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Purpose: Diagnostic ureteroscopy (dURS) is optional in the assessment of patients with upper tract urothelial carcinoma (UTUC) and provides the possibility of obtaining histology., Methods: To evaluate endoscopic biopsy techniques and outcomes, we assessed data from patients from the CROES-UTUC registry. The registry includes multicenter prospective collected data on diagnosis and management of patients suspected having UTUC., Results: We assessed 2380 patients from 101 centers. dURS with biopsy was performed in 31.6% of patients. The quality of samples was sufficient for diagnosis in 83.5% of cases. There was no significant association between biopsy techniques and quality (p = 0.458). High-grade biopsy accurately predicted high-grade disease in 95.7% and high-risk stage disease in 86%. In ureteroscopic low-grade tumours, the prediction of subsequent low-grade disease was 66.9% and low-risk stage Ta-disease 35.8%. Ureteroscopic staging correctly predicted non-invasive Ta-disease and ≥ T1 disease in 48.9% and 47.9% of patients, respectively. Cytology outcomes did not provide additional value in predicting tumour grade., Conclusion: Biopsy results adequately predict high-grade and high-risk disease, but approximately one-third of patients are under-staged. Two-thirds of patients with low-grade URS-biopsy have high-risk stage disease, highlighting the need for improved diagnostics to better assess patient risk and guide treatment decisions., Clinical Trial Registration: The study was registered at ClinicalTrials.gov (ClinicalTrials.gov NCT02281188; https://clinicaltrials.gov/ct2/show/NCT02281188 )., (© 2024. The Author(s).)

Background: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial., Objective: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management., Design: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts prior to voting during a consensus conference., Setting: Online Delphi survey and consensus conference., Participants: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management., Outcome Measurements and Statistical Analysis: Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), and 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus)., Results and Limitations: Overall, 116 statements were included in the Delphi survey. Of these statements, 33 (28%) achieved level 1 consensus and 49 (42%) achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease, and the evolving role of checkpoint inhibitor therapy in metastatic disease., Conclusions: These consensus statements provide further guidance on controversial topics in advanced and variant bladder cancer management until a time when further evidence is available to guide our approach., Patient Summary: This report summarises findings from an international, multistakeholder project organised by the EAU and ESMO. In this project, a steering committee identified areas of bladder cancer management where there is currently no good-quality evidence to guide treatment decisions. From this, they developed a series of proposed statements, 71 of which achieved consensus by a large group of experts in the field of bladder cancer. It is anticipated that these statements will provide further guidance to health care professionals and could help improve patient outcomes until a time when good-quality evidence is available., (Copyright © 2019 European Society of Medical Oncology and European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Background: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial., Objective: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management., Design: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts before voting during a consensus conference., Setting: Online Delphi survey and consensus conference., Participants: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management., Outcome Measurements and Statistical Analysis: Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus)., Results and Limitations: Overall, 116 statements were included in the Delphi survey. Of these, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease and the evolving role of checkpoint inhibitor therapy in metastatic disease., Conclusions: These consensus statements provide further guidance on controversial topics in advanced and variant bladder cancer management until a time where further evidence is available to guide our approach., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Current standard methods used to detect and monitor bladder cancer (BC) are invasive or have low sensitivity. This study aimed to develop a urine methylation biomarker classifier for BC monitoring and validate this classifier in patients in follow-up for bladder cancer (PFBC)., Methods: Voided urine samples ( N  = 725) from BC patients, controls, and PFBC were prospectively collected in four centers. Finally, 626 urine samples were available for analysis. DNA was extracted from the urinary cells and bisulfite modificated, and methylation status was analyzed using pyrosequencing. Cytology was available from a subset of patients ( N  = 399). In