Skip to main content

Advertisement

SpringerLink
Log in

Narrow-band imaging assisted cystoscopy in the follow-up of patients with transitional cell carcinoma of the bladder: a randomized study in comparison with white light cystoscopy

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the diagnostic accuracy of a second look narrow-band imaging (NBI) cystoscopy in the follow-up of patients with NMIBC as compared to a second white light cystoscopy (WLI).

Patients and methods

From August 2013 to October 2014, 600 patients with history of non-muscle invasive bladder cancer (NMIBC), who presented for follow-up cystoscopy at an academic outpatient clinic, were randomized to flexible WLI-cystoscopy plus second look NBI-cystoscopy (n = 300) or flexible WLI-cystoscopy plus second look WLI-cystoscopy (n = 300) in the same session. We analysed the detection rate of bladder tumours in second look cystoscopy as primary endpoint. In addition, we evaluated recurrence rates before study enrolment and after transurethral resection (TUR-BT) in each group.

Results

In 600 patients with a history of NMIBC, 78 out of 300 patients (26%) with WLI–NBI-cystoscopy and 70 out of 300 patients (23%) with WLI–WLI-cystoscopy were diagnosed with cancer recurrence (p = 0.507). Overall, WLI–NBI detected 404 and WLI–WLI 234 lesions, respectively. The second look cystoscopy detected 57 additional cancer lesions: 45 tumours in 18 patients with WLI–NBI and 12 tumours in 9 patients with WLI–WLI (p = 0.035). After initial examination without tumour detection an improvement was determined by the second cystoscopy in 3 patients (75 vs. 78 pat.) with WLI–NBI and in only one patient (69 vs. 70 pat.) with WLI–WLI (p = 0.137). Second look cystoscopy did not influence the detection of carcinoma in situ in both groups (p = 0.120). After TUR-BT the median recurrence-free survival was 4 months in 57 recurring patients (73%) in the group with WLI–NBI- and 6 months in 56 patients (80%) with WLI–WLI-cystoscopy (p = 0.373), respectively.

Conclusion

Our study showed no differences in per-patient tumour detection between WLI and NBI. Although NBI has significant benefits for detecting individual lesions overlooked by WLI-cystoscopy, this did not positively affect recurrence-free survival after transurethral resection.

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

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):E359–E386. https://doi.org/10.1002/ijc.29210

    Article  CAS  PubMed  Google Scholar 

  2. Fitzmaurice C, Allen C, Barber RM, Barregard L, Bhutta ZA, Brenner H, Dicker DJ, Chimed-Orchir O, Dandona R, Dandona L, Fleming T, Forouzanfar MH, Hancock J, Hay RJ, Hunter-Merrill R, Huynh C, Hosgood HD, Johnson CO, Jonas JB, Khubchandani J, Kumar GA, Kutz M, Lan Q, Larson HJ, Liang X, Lim SS, Lopez AD, MacIntyre MF, Marczak L, Marquez N, Mokdad AH, Pinho C, Pourmalek F, Salomon JA, Sanabria JR, Sandar L, Sartorius B, Schwartz SM, Shackelford KA, Shibuya K, Stanaway J, Steiner C, Sun J, Takahashi K, Vollset SE, Vos T, Wagner JA, Wang H, Westerman R, Zeeb H, Zoeckler L, Abd-Allah F, Ahmed MB, Alabed S, Alam NK, Aldhahri SF, Alem G, Alemayohu MA, Ali R, Al-Raddadi R, Amare A, Amoako Y, Artaman A, Asayesh H, Atnafu N, Awasthi A, Saleem HB, Barac A, Bedi N, Bensenor I, Berhane A, Bernabe E, Betsu B, Binagwaho A, Boneya D, Campos-Nonato I, Castaneda-Orjuela C, Catala-Lopez F, Chiang P, Chibueze C, Chitheer A, Choi JY, Cowie B, Damtew S, das Neves J, Dey S, Dharmaratne S, Dhillon P, Ding E, Driscoll T, Ekwueme D, Endries AY, Farvid M, Farzadfar F, Fernandes J, Fischer F, Gebru A, Gopalani S, Hailu A, Horino M, Horita N, Husseini A, Huybrechts I, Inoue M, Islami F, Jakovljevic M, James S, Javanbakht M, Jee SH, Kasaeian A, Kedir MS, Khader YS, Khang YH, Kim D, Leigh J, Linn S, Lunevicius R, El Razek HMA, Malekzadeh R, Malta DC, Marcenes W, Markos D, Melaku YA, Meles KG, Mendoza W, Mengiste DT, Meretoja TJ, Miller TR, Mohammad KA, Mohammadi A, Mohammed S, Moradi-Lakeh M, Nagel G, Nand D, Le Nguyen Q, Nolte S, Ogbo FA, Oladimeji KE, Oren E, Pa M, Park EK, Pereira DM, Plass D, Qorbani M, Radfar A, Rafay A, Rahman M, Rana SM, Soreide K, Satpathy M, Sawhney M, Sepanlou SG, Shaikh MA, She J, Shiue I, Shore HR, Shrime MG, So S, Soneji S, Stathopoulou V, Stroumpoulis K, Sufiyan MB, Sykes BL, Tabares-Seisdedos R, Tadese F, Tedla BA, Tessema GA, Thakur JS, Tran BX, Ukwaja KN, Uzochukwu BSC, Vlassov VV, Weiderpass E, Wubshet Terefe M, Yebyo HG, Yimam HH, Yonemoto N, Younis MZ, Yu C, Zaidi Z, Zaki MES, Zenebe ZM, Murray CJL, Naghavi M (2017) Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990–2015: a systematic analysis for the global burden of disease study. JAMA Oncol 3(4):524–548. https://doi.org/10.1001/jamaoncol.2016.5688

