Identification of risk factors associated with oral 5-aminolevulinic acid-induced hypotension in photodynamic diagnosis for non-muscle invasive bladder cancer: a multicenter retrospective study
Abstract Background To investigate risk factors for orally administered 5-aminolevulinic acid (ALA)-induced hypotension for bladder cancer patients receiving photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT). Methods Patients were categorized into two groups intr...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-11-01
|
| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-021-08976-1 |
| _version_ | 1818985521326587904 |
|---|---|
| author | Hideo Fukuhara Takahiro Nohara Koshiro Nishimoto Yutaka Hatakeyama Yuki Hyodo Yoshiyasu Okuhara Masafumi Oyama Atsushi Mizokami Keiji Inoue Hideyasu Matsuyama on behalf of the Japan Urological Photodynamic Society |
| author_facet | Hideo Fukuhara Takahiro Nohara Koshiro Nishimoto Yutaka Hatakeyama Yuki Hyodo Yoshiyasu Okuhara Masafumi Oyama Atsushi Mizokami Keiji Inoue Hideyasu Matsuyama on behalf of the Japan Urological Photodynamic Society |
| author_sort | Hideo Fukuhara |
| collection | DOAJ |
| description | Abstract Background To investigate risk factors for orally administered 5-aminolevulinic acid (ALA)-induced hypotension for bladder cancer patients receiving photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT). Methods Patients were categorized into two groups intraoperatively: a hypotensive group (minimum systolic blood pressure (SBP) ≤80 mmHg) and a non-hypotensive group (minimum SBP > 80 mmHg). We examined differences between the hypotensive group and non-hypotensive groups to identify clinical risk of ALA-induced hypotension using multivariate logistic regression analysis and decision tree analysis. Results Among 282 cases with ALA-PDD-assisted TURBT from three institutions who were screened, 245 patients were included in the final analysis. In total, 156 patients (63.7%) showed any grade of hypotension during ALA-PDD-assisted TURBT. General anesthesia and spinal anesthesia were induced intraoperatively in 113 patients (46.1%) and 132 patients (53.9%), respectively. Median SBP at baseline (before taking ALA) and at the beginning of anesthesia was 127 mmHg (range, 69–186 mmHg) and 124 mmHg (range, 69–186 mmHg), respectively. Median minimum SBP during ALA-PDD-assisted TURBT was 75 mmHg (range, 43–140 mmHg). Multivariate logistic regression analysis revealed that history of hypertension (odds ratio (OR) 7.568, p < 0.05) and general anesthesia (OR 14.435, p < 0.05) as significantly associated with an increased risk of hypotension incidence. Use of calcium antagonist showed significant negative associations with hypotension (OR 0.183, p < 0.05). Decision tree analysis showed presence of general anesthesia, age ≥ 74 years and American Society of Anesthesiologists physical status (ASA-PS) ≥2 as the most important discriminators. Conclusions General anesthesia and hypertension were independent risk factors related to ALA-induced hypotension. In contrast, use of calcium antagonists was identified as a factor associated with reduced risk of ALA-induced hypotension. |
| first_indexed | 2024-12-20T18:36:13Z |
| format | Article |
| id | doaj.art-b765102c94db4282a59ab0dcca0747cb |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-20T18:36:13Z |
| publishDate | 2021-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-b765102c94db4282a59ab0dcca0747cb2022-12-21T19:29:56ZengBMCBMC Cancer1471-24072021-11-012111810.1186/s12885-021-08976-1Identification of risk factors associated with oral 5-aminolevulinic acid-induced hypotension in photodynamic diagnosis for non-muscle invasive bladder cancer: a multicenter retrospective studyHideo Fukuhara0Takahiro Nohara1Koshiro Nishimoto2Yutaka Hatakeyama3Yuki Hyodo4Yoshiyasu Okuhara5Masafumi Oyama6Atsushi Mizokami7Keiji Inoue8Hideyasu Matsuyama9on behalf of the Japan Urological Photodynamic SocietyDepartment of Urology and Center for Photodynamic Medicine, Kochi Medical SchoolDepartment of Integrative Cancer Therapy and Urology, Kanazawa UniversityDepartment of Urology, Saitama Medical University International MedicalCenter of Medical Information Science, Kochi Medical SchoolCenter of Medical Information Science, Kochi Medical SchoolCenter of Medical Information Science, Kochi Medical SchoolDepartment of Urology, Saitama Medical University International MedicalDepartment of Integrative Cancer Therapy and Urology, Kanazawa UniversityDepartment of Urology and Center for Photodynamic Medicine, Kochi Medical SchoolDepartment of Urology, Graduate School of Medicine, Yamaguchi UniversityAbstract Background To investigate risk factors for orally administered 5-aminolevulinic acid (ALA)-induced hypotension for bladder cancer patients receiving photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT). Methods Patients were categorized into two groups intraoperatively: a hypotensive group (minimum systolic blood pressure (SBP) ≤80 mmHg) and a non-hypotensive group (minimum SBP > 80 mmHg). We examined differences between the hypotensive group and non-hypotensive groups to identify clinical risk of ALA-induced hypotension using multivariate logistic regression analysis and decision tree analysis. Results Among 282 cases with ALA-PDD-assisted TURBT from three institutions who were screened, 245 patients were included in the final analysis. In total, 156 patients (63.7%) showed any grade of hypotension during