5-aminolaevulinic acid-induced fluorescence cystoscopy during transurethral resection reduces the risk of recurrence in stage Ta/T1 bladder cancer

被引:104
作者
Babjuk, M [1 ]
Soukup, V [1 ]
Petrík, R [1 ]
Jirsa, M [1 ]
Dvorácek, J [1 ]
机构
[1] Charles Univ Prague, Fac Med 1, Gen Teaching Hosp, Dept Urol,Postgrad Inst, Prague, Czech Republic
关键词
Ta/T1 bladder cancer; recurrence-free interval; fluorescence cystoscopy; 5-aminolaevulinic acid; transurethral resection;
D O I
10.1111/j.1464-410X.2004.05715.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE To assess the influence of 5-aminolaevulinic acid-induced fluorescence cystoscopy (FC) during transurethral resection (TUR) on the recurrence rate and the length of tumour-free interval in stage Ta/T1 transitional cell carcinoma (TCC) of the urinary bladder. PATIENTS AND METHODS In all, 122 patients with primary or recurrent stage Ta/T1 bladder TCC treated with TUR were enrolled in a prospective randomized study. In group A the TUR was performed with standard white-light endoscopy, and in group B with FC. The patients were followed using standard cystoscopyand urinary cytology. The recurrence-free interval was evaluated in whole groups, for single and multiple, and for primary and recurrent tumours separately. RESULTS At the time of the first cystoscopy (10-15 weeks after TUR) tumour recurrence was detected in 23 of 62 patients (37%) in group A, but only in five of 60 patients (8%) in group B. The recurrence-free survival rates in group A were 39% and 28% after 12 and 24 months, compared to 66% and 40% respectively in group B (P=0.008, log-rank test). In separate analyses, the recurrence-free survival rates were significantly higher using FC in multiple (P= 0.001) and in recurrent (P= 0.02) tumours. In solitary and primary tumours the median time to recurrence was also longer in group B, but the difference was not statistically significant. CONCLUSION 5-aminolaevulinic acid-induced FC during TUR reduces the recurrence rate in stage Ta/T1 bladder TCC. The most significant benefit is in patients with multiple and recurrent tumours.
引用
收藏
页码:798 / 802
页数:5
相关论文
共 16 条
[1]   Second resection and prognosis of primary high risk superficial bladder cancer: Is cystectomy often too early? [J].
Brauers, A ;
Buettner, R ;
Jakse, G .
JOURNAL OF UROLOGY, 2001, 165 (03) :808-810
[2]   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 [J].
Brausi, M ;
Collette, L ;
Kurth, K ;
van der Meijden, AP ;
Oosterlinck, W ;
Witjes, JA ;
Newling, D ;
Bouffioux, C ;
Sylvester, RJ .
EUROPEAN UROLOGY, 2002, 41 (05) :523-530
[3]   Clinically relevant improvement of recurrence-free survival with 5-aminolevulinic acid induced fluorescence diagnosis in patients with superficial bladder tumors [J].
Filbeck, T ;
Pichlmeier, U ;
Knuechel, R ;
Wieland, WF ;
Roessler, W .
JOURNAL OF UROLOGY, 2002, 168 (01) :67-71
[4]   Effect of routine repeat transurethral resection for superficial bladder cancer:: A long-term observational study [J].
Grimm, MO ;
Steinhoff, C ;
Simon, X ;
Spiegelhalder, P ;
Ackermann, R ;
Vögeli, TA .
JOURNAL OF UROLOGY, 2003, 170 (02) :433-437
[5]   A second-look TUR in T1 transitional cell carcinoma:: Why? [J].
Jakse, G ;
Algaba, F ;
Malmström, PU ;
Oosterlinck, W .
EUROPEAN UROLOGY, 2004, 45 (05) :539-546
[6]   Diagnosis of bladder carcinoma using protoporphyrin IX fluorescence induced by 5-aminolaevulinic acid [J].
Koenig, F ;
McGovern, FJ ;
Larne, R ;
Enquist, H ;
Schomacker, KT ;
Deutsch, TF .
BJU INTERNATIONAL, 1999, 83 (01) :129-135
[7]   THE VALUE OF SECONDARY TRANSURETHRAL RESECTION FOR SUPERFICIAL BLADDER-TUMORS [J].
KOHRMANN, KU ;
WOESTE, M ;
KAPPES, J ;
RASSWEILER, J ;
ALKEN, P .
AKTUELLE UROLOGIE, 1994, 25 (04) :208-213
[8]   Transurethral resection for bladder cancer using 5-aminolevulinic acid induced fluorescence endoscopy versus white light endoscopy [J].
Kriegmair, M ;
Zaak, D ;
Rothenberger, KH ;
Rassweiler, J ;
Jocham, D ;
Eisenberger, F ;
Tauber, R ;
Stenzl, A ;
Hofstetter, A .
JOURNAL OF UROLOGY, 2002, 168 (02) :475-478
[9]   FLUORESCENCE PHOTODETECTION OF NEOPLASTIC UROTHELIAL LESIONS FOLLOWING INTRAVESICAL INSTILLATION OF 5-AMINOLEVULINIC ACID [J].
KRIEGMAIR, M ;
EHSAN, A ;
BAUMGARTNER, R ;
LUMPER, W ;
KNUECHEL, R ;
HOFSTADTER, F ;
STEINBACH, P ;
HOFSTETTER, A .
UROLOGY, 1994, 44 (06) :836-841
[10]   Detection of early bladder cancer by 5-aminolevulinic acid induced porphyrin fluorescence [J].
Kriegmair, M ;
Baumgartner, R ;
Knuchel, R ;
Stepp, H ;
Hofstadter, F ;
Hostetter, A .
JOURNAL OF UROLOGY, 1996, 155 (01) :105-109