    Article  PubMed  Google Scholar 

  3. Morgan TM, Keegan KA, Clark PE (2011) Bladder cancer. Curr Opin Oncol 23(3):275–282. https://doi.org/10.1097/CCO.0b013e3283446a11

    Article  CAS  PubMed  Google Scholar 

  4. Babjuk M, Bohle A, Burger M, Capoun O, Cohen D, Comperat EM, Hernandez V, Kaasinen E, Palou J, Roupret M, van Rhijn BW, Shariat SF, Soukup V, Sylvester RJ, Zigeuner R (2017) EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2016. Eur Urol 71(3):447–461. https://doi.org/10.1016/j.eururo.2016.05.041

    Article  PubMed  Google Scholar 

  5. Sylvester RJ, van der Meijden AP, Oosterlinck W, Witjes JA, Bouffioux C, Denis L, Newling DW, Kurth K (2006) Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol 49(3):466–465. https://doi.org/10.1016/j.eururo.2005.12.031(discussion 475–467)

    Article  PubMed  Google Scholar 

  6. Simon M, Bosset PO, Rouanne M, Benhamou S, Radulescu C, Molinie V, Neuzillet Y, Paoletti X, Lebret T (2019) Multiple recurrences and risk of disease progression in patients with primary low-grade (TaG1) non-muscle-invasive bladder cancer and with low and intermediate EORTC-risk score. PLoS One 14(2):e0211721. https://doi.org/10.1371/journal.pone.0211721

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Kim HS, Jeong CW, Kwak C, Kim HH, Ku JH (2018) Novel nomograms to predict recurrence and progression in primary non-muscle-invasive bladder cancer: validation of predictive efficacy in comparison with European Organization of Research and Treatment of Cancer scoring system. World J Urol. https://doi.org/10.1007/s00345-018-2581-3

    Article  PubMed  PubMed Central  Google Scholar 

  8. Brausi M, Collette L, Kurth K, van der Meijden AP, Oosterlinck W, Witjes JA, Newling D, Bouffioux C, Sylvester RJ (2002) Variability in the recurrence rate at first follow-up cystoscopy after TUR in stage Ta T1 transitional cell carcinoma of the bladder: a combined analysis of seven EORTC studies. Eur Urol 41(5):523–531

    Article  PubMed  Google Scholar 

  9. Jocham D, Stepp H, Waidelich R (2008) Photodynamic diagnosis in urology: state-of-the-art. Eur Urol 53(6):1138–1148. https://doi.org/10.1016/j.eururo.2007.11.048

    Article  CAS  PubMed  Google Scholar 

  10. Rink M, Babjuk M, Catto JW, Jichlinski P, Shariat SF, Stenzl A, Stepp H, Zaak D, Witjes JA (2013) Hexyl aminolevulinate-guided fluorescence cystoscopy in the diagnosis and follow-up of patients with non-muscle-invasive bladder cancer: a critical review of the current literature. Eur Urol 64(4):624–638. https://doi.org/10.1016/j.eururo.2013.07.007

    Article  PubMed  Google Scholar 

  11. Babjuk M, Soukup V, Petrik R, Jirsa M, Dvoracek J (2005) 5-aminolaevulinic acid-induced fluorescence cystoscopy during transurethral resection reduces the risk of recurrence in stage Ta/T1 bladder cancer. BJU Int 96(6):798–802. https://doi.org/10.1111/j.1464-410X.2004.05715.x

