Reducing understaging of bladder cancer with the aid of photodynamic
Background: The authors evaluated the role of photodynamic cystoscopy in the detection of additional urothelial lesions, mainly carcinoma in situ, that would not be detected solely with white light cystoscopy, leading to disease understaging. Methods: From 2009 to 2011, 70 patients underwent white l...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2016-06-01
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| Series: | Journal of the Egyptian National Cancer Institute |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S111003621630005X |
| _version_ | 1819226699515035648 |
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| author | K. Sfetsas D. Mitropoulos |
| author_facet | K. Sfetsas D. Mitropoulos |
| author_sort | K. Sfetsas |
| collection | DOAJ |
| description | Background: The authors evaluated the role of photodynamic cystoscopy in the detection of additional urothelial lesions, mainly carcinoma in situ, that would not be detected solely with white light cystoscopy, leading to disease understaging.
Methods: From 2009 to 2011, 70 patients underwent white light cystoscopy, followed by photodynamic cystoscopy (blue light system, Karl Storz, Tuttlingen, Germany). Preoperatively they were instilled intravesically with 50 ml of Hexvix (Hexaminolevulinate hexylester). We recorded all lesions found with white light cystoscopy and the additional lesions revealed by blue light cystoscopy. Afterward all lesions were removed and sent for pathologic evaluation.
Results: Seventeen patients (24.3%) had primary tumors while 53 patients (75.7%) had recurrent disease. In 53 out of 70 patients (75.7%) white light cystoscopy revealed urothelial lesions. In the rest 17 patients who had no findings with white light cystoscopy, blue light cystoscopy revealed 7 cases of Cis (41.2%) and 8 cases of dysplasia (47%). In the group of patients with visible lesions in white light cystoscopy photodynamic cystoscopy revealed additional carcinoma in situ in 22 patients. Altogether additional carcinoma in situ cases found with the aid of photodynamic cystoscopy were 29 out of 70 cases (41.4%).
Conclusions: Photodynamic cystoscopy is the most efficient diagnostic procedure for flat urothelial lesions and especially for carcinoma in situ. It is significantly more sensitive than conventional white light cystoscopy in Cis diagnosis, thus reducing understaging of the disease and consequently improving recurrence and progression rates. |
| first_indexed | 2024-12-23T10:29:39Z |
| format | Article |
| id | doaj.art-d03b2f7bd22f455c86e59d0b02b7c2ac |
| institution | Directory Open Access Journal |
| issn | 1110-0362 |
| language | English |
| last_indexed | 2024-12-23T10:29:39Z |
| publishDate | 2016-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of the Egyptian National Cancer Institute |
| spelling | doaj.art-d03b2f7bd22f455c86e59d0b02b7c2ac2022-12-21T17:50:28ZengSpringerOpenJournal of the Egyptian National Cancer Institute1110-03622016-06-01282899410.1016/j.jnci.2016.03.002Reducing understaging of bladder cancer with the aid of photodynamicK. Sfetsas0D. Mitropoulos1401 General Military Hospital of Athens, Department of Urology, Mesogion Avenue 138, Athens 11525, GreeceLaiko Hospital of Athens, Department of Urology, Agiou Thoma 17, Athens 11527, GreeceBackground: The authors evaluated the role of photodynamic cystoscopy in the detection of additional urothelial lesions, mainly carcinoma in situ, that would not be detected solely with white light cystoscopy, leading to disease understaging. Methods: From 2009 to 2011, 70 patients underwent white light cystoscopy, followed by photodynamic cystoscopy (blue light system, Karl Storz, Tuttlingen, Germany). Preoperatively they were instilled intravesically with 50 ml of Hexvix (Hexaminolevulinate hexylester). We recorded all lesions found with white light cystoscopy and the additional lesions revealed by blue light cystoscopy. Afterward all lesions were removed and sent for pathologic evaluation. Results: Seventeen patients (24.3%) had primary tumors while 53 patients (75.7%) had recurrent disease. In 53 out of 70 patients (75.7%) white light cystoscopy revealed urothelial lesions. In the rest 17 patients who had no findings with white light cystoscopy, blue light cystoscopy revealed 7 cases of Cis (41.2%) and 8 cases of dysplasia (47%). In the group of patients with visible lesions in white light cystoscopy photodynamic cystoscopy revealed additional carcinoma in situ in 22 patients. Altogether additional carcinoma in situ cases found with the aid of photodynamic cystoscopy were 29 out of 70 cases (41.4%). Conclusions: Photodynamic cystoscopy is the most efficient diagnostic procedure for flat urothelial lesions and especially for carcinoma in situ. It is significantly more sensitive than conventional white light cystoscopy in Cis diagnosis, thus reducing understaging of the disease and consequently improving recurrence and progression rates.http://www.sciencedirect.com/science/article/pii/S111003621630005XBladderCancerPhotodynamicCystoscopy |
| spellingShingle | K. Sfetsas D. Mitropoulos Reducing understaging of bladder cancer with the aid of photodynamic Journal of the Egyptian National Cancer Institute Bladder Cancer Photodynamic Cystoscopy |
| title | Reducing understaging of bladder cancer with the aid of photodynamic |
| title_full | Reducing understaging of bladder cancer with the aid of photodynamic |
| title_fullStr | Reducing understaging of bladder cancer with the aid of photodynamic |
| title_full_unstemmed | Reducing understaging of bladder cancer with the aid of photodynamic |
| title_short | Reducing understaging of bladder cancer with the aid of photodynamic |
| title_sort | reducing understaging of bladder cancer with the aid of photodynamic |
| topic | Bladder Cancer Photodynamic Cystoscopy |
| url | http://www.sciencedirect.com/science/article/pii/S111003621630005X |
| work_keys_str_mv | AT ksfetsas reducingunderstagingofbladdercancerwiththeaidofphotodynamic AT dmitropoulos reducingunderstagingofbladdercancerwiththeaidofphotodynamic |