Feasibility of photodynamic diagnosis for challenging TUR-Bt cases including muscle invasive bladder cancer, BCG failure or 2nd-TUR

Tomoaki Takai, Teruo Inamoto, Kazumasa Komura, Yuki Yoshikawa, Taizo Uchimoto, Kenkichi Saito, Naoki Tanda, Junko Kouno, Koichiro Minami, Hirofumi Uehara, Kiyoshi Takahara, Hajime Hirano, Hayahito Nomi, Satoshi Kiyama, Haruhito Azuma

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Despite widely adopted standard methods for follow-up including cystoscopy plus cytology, recurrence rates of non muscle-invasive bladder cancer (NMIBC) have not improved over the past decades, still ranging from 60% through 70%. Hence, widely acceptable surveillance strategies with excellent sensitivity are needed. Early recurrence has led to the development of a novel cystoscopy technique utilizing photodynamic diagnosis (PDD). Although, no studies have evaluated the efficacy of PDD for patients of MIBC, BCG failure or 2nd-transurethelial resection (TUR). Materials and Methods: The present study was performed from October 2012 through May 2013. IRB approved 25 patients initially underwent a cystoscopy examination of white light and blue light followed by the resection of tumors identified. Resections were performed from bladder mucosa areas considered suspicious at PDD, along with PDD negative normal bladder mucosa area resected by random biopsy. Specimens were divided into two groups, PDD positive and negative. Primary endpoints were sensitivity and specificity. Results: A total of 147 specimens extracted from 25 patients were included in the analysis. Some 45 out of 92 PDD-positive specimens were confirmed to have bladder cancer, and 51 out of PDD-negative 55 specimens were confirmed to be cancer negative. The sensitivity of PDD was 91.8% (45/49) and specificity was 52.0% (51/98). The sensitivity:specificity was 89.5% (17/19): 47.6% (30/63) in 12 2nd-TUR patients, 90.5% (19/21): 61.1% (11/18) in seven MIBC patients, and 95.0% (19/20): 48.5% (16/33) in eight failed BCG cases. Conclusions: PDD-TURBT has high sensitivity to diagnose BC even for 2nd-TUR, MIBC or BCG failure cases.

Original languageEnglish
Pages (from-to)2297-2301
Number of pages5
JournalAsian Pacific Journal of Cancer Prevention
Volume16
Issue number6
DOIs
Publication statusPublished - 01-01-2015
Externally publishedYes

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Mycobacterium bovis
Urinary Bladder Neoplasms
Muscles
Cystoscopy
Mucous Membrane
Urinary Bladder
Light
Recurrence
Sensitivity and Specificity
Research Ethics Committees
Cell Biology
Neoplasms
Biopsy

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Oncology
  • Public Health, Environmental and Occupational Health
  • Cancer Research

Cite this

Takai, Tomoaki ; Inamoto, Teruo ; Komura, Kazumasa ; Yoshikawa, Yuki ; Uchimoto, Taizo ; Saito, Kenkichi ; Tanda, Naoki ; Kouno, Junko ; Minami, Koichiro ; Uehara, Hirofumi ; Takahara, Kiyoshi ; Hirano, Hajime ; Nomi, Hayahito ; Kiyama, Satoshi ; Azuma, Haruhito. / Feasibility of photodynamic diagnosis for challenging TUR-Bt cases including muscle invasive bladder cancer, BCG failure or 2nd-TUR. In: Asian Pacific Journal of Cancer Prevention. 2015 ; Vol. 16, No. 6. pp. 2297-2301.
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title = "Feasibility of photodynamic diagnosis for challenging TUR-Bt cases including muscle invasive bladder cancer, BCG failure or 2nd-TUR",
abstract = "Background: Despite widely adopted standard methods for follow-up including cystoscopy plus cytology, recurrence rates of non muscle-invasive bladder cancer (NMIBC) have not improved over the past decades, still ranging from 60{\%} through 70{\%}. Hence, widely acceptable surveillance strategies with excellent sensitivity are needed. Early recurrence has led to the development of a novel cystoscopy technique utilizing photodynamic diagnosis (PDD). Although, no studies have evaluated the efficacy of PDD for patients of MIBC, BCG failure or 2nd-transurethelial resection (TUR). Materials and Methods: The present study was performed from October 2012 through May 2013. IRB approved 25 patients initially underwent a cystoscopy examination of white light and blue light followed by the resection of tumors identified. Resections were performed from bladder mucosa areas considered suspicious at PDD, along with PDD negative normal bladder mucosa area resected by random biopsy. Specimens were divided into two groups, PDD positive and negative. Primary endpoints were sensitivity and specificity. Results: A total of 147 specimens extracted from 25 patients were included in the analysis. Some 45 out of 92 PDD-positive specimens were confirmed to have bladder cancer, and 51 out of PDD-negative 55 specimens were confirmed to be cancer negative. The sensitivity of PDD was 91.8{\%} (45/49) and specificity was 52.0{\%} (51/98). The sensitivity:specificity was 89.5{\%} (17/19): 47.6{\%} (30/63) in 12 2nd-TUR patients, 90.5{\%} (19/21): 61.1{\%} (11/18) in seven MIBC patients, and 95.0{\%} (19/20): 48.5{\%} (16/33) in eight failed BCG cases. Conclusions: PDD-TURBT has high sensitivity to diagnose BC even for 2nd-TUR, MIBC or BCG failure cases.",
author = "Tomoaki Takai and Teruo Inamoto and Kazumasa Komura and Yuki Yoshikawa and Taizo Uchimoto and Kenkichi Saito and Naoki Tanda and Junko Kouno and Koichiro Minami and Hirofumi Uehara and Kiyoshi Takahara and Hajime Hirano and Hayahito Nomi and Satoshi Kiyama and Haruhito Azuma",
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Takai, T, Inamoto, T, Komura, K, Yoshikawa, Y, Uchimoto, T, Saito, K, Tanda, N, Kouno, J, Minami, K, Uehara, H, Takahara, K, Hirano, H, Nomi, H, Kiyama, S & Azuma, H 2015, 'Feasibility of photodynamic diagnosis for challenging TUR-Bt cases including muscle invasive bladder cancer, BCG failure or 2nd-TUR', Asian Pacific Journal of Cancer Prevention, vol. 16, no. 6, pp. 2297-2301. https://doi.org/10.7314/APJCP.2015.16.6.2297