    Article  CAS  PubMed  Google Scholar 

  12. Witjes JA, Douglass J (2007) The role of hexaminolevulinate fluorescence cystoscopy in bladder cancer. Nat Clin Pract Urol 4(10):542–549. https://doi.org/10.1038/ncpuro0917

    Article  CAS  PubMed  Google Scholar 

  13. Kausch I, Sommerauer M, Montorsi F, Stenzl A, Jacqmin D, Jichlinski P, Jocham D, Ziegler A, Vonthein R (2010) Photodynamic diagnosis in non-muscle-invasive bladder cancer: a systematic review and cumulative analysis of prospective studies. Eur Urol 57(4):595–606. https://doi.org/10.1016/j.eururo.2009.11.041

    Article  PubMed  Google Scholar 

  14. Chou R, Selph S, Buckley DI, Fu R, Griffin JC, Grusing S, Gore JL (2017) Comparative effectiveness of fluorescent versus white light cystoscopy for initial diagnosis or surveillance of bladder cancer on clinical outcomes: systematic review and meta-analysis. J Urol 197(3 Pt 1):548–558. https://doi.org/10.1016/j.juro.2016.10.061

    Article  PubMed  Google Scholar 

  15. Chiu HM, Chang CY, Chen CC, Lee YC, Wu MS, Lin JT, Shun CT, Wang HP (2007) A prospective comparative study of narrow-band imaging, chromoendoscopy, and conventional colonoscopy in the diagnosis of colorectal neoplasia. Gut 56(3):373–379. https://doi.org/10.1136/gut.2006.099614

    Article  PubMed  Google Scholar 

  16. Kara MA, Peters FP, Fockens P, ten Kate FJ, Bergman JJ (2006) Endoscopic video-autofluorescence imaging followed by narrow band imaging for detecting early neoplasia in Barrett’s esophagus. Gastrointest Endosc 64(2):176–185. https://doi.org/10.1016/j.gie.2005.11.050

    Article  PubMed  Google Scholar 

  17. Herr HW, Donat SM (2008) A comparison of white-light cystoscopy and narrow-band imaging cystoscopy to detect bladder tumour recurrences. BJU Int 102(9):1111–1114. https://doi.org/10.1111/j.1464-410X.2008.07846.x

    Article  PubMed  Google Scholar 

  18. Bryan RT, Billingham LJ, Wallace DM (2008) Narrow-band imaging flexible cystoscopy in the detection of recurrent urothelial cancer of the bladder. BJU Int 101(6):702–705. https://doi.org/10.1111/j.1464-410x.2007.07317.x(discussion 705-706)

    Article  PubMed  Google Scholar 

  19. Naselli A, Introini C, Timossi L, Spina B, Fontana V, Pezzi R, Germinale F, Bertolotto F, Puppo P (2012) A randomized prospective trial to assess the impact of transurethral resection in narrow band imaging modality on non-muscle-invasive bladder cancer recurrence. Eur Urol 61(5):908–913. https://doi.org/10.1016/j.eururo.2012.01.018

    Article  PubMed  Google Scholar 

  20. Kim SB, Yoon SG, Tae J, Kim JY, Shim JS, Kang SG, Cheon J, Lee JG, Kim JJ, Kang SH (2018) Detection and recurrence rate of transurethral resection of bladder tumors by narrow-band imaging: prospective, randomized comparison with white light cystoscopy. Investig Clin Urol 59(2):98–105. https://doi.org/10.4111/icu.2018.59.2.98

    Article  PubMed  PubMed Central  Google Scholar 

  21. Drejer D, Beji S, Oezeke R, Nielsen AM, Hoyer S, Bjerklund Johansen TE, Lam GW, Jensen JB (2017) Comparison of white light, photodynamic diagnosis, and narrow-band imaging in detection of carcinoma in situ or flat dysplasia at transurethral resection of the bladder: the DaBlaCa-8 study. Urology 102:138–142. https://doi.org/10.1016/j.urology.2016.11.032

    Article  PubMed  Google Scholar 

  22. Hirner L, Stagge E, Rubben H, Schenck M, Eisenhardt A (2016) Narrow band imaging-assisted cystoscopy in bladder tumor follow-up: can more tumors be identified? Der Urologe Ausg A 55(3):370–375. https://doi.org/10.1007/s00120-015-3942-9

    Article  CAS  PubMed  Google Scholar 

  23. Li K, Lin T, Fan X, Duan Y, Huang J (2013) Diagnosis of narrow-band imaging in non-muscle-invasive bladder cancer: a systematic review and meta-analysis. Int J Urol 20(6):602–609. https://doi.org/10.1111/j.1442-2042.2012.03211.x