the discovery phase, seven selected genes from the literature ( CDH13 , CFTR , NID2 , SALL3 , TMEFF2 , TWIST1 , and VIM2 ) were studied in 111 BC and 57 control samples. This training set was used to develop a gene classifier by logistic regression and was validated in 458 PFBC samples (173 with recurrence)., Results: A three-gene methylation classifier containing CFTR , SALL3 , and TWIST1 was developed in the training set (AUC 0.874). The classifier achieved an AUC of 0.741 in the validation series. Cytology results were available for 308 samples from the validation set. Cytology achieved AUC 0.696 whereas the classifier in this subset of patients reached an AUC 0.768. Combining the methylation classifier with cytology results achieved an AUC 0.86 in the validation set, with a sensitivity of 96%, a specificity of 40%, and a positive and negative predictive value of 56 and 92%, respectively., Conclusions: The combination of the three-gene methylation classifier and cytology results has high sensitivity and high negative predictive value in a real clinical scenario (PFBC). The proposed classifier is a useful test for predicting BC recurrence and decrease the number of cystoscopies in the follow-up of BC patients. If only patients with a positive combined classifier result would be cystoscopied, 36% of all cystoscopies can be prevented., Competing Interests: The study was approved by the Institutional Review Boards of the Hospital Clínic of Barcelona (Spain); Radboud University Medical Center in Nijmegen (The Netherlands), St. John Emergency Hospital, Bucharest (Romania); and MD Anderson Cancer Center, Houston, Texas, (USA). Patients’ informed consents were obtained before the sample collection.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Background: A retrospective study was aimed to establish the eventual impact of narrow band imaging (NBI) cystos copy over the short term residual tumors’ rate determined during the first follow-up endoscopic control in newly determined non-muscle invasive bladder cancer (NMIBC) cases., Methods: 68 patients were found with NMIBC by means of both white light cystoscopy (WLC) and NBI. A follow-up using both investigation modalities was performed at 3 months from the initial procedure in 67 cases (one was lost from follow-up). RESULTS concerning the short termer currences were retrospectively compared to those obtain ending a similar series of 67 patients previously diagnosed and treated by means of classical WLC and resection only., Results: The short term residual tumors’ rate established during the first follow-up cystoscopy was lower in the study group initially benefiting from the NBI mode by comparison to the WLC control series (4.5% versus 11.9%). When drawing a parallel with the tumor map location outlined during the initial procedure, the most important differences were emphasized concerning other site recurrences (3%versus 8.95%)., Conclusions: NBI cystoscopy and resection displayed a substantially favorable influence over the short termoncologic outcome in newly diagnosed NMIBC cases when compared to the standard protocol., Abbreviations: NBI â€" narrow band imaging; NMIBC â€"non-muscle invasive bladder cancer; WLC â€" white light cystoscopy; TURBT â€" transurethral resection of bladdertumors; CIS â€" carcinoma in situ., (Celsius.)

Objectives: A single centre, retrospective trial was performed trying to assess the impact of NBI cystoscopy in cases of non-muscle invasive bladder tumors (NMIBT) by comparison to the standard approach. Our goal was to determine the superiority of the new method in terms of detection rates and subsequent postoperative treatment changes., Materials and Methods: A total of 320 NMIBT suspected consecutive cases were enrolled in the study. The inclusion criteria were represented by hematuria, positive urinary cytology and/or ultrasound suspicion of bladder tumors. All patients underwent WLC and NBI cystoscopy. Standard transurethral resection of bladder tumors (TURBT) was performed for all lesions visible in WL and NBI guided resection for solely NBI observed tumors., Results: The overall NMIBT and CIS patients' detection rates were significantly improved for the NBI evaluation ((94.9% versus 88.1% and 95.7% versus 65.2%). Also, on a lesions' related basis, NBI cystoscopy emphasized a significantly superior diagnostic accuracy concerning the CIS, pTa and overall NMIBT formations ((95.2% versus 60.3%, 92.8% versus 83.9% and 94.1% versus 82%). Additional tumors were diagnosed by NBI in a significantly higher proportion of CIS, pTa, pT1 and NMIBT patients (56.6% versus 8.7%, 28% versus 10.3%, 30.3% versus 10.6% and 31.6% versus 9.4%). As a result of these supplementary findings, the postoperative treatment was significantly improved in a substantial proportion of cases (15.4% versus 5.1%)., Conclusions: NBI cystoscopy represents a valuable diagnostic alternative in NMIBT patients, with significant improvement of tumor visual accuracy as well as detection rates. This approach provided a substantial amelioration to the risk category stratification and subsequent bladder cancer therapeutic management.