Feasibility of photodynamic diagnosis for challenging TUR-Bt cases including muscle invasive bladder cancer, BCG failure or 2nd-TUR. / Takai, Tomoaki; Inamoto, Teruo; Komura, Kazumasa; Yoshikawa, Yuki; Uchimoto, Taizo; Saito, Kenkichi; Tanda, Naoki; Kouno, Junko; Minami, Koichiro; Uehara, Hirofumi; Takahara, Kiyoshi; Hirano, Hajime; Nomi, Hayahito; Kiyama, Satoshi; Azuma, Haruhito.

In: Asian Pacific Journal of Cancer Prevention, Vol. 16, No. 6, 01.01.2015, p. 2297-2301.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Feasibility of photodynamic diagnosis for challenging TUR-Bt cases including muscle invasive bladder cancer, BCG failure or 2nd-TUR

AU - Takai, Tomoaki

AU - Inamoto, Teruo

AU - Komura, Kazumasa

AU - Yoshikawa, Yuki

AU - Uchimoto, Taizo

AU - Saito, Kenkichi

AU - Tanda, Naoki

AU - Kouno, Junko

AU - Minami, Koichiro

AU - Uehara, Hirofumi

AU - Takahara, Kiyoshi

AU - Hirano, Hajime

AU - Nomi, Hayahito

AU - Kiyama, Satoshi

AU - Azuma, Haruhito

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background: Despite widely adopted standard methods for follow-up including cystoscopy plus cytology, recurrence rates of non muscle-invasive bladder cancer (NMIBC) have not improved over the past decades, still ranging from 60% through 70%. Hence, widely acceptable surveillance strategies with excellent sensitivity are needed. Early recurrence has led to the development of a novel cystoscopy technique utilizing photodynamic diagnosis (PDD). Although, no studies have evaluated the efficacy of PDD for patients of MIBC, BCG failure or 2nd-transurethelial resection (TUR). Materials and Methods: The present study was performed from October 2012 through May 2013. IRB approved 25 patients initially underwent a cystoscopy examination of white light and blue light followed by the resection of tumors identified. Resections were performed from bladder mucosa areas considered suspicious at PDD, along with PDD negative normal bladder mucosa area resected by random biopsy. Specimens were divided into two groups, PDD positive and negative. Primary endpoints were sensitivity and specificity. Results: A total of 147 specimens extracted from 25 patients were included in the analysis. Some 45 out of 92 PDD-positive specimens were confirmed to have bladder cancer, and 51 out of PDD-negative 55 specimens were confirmed to be cancer negative. The sensitivity of PDD was 91.8% (45/49) and specificity was 52.0% (51/98). The sensitivity:specificity was 89.5% (17/19): 47.6% (30/63) in 12 2nd-TUR patients, 90.5% (19/21): 61.1% (11/18) in seven MIBC patients, and 95.0% (19/20): 48.5% (16/33) in eight failed BCG cases. Conclusions: PDD-TURBT has high sensitivity to diagnose BC even for 2nd-TUR, MIBC or BCG failure cases.

AB - Background: Despite widely adopted standard methods for follow-up including cystoscopy plus cytology, recurrence rates of non muscle-invasive bladder cancer (NMIBC) have not improved over the past decades, still ranging from 60% through 70%. Hence, widely acceptable surveillance strategies with excellent sensitivity are needed. Early recurrence has led to the development of a novel cystoscopy technique utilizing photodynamic diagnosis (PDD). Although, no studies have evaluated the efficacy of PDD for patients of MIBC, BCG failure or 2nd-transurethelial resection (TUR). Materials and Methods: The present study was performed from October 2012 through May 2013. IRB approved 25 patients initially underwent a cystoscopy examination of white light and blue light followed by the resection of tumors identified. Resections were performed from bladder mucosa areas considered suspicious at PDD, along with PDD negative normal bladder mucosa area resected by random biopsy. Specimens were divided into two groups, PDD positive and negative. Primary endpoints were sensitivity and specificity. Results: A total of 147 specimens extracted from 25 patients were included in the analysis. Some 45 out of 92 PDD-positive specimens were confirmed to have bladder cancer, and 51 out of PDD-negative 55 specimens were confirmed to be cancer negative. The sensitivity of PDD was 91.8% (45/49) and specificity was 52.0% (51/98). The sensitivity:specificity was 89.5% (17/19): 47.6% (30/63) in 12 2nd-TUR patients, 90.5% (19/21): 61.1% (11/18) in seven MIBC patients, and 95.0% (19/20): 48.5% (16/33) in eight failed BCG cases. Conclusions: PDD-TURBT has high sensitivity to diagnose BC even for 2nd-TUR, MIBC or BCG failure cases.

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