    Article  PubMed  Google Scholar 

  24. Chen G, Wang B, Li H, Ma X, Shi T, Zhang X (2013) Applying narrow-band imaging in complement with white-light imaging cystoscopy in the detection of urothelial carcinoma of the bladder. Urol Oncol 31(4):475–479. https://doi.org/10.1016/j.urolonc.2011.02.009

    Article  PubMed  Google Scholar 

  25. Herr HW (2001) Does cystoscopy correlate with the histology of recurrent papillary tumours of the bladder? BJU Int 88(7):683–685

    Article  CAS  PubMed  Google Scholar 

  26. Hernandez V, Alvarez M, de la Pena E, Amaruch N, Martin MD, de la Morena JM, Gomez V, Llorente C (2009) Safety of active surveillance program for recurrent nonmuscle-invasive bladder carcinoma. Urology 73(6):1306–1310. https://doi.org/10.1016/j.urology.2008.12.061

    Article  CAS  PubMed  Google Scholar 

  27. Kobatake K, Mita K, Ohara S, Kato M (2015) Advantage of transurethral resection with narrow band imaging for non-muscle invasive bladder cancer. Oncol Lett 10(2):1097–1102. https://doi.org/10.3892/ol.2015.3280

    Article  PubMed  PubMed Central  Google Scholar 

  28. Kang W, Cui Z, Chen Q, Zhang D, Zhang H, Jin X (2017) Narrow band imaging-assisted transurethral resection reduces the recurrence risk of non-muscle invasive bladder cancer: a systematic review and meta-analysis. Oncotarget 8(14):23880–23890. https://doi.org/10.18632/oncotarget.13054

    Article  PubMed  Google Scholar 

  29. Naito S, Algaba F, Babjuk M, Bryan RT, Sun YH, Valiquette L, de la Rosette J (2016) The Clinical research office of the endourological society (CROES) multicentre randomised trial of narrow band imaging-assisted transurethral resection of bladder tumour (TURBT) versus conventional white light imaging-assisted TURBT in primary non-muscle-invasive bladder cancer patients: trial protocol and 1-year results. Eur Urol 70(3):506–515. https://doi.org/10.1016/j.eururo.2016.03.053

    Article  PubMed  Google Scholar 

  30. Cauberg EC, Mamoulakis C, de la Rosette JJ, de Reijke TM (2011) Narrow band imaging-assisted transurethral resection for non-muscle invasive bladder cancer significantly reduces residual tumour rate. World J Urol 29(4):503–509. https://doi.org/10.1007/s00345-011-0659-2

    Article  PubMed  PubMed Central  Google Scholar 

  31. Mowatt G, N’Dow J, Vale L, Nabi G, Boachie C, Cook JA, Fraser C, Griffiths TR (2011) Photodynamic diagnosis of bladder cancer compared with white light cystoscopy: systematic review and meta-analysis. Int J Technol Assess Health Care 27(1):3–10. https://doi.org/10.1017/s0266462310001364

    Article  PubMed  Google Scholar 

  32. Lee JY, Cho KS, Kang DH, Jung HD, Kwon JK, Oh CK, Ham WS, Choi YD (2015) A network meta-analysis of therapeutic outcomes after new image technology-assisted transurethral resection for non-muscle invasive bladder cancer: 5-aminolaevulinic acid fluorescence vs hexylaminolevulinate fluorescence vs narrow band imaging. BMC Cancer 15:566. https://doi.org/10.1186/s12885-015-1571-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany

    S. Tschirdewahn, N. N. Harke, L. Hirner, B. Hadaschik & Andreas Eisenhardt

  2. Outpatient Clinic Praxisklinik für Urologie Rhein/Ruhr, Schulstr. 11, 45468, Mülheim an der Ruhr, Germany

    E. Stagge & Andreas Eisenhardt

Authors
  1. S. Tschirdewahn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N. N. Harke
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. Hirner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. Stagge
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. Hadaschik
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Andreas Eisenhardt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andreas Eisenhardt.

Ethics declarations

Conflict of interest

The study was supported by a grant of Olympus, Germany.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tschirdewahn, S., Harke, N.N., Hirner, L. et al. Narrow-band imaging assisted cystoscopy in the follow-up of patients with transitional cell carcinoma of the bladder: a randomized study in comparison with white light cystoscopy. World J Urol 38, 1509–1515 (2020). https://doi.org/10.1007/s00345-019-02926-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-019-02926-0

Keywords

Search

Navigation