PD30-02 DIAGNOSTIC PERFORMANCE OF FLUORESCENCE CYSTOSCOPY USING ORAL 5-AMINOLEVULINIC ACID IN TRANSURETHRAL RESECTION OF BLADDER TUMOR AFTER BCG TREATMENT

You have accessJournal of UrologyBladder Cancer: Non-invasive II (PD30)1 May 2024PD30-02 DIAGNOSTIC PERFORMANCE OF FLUORESCENCE CYSTOSCOPY USING ORAL 5-AMINOLEVULINIC ACID IN TRANSURETHRAL RESECTION OF BLADDER TUMOR AFTER BCG TREATMENT Yudai Ishikawa, Hajime Tanaka, Bo Fan, Masaki Kobayashi, Motohiro Fujiwara, Yuki Nakamura, Shohei Fukuda, Yuma Waseda, Soichiro Yoshida, and Yasuhisa Fujii Yudai IshikawaYudai Ishikawa , Hajime TanakaHajime Tanaka , Bo FanBo Fan , Masaki KobayashiMasaki Kobayashi , Motohiro FujiwaraMotohiro Fujiwara , Yuki NakamuraYuki Nakamura , Shohei FukudaShohei Fukuda , Yuma WasedaYuma Waseda , Soichiro YoshidaSoichiro Yoshida , and Yasuhisa FujiiYasuhisa Fujii View All Author Informationhttps://doi.org/10.1097/01.JU.0001008848.77629.6f.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Fluorescence cystoscopy (FL) using oral 5-aminolevulinic acid (ALA) is generally acknowledged to have improved detection of bladder cancer; however, its diagnostic accuracy in transurethral resection of bladder tumor (TURBT) after BCG treatment has not been sufficiently evaluated. We examined the diagnostic accuracy of FL using oral ALA in TURBT after BCG treatment in comparison to the white-light endoscopy (WL). METHODS: Between 2018 and 2023, 1469 specimens from 302 patients with non-muscle-invasive bladder cancer who underwent TURBT with FL using oral ALA were analyzed. The sensitivity and specificity for the diagnosis of urothelial carcinoma (UC) were compared between WL and FL in patients with and without prior BCG treatment. The diagnostic performance of WL and FL were further evaluated according to the time from the last BCG instillation to TURBT. RESULTS: The median age was 73 years, and 250 patients (83%) were male. Overall, 63 patients had a prior history of BCG treatment; among them, the median time from the last BCG intravesical injection was 24 months. Among 1469 lesions resected, 478 lesions were diagnosed as cancer (T1/a/is: n=73/264/141). The sensitivity and specificity by WL/FL were 78/87% and 74/70%, respectively (p<0.01/<0.01) in patients without prior BCG, and 88/87% and 68/62%, respectively (p=0.81/0.03) in those with prior BCG. In the patients with prior BCG treatment, there were no specific trends in sensitivity and specificity by WL or FL according to the time from the last BCG instillation. The sensitivity by WL and FL was 80% or greater at almost all the time points after BCG treatment, and no significant difference was observed in sensitivity between WL and FL at any time points. In the patients with prior BCG treatment, FL contributed to the diagnosis of 8 of 89 cancer lesions (9.0%) and 1 of 42 patients with bladder cancer, that were missed by WL alone. CONCLUSIONS: No superiority of FL over WL was observed in the diagnostic accuracy in patients who had prior BCG treatment regardless of the time elapsed after BCG therapy, although FL contributed to the improvement of cancer detection in a limited number of cases. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e624 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Yudai Ishikawa More articles by this author Hajime Tanaka More articles by this author Bo Fan More articles by this author Masaki Kobayashi More articles by this author Motohiro Fujiwara More articles by this author Yuki Nakamura More articles by this author Shohei Fukuda More articles by this author Yuma Waseda More articles by this author Soichiro Yoshida More articles by this author Yasuhisa Fujii More articles by this author Expand All Advertisement PDF downloadLoading ...