Photodynamic Diagnosis-Assisted Transurethral Resection Using Oral 5-Aminolevulinic Acid Decreases the Risk of Repeated Recurrence in Non-Muscle-Invasive Bladder Cancer: A Cumulative Incidence Analysis by the Person-Time Method
Clinical evidence regarding risk reduction of repeated bladder recurrence after initial photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT) is still limited in patients with non-muscle-invasive bladder cancer (NMIBC). We analyzed patients with primary NMIBC undergo...
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| Format: | Article |
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MDPI AG
2021-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/2/185 |
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| author | Makito Miyake Nobutaka Nishimura Yasushi Nakai Tomomi Fujii Takuya Owari Shunta Hori Yosuke Morizawa Daisuke Gotoh Satoshi Anai Kazumasa Torimoto Nobumichi Tanaka Yoshihiko Hirao Kiyohide Fujimoto |
| author_facet | Makito Miyake Nobutaka Nishimura Yasushi Nakai Tomomi Fujii Takuya Owari Shunta Hori Yosuke Morizawa Daisuke Gotoh Satoshi Anai Kazumasa Torimoto Nobumichi Tanaka Yoshihiko Hirao Kiyohide Fujimoto |
| author_sort | Makito Miyake |
| collection | DOAJ |
| description | Clinical evidence regarding risk reduction of repeated bladder recurrence after initial photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT) is still limited in patients with non-muscle-invasive bladder cancer (NMIBC). We analyzed patients with primary NMIBC undergoing TURBT without any adjuvant treatment to compare the risk of cumulative recurrence between the conventional white-light (WL)-TURBT and PDD-TURBT. Out of 430 patients diagnosed with primary NMIBC from 2010 to 2019, 40 undergoing WL-TURBT and 60 undergoing PDD-TURBT were eligible. Multivariate Cox regression analysis for time to the first recurrence demonstrated that PDD assistance was an independent prognostic factor with better outcome (<i>p</i> = 0.038, hazard ratio = 0.39, and 95% confidence interval 0.16–0.95). While no patient experienced more than one recurrence within 1000 postoperative days in the PDD-TURBT group, five out of 40 patients treated by WL-TURBT experienced repeated recurrence. The comparison of cumulative incidence per 10,000 person-days between the two groups revealed that PDD assistance decreased by 6.6 recurrences per 10,000 person-days (exact <i>p</i> = 0.011; incidence rate ratio 0.37, Clopper–Pearson confidence interval 0.15–0.82). This is the first study addressing PDD assistance-induced risk reduction of repeated bladder recurrence using the person-time method. Our findings could support clinical decision making, especially on adjuvant therapy after TURBT. |
| first_indexed | 2024-03-09T03:27:32Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T03:27:32Z |
| publishDate | 2021-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-930ca7fbd14b4f26aca341a41fb59f4c2023-12-03T15:00:56ZengMDPI AGDiagnostics2075-44182021-01-0111218510.3390/diagnostics11020185Photodynamic Diagnosis-Assisted Transurethral Resection Using Oral 5-Aminolevulinic Acid Decreases the Risk of Repeated Recurrence in Non-Muscle-Invasive Bladder Cancer: A Cumulative Incidence Analysis by the Person-Time MethodMakito Miyake0Nobutaka Nishimura1Yasushi Nakai2Tomomi Fujii3Takuya Owari4Shunta Hori5Yosuke Morizawa6Daisuke Gotoh7Satoshi Anai8Kazumasa Torimoto9Nobumichi Tanaka10Yoshihiko Hirao11Kiyohide Fujimoto12Department of Urology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Diagnostic Pathology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Prostate Brachytherapy Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Urology, Osaka Gyoumeikan Hospital, Konohana-ku, Osaka 554-0012, JapanDepartment of Urology, Nara Medical University, Kashihara, Nara 634-8522, JapanClinical evidence regarding risk reduction