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Photodynamic diagnostics of bladder tumors

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Abstract

Approximately 18,000 new cases of urothelial cancer of the bladder occur annually, making it the most frequent urogenital neoplasia representing nearly 4% of all malignomas. Tumor stage defines two subgroups requiring specific therapeutic approaches and implying distinct prognoses. Non-muscle-invasive urothelial cancer recurs frequently and occasionally progresses to muscle-invasive stages. Remnant tumor after initial resection is seen as one major factor in high recurrence rates. Although photodynamic diagnostics improving detection and increasing recurrence-free survival has been introduced to broad application, it has yet not been established as standard procedure. This article reviews the current literature and discusses controversial aspects.

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References and Recommended Reading

  1. Oosterlinck W, Lobel B, Jakse G, et al.: Guidelines on bladder cancer. Eur Urol 2002, 41:105–112.

    Article  PubMed  Google Scholar 

  2. Sylvester RJ, van der Meijden AP, Oosterlinck W, et al.: 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 2006, 49:466–475.

    Article  PubMed  Google Scholar 

  3. Zaak D, Karl A, Knüchel R, et al.: Diagnosis of urothelial carcinoma of the bladder using fluorescence endoscopy. BJU Int 2005, 96:217–222.

    Article  PubMed  Google Scholar 

  4. Reuter MA: Entwicklung der endourologie. In Illustrierte Geschichte der Urologie. Edited by Konert J, Dietrich HG. Berlin, Heidelberg, New York: Springer; 2004:149–163.

    Google Scholar 

  5. D’Hallewin MA, Bezdetnaya L, Guillemin F: Fluorescence detection of bladder cancer: a review. Eur Urol 2002, 42:417–425.

    Article  PubMed  CAS  Google Scholar 

  6. Jain S, Kockelbergh RC: The role of photodynamic diagnosis in the contemporary management of superficial bladder cancer. BJU Int 2005, 96:17–21.

    Article  PubMed  Google Scholar 

  7. Grimbergen MCM, van Swol CFP, Jonges TGN, et al.: Reduced specificity of 5-ALA induced fluorescence in photodynamic diagnosis of transitional cell carcinoma after previous intravesical therapy. Eur Urol 2003, 44:51–56.

    Article  PubMed  CAS  Google Scholar 

  8. Kamuhabwa AR, Huygens A, Roskams T, et al.: Enhancing the photodynamic effect of hypericin in human bladder transitional cell carcinoma spheroids by the use of the oxygen carrier, perfluorodecalin. Int J Oncol 2006, 28:775–780.

    PubMed  CAS  Google Scholar 

  9. Jichlinski P, Guillou L, Karlsen SJ, et al.: Hexyl aminolevulinate fluorescence cystoscopy: new diagnostic tool for photodiagnosis of superficial bladder cancer-a multicenter study. J Urol 2003, 170:226–229.

    Article  PubMed  Google Scholar 

  10. Schmidbauer J, Witjes F, Schmeller N, et al.: Improved detection of urothelial carcinom a in situ with hexaminolevulinate fluorescence cystoscopy. J Urol 2004, 171:135–138.

    Article  PubMed  Google Scholar 

  11. Cunderlikova B, Wahlqvist R, Berner A, et al.: Detection of urinary bladder cancer with flow cytometry and hexaminolevulinate in urine samples. Cytopathology 2007, 18:87–95.

    Article  PubMed  CAS  Google Scholar 

  12. Jocham D, Witjes F, Wagner S: Improved detection and treatment of bladder cancer using hexaminolevulinate imaging: a prospective, phase III multicenter study. J Urol 2005, 174:862–866.

    Article  PubMed  Google Scholar 

  13. 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, 178:62–67.

    Article  PubMed  Google Scholar 

  14. Fradet Y, Grossman HB, Gomella L, et al.: 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, 178:68–73.

    Article  PubMed  Google Scholar 

  15. Denzinger S, Burger M, Walter B, et al.: Clinically relevant reduction in the risk of recurrence of superficial bladder cancer using 5-aminolevulinic acid-induced fluorescence diagnosis: 8-year results of a prospective randomized study. Urology 2007, 69:675–679.

    Article  PubMed  Google Scholar 

  16. Witjes JA, Moonen PM, van der Heijden AG: Comparison of hexaminolevulinate based flexible and rigid fluorescence cystoscopy with rigid white light cystoscopy in bladder cancer: results of a prospective phase II study. Eur Urol 2005, 47:319–322.

