.

    Article  PubMed  Google Scholar 

  10. Kriegmair M, Baumgartner R, Knuchel R, Stepp H, Hofstadter F, Hofstetter A. Detection of early bladder cancer by 5-aminolevulinic acid induced porphyrin fluorescence. J Urol. 1996;155(1):105–9. discussion 109-110.

    Article  PubMed  CAS  Google Scholar 

  11. Jichlinski P, Guillou L, Karlsen SJ, Malmstrom PU, Jocham D, Brennhovd B, Johansson E, Gartner T, Lange N, van den Bergh H, Leisinger HJ. Hexyl aminolevulinate fluorescence cystoscopy: new diagnostic tool for photodiagnosis of superficial bladder cancer–a multicenter study. J Urol. 2003;170(1):226–9.

    Article  PubMed  Google Scholar 

  12. Zaak D, Kriegmair M, Stepp H, Baumgartner R, Oberneder R, Schneede P, Corvin S, Frimberger D, Knuchel R, Hofstetter A. Endoscopic detection of transitional cell carcinoma with 5-aminolevulinic acid: results of 1012 fluorescence endoscopies. Urology. 2001;57(4):690–4.

    Article  PubMed  CAS  Google Scholar 

  13. •• Grossman HB, Stenzl A, Fradet Y, Mynderse LA, Kriegmair M, Witjes JA, Soloway MS, Karl A, Burger M. Long-term decrease in bladder cancer recurrence with hexaminolevulinate enabled fluorescence cystoscopy. J Urol. 2012;188(1):58–62.

    Article  PubMed  Google Scholar 

  14. Hermann GG, Mogensen K, Carlsson S, Marcussen N, Duun S. Fluorescence-guided transurethral resection of bladder tumours reduces bladder tumour recurrence due to less residual tumour tissue in Ta/T1 patients: a randomized two-centre study. BJU Int. 2011;108(8 Pt 2):E297–303. doi:10.1111/j.1464-410X.2011.10090.x.

    Article  PubMed  Google Scholar 

  15. Dragoescu O, Tomescu P, Panus A, Enache M, Maria C, Stoica L, Plesea IE. Photodynamic diagnosis of non-muscle invasive bladder cancer using hexaminolevulinic acid. Rom J Morphol Embryol. 2011;52(1):123–7.

    PubMed  CAS  Google Scholar 

  16. Babjuk M, Oosterlinck W, Sylvester R, et al. EAU guidelines on non– muscle-invasive urothelial carcinoma of the bladder, the 2011 update. Eur Urol. 2011;59:997–1008.

    Article  PubMed  Google Scholar 

  17. Karl A, Tritschler S, Stanislaus P, Gratzke C, Tilki D, Strittmatter F, Knüchel R, Stief CG, Zaak D. Positive urine cytology but negative white-light cystoscopy: an indication for fluorescence cystoscopy? BJU Int. 2009;103(4):484–7.

    Article  PubMed  Google Scholar 

  18. •• Fradet Y, Grossman HB, Gomella L, Lerner S, Cookson M, Albala D, Droller MJ. A comparison of hexaminolevulinate fluorescence cystoscopy and white light cystoscopy for the detection of carcinoma in situ in patients with bladder cancer: a phase III, multicenter study. J Urol. 2007;178(1):68–73. discussion 73.

    Article  PubMed  Google Scholar 

  19. Otto W, Burger M, Fritsche HM, et al. Photodynamic diagnosis for superficial bladder cancer: do all risk-groups profit equally from oncological and economic long-term results? Clin Med Oncol. 2009;3:53–8.

    PubMed  Google Scholar 

  20. Grossman HB, Gomella L, Fradet Y, et al. A phase III, multicenter comparison of hexaminolevulinate fluorescence cystoscopy and white light cystoscopy for the detection of superficial papillary lesions in patients with bladder cancer. J Urol. 2007;178:62.

    Article  PubMed  Google Scholar 

  21. Stanislaus P, Zaak D, Stadler T, Tritschler S, Knuchel R, Stief CG, Karl A. Photodynamic diagnosis in patients with T1G3 bladder cancer: influence on recurrence rate. World J Urol. 2010;28(4):407–11. doi:10.1007/s00345-010-0574-y.

    Article  PubMed  Google Scholar 

  22. Denzinger S, Wieland WF, Otto W, Filbeck T, Knuechel R, Burger M. Does photodynamic transurethral resection of bladder tumour improve the outcome of initial T1 high-grade bladder cancer? A long-term follow-up of a randomized study. BJU Int. 2008;101(5):566–9.

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

Dr. Maximilian Burger thanks Ipsen Pharma and Photocure ASA for the generous grant.

Disclosure

Dr. Maximilian Burger received honoraria from Astellas Pharma, Ipsen Pharma, Photocure ASA, Pfizer, and Novartis.

Dr. Roman Mayr reported no conflicts of interest relevant to this article.

Author information

Authors and Affiliations

  1. Department of Urology, Central Hospital of Bolzano, Bolzano, Italy

    Roman Mayr

  2. Department of Urology and Pediatric Urology, Julius-Maximilians-University of Würzburg, Würzburg, Germany

    Maximilian Burger

Authors
  1. Roman Mayr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maximilian Burger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maximilian Burger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mayr, R., Burger, M. Value of Fluorescence Cystoscopy in High Risk Non-muscle Invasive Bladder Cancer. Curr Urol Rep 14, 90–93 (2013). https://doi.org/10.1007/s11934-013-0306-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11934-013-0306-0

Keywords

Search

Navigation