Objectives: A prospective study was performed aiming to evaluate the surgical efficacy, perioperative safety profile, diagnostic accuracy and medium term results of a multi-modal approach consisting in narrow band imaging (NBI) cystoscopy and bipolar plasma vaporization (BPV) when compared to the standard protocol represented by white light cystoscopy (WLC) and transurethral resection of bladder tumors (TURBT)., Materials & Methods: A total of 260 patients with apparently at least one bladder tumor over 3 cm were included in the trial. In the first group, 130 patients underwent conventional and NBI cystoscopy followed by BPV, while in a similar number of cases of the second arm, classical WLC and TURBT were applied. In all non-muscle invasive bladder tumors' (NMIBT) pathologically confirmed cases, standard monopolar Re-TUR was performed at 4-6 weeks after the initial intervention, followed by one year' BCG immunotherapy. The follow-up protocol included abdominal ultrasound, urinary cytology and WLC, performed every 3 months for a period of 2 years., Results: The obturator nerve stimulation, bladder wall perforation, mean hemoglobin level drop, postoperative bleeding, catheterization period and hospital stay were significantly reduced for the plasma vaporization technique by comparison to conventional resection. Concerning tumoral detection, the present data confirmed the NBI superiority when compared to standard WLC regardless of tumor stage (95.3% vs. 65.1% for CIS, 93.3% vs. 82.2% for pTa, 97.4% vs. 94% for pT1, 95% vs. 84.2% overall). During standard Re-TUR the overall (6.3% versus 17.4%) and primary site (3.6% versus 12.8%) residual tumors' rates were significantly lower for the NBI-BPV group. The 1 (7.2% versus 18.3%) and 2 (11.5% versus 25.8%) years' recurrence rates were substantially lower for the combined approach., Conclusions: NBI cystoscopy significantly improved diagnostic accuracy, while bipolar technology showed a higher surgical efficiency, lower morbidity and faster postoperative recovery. The combined technique offered a reduced rate of residual tumors at Re-TUR, both globally as well as for orthotopic tumors. Substantially lower recurrence rates were found at 1 and 2 years among the NBI-BPV cases.

Introduction: The standard non-muscle invasive bladder cancer (NMIBC) endoscopic diagnosis suffers from the frequently unsatisfactory white light evaluation accuracy leading to residual lesions being left behind. Monopolar transurethral resection of bladder tumors (TURBT) is marked by a substantial morbidity rate requiring further amelioration., Methods: Small size tumors (under 1 cm) are feasible for "en bloc" resection. Bipolar TURBT was defined as being able to challenge the gold-standard status of monopolar resection due to the reduced complication rates. Plasma-button vaporization was introduced as a promising large bladder tumors' ablation modality. Narrow band imaging (NBI) cystoscopy became an increasingly popular method of enhancing tumor detection., Results: The "en bloc" resection of small size or thin pedicle tumors provides the conditions for avoiding tumoral tissue scattering. Bipolar resection is characterized by decreased perioperative bleeding risks and faster patient recovery. Plasma-button vaporization gained confirmation as an innovative approach, able to dispose large tumor bulks under complete control while minimizing the associated morbidity. NBI cystoscopy is a useful tool in identifying CIS lesions, small papillary tumors or extended margins of large tumor formations. As a cost-free technique, it may be extensively used both during the NMIBC initial diagnostic as well as during follow-up evaluation protocol., Conclusions: Having in mind the various modalities of ameliorating the bladder cancer diagnostic and treatment, NMIBC management should be tailored in accordance with the particularities of each case.

Introduction: A correlation between urothelial bladder tumor incidence and exposure to various occupational toxic factors was established for more than a century. The aim of our study was to establish the relationship between these two features., Materials and Methods: We analyzed one hundred consecutive bladder tumor patients treated in "Sf. Ioan" Clinical Emergency Hospital, Department of Urology. These cases were studied concerning their occupation and pathological findings., Results: We identified 58 patients having potential urothelial bladder tumors inducing occupations: dye industry, motor vehicle drivers and miners. Among these patients, the incidence of muscle invasive tumors was of 33%, of the high-grade tumors was of 69%, of the multiple tumors was of 60% and of the associated CIS lesions was of 38%. All these rates were significantly lower in the non-occupational hazard group: 12%, 26%, 29% and 14% respectively., Conclusions: Exposure to occupational toxic factors seems to influence the evolution of urothelial bladder tumor into more aggressive patterns. Further studies in this regard are necessary.