of repeated bladder recurrence after initial photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT) is still limited in patients with non-muscle-invasive bladder cancer (NMIBC). We analyzed patients with primary NMIBC undergoing TURBT without any adjuvant treatment to compare the risk of cumulative recurrence between the conventional white-light (WL)-TURBT and PDD-TURBT. Out of 430 patients diagnosed with primary NMIBC from 2010 to 2019, 40 undergoing WL-TURBT and 60 undergoing PDD-TURBT were eligible. Multivariate Cox regression analysis for time to the first recurrence demonstrated that PDD assistance was an independent prognostic factor with better outcome (<i>p</i> = 0.038, hazard ratio = 0.39, and 95% confidence interval 0.16–0.95). While no patient experienced more than one recurrence within 1000 postoperative days in the PDD-TURBT group, five out of 40 patients treated by WL-TURBT experienced repeated recurrence. The comparison of cumulative incidence per 10,000 person-days between the two groups revealed that PDD assistance decreased by 6.6 recurrences per 10,000 person-days (exact <i>p</i> = 0.011; incidence rate ratio 0.37, Clopper–Pearson confidence interval 0.15–0.82). This is the first study addressing PDD assistance-induced risk reduction of repeated bladder recurrence using the person-time method. Our findings could support clinical decision making, especially on adjuvant therapy after TURBT.https://www.mdpi.com/2075-4418/11/2/185bladder cancerurothelial carcinomatransurethral resectionfluorescencephotodynamic diagnosis5-aminolevulinic acid |
| spellingShingle | Makito Miyake Nobutaka Nishimura Yasushi Nakai Tomomi Fujii Takuya Owari Shunta Hori Yosuke Morizawa Daisuke Gotoh Satoshi Anai Kazumasa Torimoto Nobumichi Tanaka Yoshihiko Hirao Kiyohide Fujimoto Photodynamic Diagnosis-Assisted Transurethral Resection Using Oral 5-Aminolevulinic Acid Decreases the Risk of Repeated Recurrence in Non-Muscle-Invasive Bladder Cancer: A Cumulative Incidence Analysis by the Person-Time Method Diagnostics bladder cancer urothelial carcinoma transurethral resection fluorescence photodynamic diagnosis 5-aminolevulinic acid |
| title | Photodynamic Diagnosis-Assisted Transurethral Resection Using Oral 5-Aminolevulinic Acid Decreases the Risk of Repeated Recurrence in Non-Muscle-Invasive Bladder Cancer: A Cumulative Incidence Analysis by the Person-Time Method |
| title_full | Photodynamic Diagnosis-Assisted Transurethral Resection Using Oral 5-Aminolevulinic Acid Decreases the Risk of Repeated Recurrence in Non-Muscle-Invasive Bladder Cancer: A Cumulative Incidence Analysis by the Person-Time Method |
| title_fullStr | Photodynamic Diagnosis-Assisted Transurethral Resection Using Oral 5-Aminolevulinic Acid Decreases the Risk of Repeated Recurrence in Non-Muscle-Invasive Bladder Cancer: A Cumulative Incidence Analysis by the Person-Time Method |
| title_full_unstemmed | Photodynamic Diagnosis-Assisted Transurethral Resection Using Oral 5-Aminolevulinic Acid Decreases the Risk of Repeated Recurrence in Non-Muscle-Invasive Bladder Cancer: A Cumulative Incidence Analysis by the Person-Time Method |
| title_short | Photodynamic Diagnosis-Assisted Transurethral Resection Using Oral 5-Aminolevulinic Acid Decreases the Risk of Repeated Recurrence in Non-Muscle-Invasive Bladder Cancer: A Cumulative Incidence Analysis by the Person-Time Method |
| title_sort | photodynamic diagnosis assisted transurethral resection using oral 5 aminolevulinic acid decreases the risk of repeated recurrence in non muscle invasive bladder cancer a cumulative incidence analysis by the person time method |
| topic | bladder cancer urothelial carcinoma transurethral resection fluorescence photodynamic diagnosis 5-aminolevulinic acid |
| url | https://www.mdpi.com/2075-4418/11/2/185 |
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