Hexaminolevulinate hydrochloride in the detection of nonmuscle invasive cancer of the bladder
Clinical trials have shown that hexaminolevulinate (HAL) fluorescence cystoscopy improves the detection of bladder tumors compared with standard white-light cystoscopy, resulting in more efficacious treatment. However, some recent meta-analyses report controversially on recurrence-free rates with th...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2015-12-01
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| Series: | Therapeutic Advances in Urology |
| Online Access: | https://doi.org/10.1177/1756287215603274 |
| _version_ | 1828813627302346752 |
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| author | Savino M. Di Stasi Francesco De Carlo Vincenzo Pagliarulo Francesco Masedu Cristian Verri Francesco Celestino Claus Riedl |
| author_facet | Savino M. Di Stasi Francesco De Carlo Vincenzo Pagliarulo Francesco Masedu Cristian Verri Francesco Celestino Claus Riedl |
| author_sort | Savino M. Di Stasi |
| collection | DOAJ |
| description | Clinical trials have shown that hexaminolevulinate (HAL) fluorescence cystoscopy improves the detection of bladder tumors compared with standard white-light cystoscopy, resulting in more efficacious treatment. However, some recent meta-analyses report controversially on recurrence-free rates with this procedure. A systematic review of literature was performed from December 2014 to January 2015 using the PubMed, Embase and Cochrane databases for controlled trials on photodynamic diagnosis (PDD) with HAL. A total of 154 publications were found up to January 2015. Three of the authors separately reviewed the records to evaluate eligibility and methodological quality of clinical trials. A total of 16 publications were considered eligible for analysis. HAL–PDD-guided cystoscopy increased overall tumor detection rate (proportion difference 19%, 95% confidence interval [CI] 0.152–0.236) although the benefit was particularly significant in patients with carcinoma in situ (CIS) lesion (proportion difference 15.7%, 95% CI 0.069–0.245) and was reduced in papillary lesions (Ta proportion difference 5.9%, 95% CI 0.014–0.103 and T1 proportion difference 1.2%, 95% CI 0.033–0.057). Moreover, there were 15% of patients (95% CI 0.098–0.211) with at least one additional tumor seen with PDD. With regard to recurrence rates, the data sample was insufficient for a statistical analysis, although the evaluation of raw data showed a trend in favor of HAL–PDD. This meta-analysis confirms the increased tumor detection rate by HAL–PDD with a most pronounced benefit for CIS lesion. |
| first_indexed | 2024-12-12T10:04:11Z |
| format | Article |
| id | doaj.art-4fe4431802244eee9720573782f82613 |
| institution | Directory Open Access Journal |
| issn | 1756-2872 1756-2880 |
| language | English |
| last_indexed | 2024-12-12T10:04:11Z |
| publishDate | 2015-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Urology |
| spelling | doaj.art-4fe4431802244eee9720573782f826132022-12-22T00:27:55ZengSAGE PublishingTherapeutic Advances in Urology1756-28721756-28802015-12-01710.1177/1756287215603274Hexaminolevulinate hydrochloride in the detection of nonmuscle invasive cancer of the bladderSavino M. Di StasiFrancesco De CarloVincenzo PagliaruloFrancesco MaseduCristian VerriFrancesco CelestinoClaus RiedlClinical trials have shown that hexaminolevulinate (HAL) fluorescence cystoscopy improves the detection of bladder tumors compared with standard white-light cystoscopy, resulting in more efficacious treatment. However, some recent meta-analyses report controversially on recurrence-free rates with this procedure. A systematic review of literature was performed from December 2014 to January 2015 using the PubMed, Embase and Cochrane databases for controlled trials on photodynamic diagnosis (PDD) with HAL. A total of 154 publications were found up to January 2015. Three of the authors separately reviewed the records to evaluate eligibility and methodological quality of clinical trials. A total of 16 publications were considered eligible for analysis. HAL–PDD-guided cystoscopy increased overall tumor detection rate (proportion difference 19%, 95% confidence interval [CI] 0.152–0.236) although the benefit was particularly significant in patients with carcinoma in situ (CIS) lesion (proportion difference 15.7%, 95% CI 0.069–0.245) and was reduced in papillary lesions (Ta proportion difference 5.9%, 95% CI 0.014–0.103 and T1 proportion difference 1.2%, 95% CI 0.033–0.057). Moreover, there were 15% of patients (95% CI 0.098–0.211) with at least one additional tumor seen with PDD. With regard to recurrence rates, the data sample was insufficient for a statistical analysis, although the evaluation of raw data showed a trend in favor of HAL–PDD. This meta-analysis confirms the increased tumor detection rate by HAL–PDD with a most pronounced benefit for CIS lesion.https://doi.org/10.1177/1756287215603274 |
| spellingShingle | Savino M. Di Stasi Francesco De Carlo Vincenzo Pagliarulo Francesco Masedu Cristian Verri Francesco Celestino Claus Riedl Hexaminolevulinate hydrochloride in the detection of nonmuscle invasive cancer of the bladder Therapeutic Advances in Urology |
| title | Hexaminolevulinate hydrochloride in the detection of nonmuscle invasive cancer of the bladder |
| title_full | Hexaminolevulinate hydrochloride in the detection of nonmuscle invasive cancer of the bladder |
| title_fullStr | Hexaminolevulinate hydrochloride in the detection of nonmuscle invasive cancer of the bladder |
| title_full_unstemmed | Hexaminolevulinate hydrochloride in the detection of nonmuscle invasive cancer of the bladder |
| title_short | Hexaminolevulinate hydrochloride in the detection of nonmuscle invasive cancer of the bladder |
| title_sort | hexaminolevulinate hydrochloride in the detection of nonmuscle invasive cancer of the bladder |
| url | https://doi.org/10.1177/1756287215603274 |
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