ALA-PDD-assisted TURBT. General anesthesia and spinal anesthesia were induced intraoperatively in 113 patients (46.1%) and 132 patients (53.9%), respectively. Median SBP at baseline (before taking ALA) and at the beginning of anesthesia was 127 mmHg (range, 69–186 mmHg) and 124 mmHg (range, 69–186 mmHg), respectively. Median minimum SBP during ALA-PDD-assisted TURBT was 75 mmHg (range, 43–140 mmHg). Multivariate logistic regression analysis revealed that history of hypertension (odds ratio (OR) 7.568, p < 0.05) and general anesthesia (OR 14.435, p < 0.05) as significantly associated with an increased risk of hypotension incidence. Use of calcium antagonist showed significant negative associations with hypotension (OR 0.183, p < 0.05). Decision tree analysis showed presence of general anesthesia, age ≥ 74 years and American Society of Anesthesiologists physical status (ASA-PS) ≥2 as the most important discriminators. Conclusions General anesthesia and hypertension were independent risk factors related to ALA-induced hypotension. In contrast, use of calcium antagonists was identified as a factor associated with reduced risk of ALA-induced hypotension.https://doi.org/10.1186/s12885-021-08976-15-aminolevulinic acidPhotodynamic diagnosisHypotensionNon-muscle invasive bladder cancerTransurethral resection of bladder tumor |
| spellingShingle | Hideo Fukuhara Takahiro Nohara Koshiro Nishimoto Yutaka Hatakeyama Yuki Hyodo Yoshiyasu Okuhara Masafumi Oyama Atsushi Mizokami Keiji Inoue Hideyasu Matsuyama on behalf of the Japan Urological Photodynamic Society Identification of risk factors associated with oral 5-aminolevulinic acid-induced hypotension in photodynamic diagnosis for non-muscle invasive bladder cancer: a multicenter retrospective study BMC Cancer 5-aminolevulinic acid Photodynamic diagnosis Hypotension Non-muscle invasive bladder cancer Transurethral resection of bladder tumor |
| title | Identification of risk factors associated with oral 5-aminolevulinic acid-induced hypotension in photodynamic diagnosis for non-muscle invasive bladder cancer: a multicenter retrospective study |
| title_full | Identification of risk factors associated with oral 5-aminolevulinic acid-induced hypotension in photodynamic diagnosis for non-muscle invasive bladder cancer: a multicenter retrospective study |
| title_fullStr | Identification of risk factors associated with oral 5-aminolevulinic acid-induced hypotension in photodynamic diagnosis for non-muscle invasive bladder cancer: a multicenter retrospective study |
| title_full_unstemmed | Identification of risk factors associated with oral 5-aminolevulinic acid-induced hypotension in photodynamic diagnosis for non-muscle invasive bladder cancer: a multicenter retrospective study |
| title_short | Identification of risk factors associated with oral 5-aminolevulinic acid-induced hypotension in photodynamic diagnosis for non-muscle invasive bladder cancer: a multicenter retrospective study |
| title_sort | identification of risk factors associated with oral 5 aminolevulinic acid induced hypotension in photodynamic diagnosis for non muscle invasive bladder cancer a multicenter retrospective study |
| topic | 5-aminolevulinic acid Photodynamic diagnosis Hypotension Non-muscle invasive bladder cancer Transurethral resection of bladder tumor |
| url | https://doi.org/10.1186/s12885-021-08976-1 |
| work_keys_str_mv | AT hideofukuhara identificationofriskfactorsassociatedwithoral5aminolevulinicacidinducedhypotensioninphotodynamicdiagnosisfornonmuscleinvasivebladdercanceramulticenterretrospectivestudy AT takahironohara identificationofriskfactorsassociatedwithoral5aminolevulinicacidinducedhypotensioninphotodynamicdiagnosisfornonmuscleinvasivebladdercanceramulticenterretrospectivestudy AT koshironishimoto identificationofriskfactorsassociatedwithoral5aminolevulinicacidinducedhypotensioninphotodynamicdiagnosisfornonmuscleinvasivebladdercanceramulticenterretrospectivestudy AT yutakahatakeyama identificationofriskfactorsassociatedwithoral5aminolevulinicacidinducedhypotensioninphotodynamicdiagnosisfornonmuscleinvasivebladdercanceramulticenterretrospectivestudy AT yukihyodo identificationofriskfactorsassociatedwithoral5aminolevulinicacidinducedhypotensioninphotodynamicdiagnosisfornonmuscleinvasivebladdercanceramulticenterretrospectivestudy AT yoshiyasuokuhara identificationofriskfactorsassociatedwithoral5aminolevulinicacidinducedhypotensioninphotodynamicdiagnosisfornonmuscleinvasivebladdercanceramulticenterretrospectivestudy AT masafumioyama identificationofriskfactorsassociatedwithoral5aminolevulinicacidinducedhypotensioninphotodynamicdiagnosisfornonmuscleinvasivebladdercanceramulticenterretrospectivestudy AT atsushimizokami identificationofriskfactorsassociatedwithoral5aminolevulinicacidinducedhypotensioninphotodynamicdiagnosisfornonmuscleinvasivebladdercanceramulticenterretrospectivestudy AT keijiinoue identificationofriskfactorsassociatedwithoral5aminolevulinicacidinducedhypotensioninphotodynamicdiagnosisfornonmuscleinvasivebladdercanceramulticenterretrospectivestudy AT hideyasumatsuyama identificationofriskfactorsassociatedwithoral5aminolevulinicacidinducedhypotensioninphotodynamicdiagnosisfornonmuscleinvasivebladdercanceramulticenterretrospectivestudy AT onbehalfofthejapanurologicalphotodynamicsociety identificationofriskfactorsassociatedwithoral5aminolevulinicacidinducedhypotensioninphotodynamicdiagnosisfornonmuscleinvasivebladdercanceramulticenterretrospectivestudy |