Objective: To evaluate the efficacy of narrow band imaging (NBI) cystoscopy associated with bipolar plasma vaporization (BPV) in cases of large nonmuscle-invasive bladder tumors (NMIBTs) compared with white light cystoscopy (WLC) and monopolar transurethral resection of bladder tumors (TURBTs)., Methods: A total of 220 cases with ≥ 1 bladder tumor >3 cm determined by abdominal ultrasonography, computed tomography, and flexible WLC were included in the present trial. The patients in the first arm underwent WLC and NBI cystoscopy followed by BPV, and the patients in the second arm underwent only WLC and TURBT. The patients with NMIBTs underwent standard repeat TUR at 4 weeks and follow-up urinary cytology and WLC at 3, 6, 9, and 12 months., Results: The carcinoma in situ, Stage pTa, and overall NMIBT detection rates were significantly improved for NBI compared with WLC. BPV provided lower obturator nerve stimulation and bladder wall perforation rates and significantly reduced the mean hemoglobin decrease, catheterization period, and hospital stay compared with TURBT. The repeat TUR overall and primary site residual tumor rates were significantly decreased in the NBI-BPV group (6.3% vs 17.5% and 4.2% vs 13.4%, respectively). The overall and other site 1-year recurrence rates were significantly reduced in the NBI-BPV series (7.9% vs 17.8% and 3.4% vs 12.2%, respectively)., Conclusion: NBI cystoscopy significantly improved the diagnostic accuracy in cases of large NMIBTs, and BPV emphasized superior efficacy and safety compared with TURBT. This combined approach provided a lower residual tumor rate at repeat TUR and a reduced 1-year recurrence rate., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objectives: •  To evaluate in a prospective, randomized study the impact of hexaminolevulinate blue-light cystoscopy (HAL-BLC) on the diagnostic accuracy and treatment changes in cases of non-muscle invasive bladder cancer (NMIBC) compared with standard white-light cystoscopy (WLC). •  To compare the long-term recurrence rates in the two study arms., Patients and Methods: •  In all, 362 patients suspected of NMIBC were included in the trial based on positive urinary cytology and/or ultrasonographic suspicion of bladder tumours and underwent transurethral resection of bladder tumours. •  A single postoperative mytomicin-C instillation was performed in all cases, intravesical chemotherapy for intermediate-risk patients and BCG instillations for high-risk cases. •  The follow-up protocol consisted of urinary cytology and WLC every 3 months for 2 years. •  Only first-time recurrences after the initial diagnosis were considered., Results: •  In the 142 patients with NMIBC in the HAL-BLC series, tumour detection rates significantly improved for carcinoma in situ, pTa andoverall cases. •  In 35.2% of the cases, additional malignant lesions were found by HAL-BLC and consequently, the recurrence- and progression-risk categories of patients and subsequent treatment improved in 19% of the cases due to fluorescence cystoscopy. •  In all, 125 patients in the HAL-BLC group and 114 of the WLC group completed the follow-up. •  The recurrence rate at 3 months was lower in the HAL-BLC series (7.2% vs 15.8%) due to fewer 'other site' recurrences when compared with the WLC series (0.8% vs 6.1%). •  The 1 and 2 years recurrence rates were significantly decreased in the HAL-BLC group compared with the WLC group (21.6% vs 32.5% and 31.2% vs 45.6%, respectively)., Conclusions: •  HAL-BLC was better than WLC for detecting NMIBC cases and improved tumour detection rates. •  HAL-BLC significantly modified the postoperative treatment of cases. •  The 3 months, 1 and 2 years recurrence rates were significantly improved in the HAL-BLC arm., (© 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.)