    Article  PubMed  Google Scholar 

  17. Loidl W, Schmidbauer J, Susani M, et al.: Flexible cystoscopy assisted by hexaminolevulinate induced fluorescence: a new approach for bladder cancer detection and surveillance? Eur Urol 2005, 47:323–326.

    Article  PubMed  CAS  Google Scholar 

  18. Zlotta A: Fluorescence cystoscopy: is flexible scope as effective as rigid? Eur Urol 2005, 47:318–319.

    Article  PubMed  Google Scholar 

  19. Burger M, Zaak D, Stief CG et al.: Photodynamic diagnostics and noninvasive bladder cancer: Is it cost-effective in long-term application? Eur Urol 2007, 52:142–147.

    Article  PubMed  Google Scholar 

  20. Hungerhuber E, Stepp H, Kriegmair M, et al.: Seven years experience with 5-aminolevulinic acid in detection of transitional cell carcinoma of the bladder. Urology 2007, 69:260–264.

    Article  PubMed  Google Scholar 

  21. Hendricksen K, Moonen PM, der Heijden AG, et al.: False-positive lesions detected by fluorescence cystoscopy: any association with p53 and p16 expression? World J Urol 2006, 24:597–601.

    Article  PubMed  CAS  Google Scholar 

  22. Riedl CR, Daniltchenko D, Koenig F, et al.: Fluorescence endoscopy with 5-aminolevulinic acid reduces early recurrence rate in superficial bladder cancer. J Urol 2001, 165:1121–1123.

    Article  PubMed  CAS  Google Scholar 

  23. Kriegmair M, Zaak D, Rothenberger KH, et al.: Transurethral resection for bladder cancer using 5-aminolevulinic acid induced fluorescence endoscopy versus white light endoscopy. J Urol 2002, 168:475–478.

    Article  PubMed  Google Scholar 

  24. Filbeck T, Pichlmeier U, Knuechel R, et al.: Do patients profit from 5-aminolevulinic acid-induced fluorescence diagnosis in transurethral resection of bladder carcinoma? Urology 2002, 60:1025–1028.

    Article  PubMed  CAS  Google Scholar 

  25. Babju M, Soukup V, Petrik R, et al.: 5-aminolaevulinic acid-induced fluorescence cystoscopy during transurethral resection reduces the risk of recurrence in stage Ta/T1 bladder cancer. BJU Int 2005, 96:798–802.

    Article  Google Scholar 

  26. Daniltchenko DI, Riedl CR, Sachs MD, et al.: 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, 174:2129–2133.

    Article  PubMed  CAS  Google Scholar 

  27. Filbeck T, Pichlmeier U, Knuechel R, et al.: Clinically relevant improvement of recurrence-free survival with 5-aminolevulinic acid induced fluorescence diagnosis in patients with superficial bladder tumors. J Urol 2002, 168:67–71.

    Article  PubMed  Google Scholar 

  28. Denzinger S, Stief CG, Zaak D, et al.: Does photodynamic TURB improve outcome of initial T1 high grade bladder cancer? Long term follow-up of a randomized study. BJU Int 2007, In press.

  29. Lotan Y, Svatek RS, Sagalowsky AI: Should we screen for bladder cancer in a high-risk population? A cost per lifeyear saved analysis. Cancer 2006, 107:982–990.

    Article  PubMed  Google Scholar 

  30. Hedelin H, Holmang S, Wiman L: The cost of bladder tumour treatment and follow-up. Scand J Urol Nephrol 2002, 36:344–347.

    Article  PubMed  Google Scholar 

  31. Filbeck T, Roessler W, Knuechel R, et al.: 5-aminolevulinic acid-induced fluorescence endoscopy applied at secondary transurethral resection after conventional resection of primary superficial bladder tumors. Urology 1999, 53:77–81.

    Article  PubMed  CAS  Google Scholar 

  32. van der Meijden AP, Sylvester R, Oosterlinck W, et al.: EAU guidelines on the diagnosis and treatment of urothelial carcinoma in situ. Eur Urol 2005, 48:363–371.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, University of Regensburg, Landshuterstr, 65 93053, Regensburg, Germany

    Stefan Denzinger

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  1. Stefan Denzinger
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  2. Maximilian Burger
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Correspondence to Stefan Denzinger.

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Denzinger, S., Burger, M. Photodynamic diagnostics of bladder tumors. Curr Urol Rep 9, 101–105 (2008). https://doi.org/10.1007/s11934-008-0020-5

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  • DOI: https://doi.org/10.1007/s11934-008-0020-5

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