Objectives: To evaluate the efficacy and safety of a newly introduced endoscopic technique in the treatment of nonmuscle-invasive bladder tumors (NMIBT), the bipolar plasma vaporization of bladder tumors (BPV-BT), and to compare it with monopolar transurethral resection of bladder tumors (TURBT)., Methods: A total of 120 patients with at least one bladder tumor larger than 3 cm were enrolled in the study and randomized for BPV-BT and TURBT. Resection biopsy followed by tumor plasma vaporization and biopsies of the tumoral bed were performed in the 60 cases of the BPV-BT arm. All NMIBT patients underwent monopolar Re-TURBT 4 weeks after the initial procedure., Results: The mean operative time and postoperative hemoglobin decrease were significantly improved for BPV-BT compared with TURBT (21.4 minutes vs 32.7 minutes and 0.3 g/dL vs 0.9 g/dL). The perioperative complications were more frequent in the TURBT arm. The mean catheterization period and hospital stay were significantly shorter in the BPV-BT series (2.5 vs 3.5 days and 3.5 vs 4.5 days). During follow-up, the overall residual tumors' rate at Re-TURBT was 9.3% in the BPVBT group vs 20.8% in the TURBT group. Primary site recurrences occurred in 7.4% vs 17% of the cases, whereas in patients with initial multiple tumors, the recurrence rate was 9.7% vs 25%., Conclusions: BPV-BT seems to represent a promising endoscopic treatment alternative for NMIBT patients, with good efficacy, reduced morbidity, fast postoperative recovery, and significantly decreased residual tumors' rate by compared with TURBT., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Objectives: To evaluate the impact of hexaminolevulinate blue-light cystoscopy and transurethral resection of bladder tumors (TURBT) upon the short-term recurrence rate in high-risk nonmuscle-invasive bladder cancer (NMIBC) compared with conventional cystoscopy and resection., Methods: Between December 2007 and November 2009, 446 patients were randomized for blue-light cystoscopy/resection and for standard cystoscopy/resection, respectively. The inclusion criteria consisted of positive urinary cytology and ultrasonographic suspicion of bladder tumors. High-risk NMIBC patients (carcinoma in situ [CIS], pTaG3, and pT1) from both series underwent standard Re-TURBT 6 weeks after the initial procedure., Results: The proportions of CIS, pTaG3, and pT1 cases in the initial series were 13.1%, 5.7%, and 22.2% in the blue light series and 11.3%, 5.7%, and 23.3% in the white light series. In total, 72 and 64 high-risk cases, respectively, were diagnosed in the blue- and white-light series. The overall short-term recurrence rate at Re-TURBT was 11.1% for the blue-light group and 31.2% for the white-light group. The recurrence rates were 4.3% versus 27.8% for CIS, 10% versus 22.2% for pTaG3, and 15.4% versus 35.1% for pT1 cases, in favor of the blue-light arm. The recurrence rate in patients presenting with high-grade tumors was 17.2% in the blue-light group and 37% in the white-light group., Conclusions: Blue-light cystoscopy and resection significantly reduced the short-term recurrence rates determined during the standard Re-TURBT in all categories of high-risk patients compared with the standard cystoscopy and resection., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Objectives: The aim of our study was to evaluate the efficacy and safety of a newly introduced endoscopic technique in the treatment of non-muscle invasive bladder cancer (NMIBC), the bipolar plasma vaporization of bladder tumors (BPV-BT)., Materials and Methods: Between May and November 2009, 72 consecutive patients presenting papillary bladder tumors over 1 cm underwent BPV-BT and a 3 months follow-up. Initial biopsy followed by plasma vaporization of the tumor and biopsies of the tumoral bed were performed in all cases. The follow-up protocol included abdominal ultrasonography, urinary cytology and cystoscopy at 3 months., Results: BPV-BT was successfully performed in all cases. Multiple tumors were found in 45.9% and tumors over 3 cm in 33.3% of the cases. The mean tumoral volume was 10.5 ml. The mean operative time was 16 minutes, the mean hemoglobin decrease was 0.4 g/dl, the mean catheterization period was 2.3 days and the mean hospital stay was 3.4 days. There was no major intra- or postoperative complications. The pathological exam diagnosed 58.3% pTa, 30.6% pT1 and 11.1% pT2 cases. No tumoral base biopsies were positive for malignancy. The recurrence rate was 15.6% for the NMIBC patients, 13.3% for patients with single tumor under 3 cm and 16.3% in cases of single tumors over 3 cm or multiple tumors. Orthotopic recurrent tumors were encountered in 3.1% of the cases., Conclusions: BPV-BT seems to represent a promising endoscopic treatment alternative for NMIBC patients, with good efficacy, reduced morbidity, fast postoperative recovery and satisfactory follow-up parameters.

Introduction: The development of bipolar resection using saline irrigation provided significant improvements in NMIBT treatment. The aim of our study was to evaluate the efficacy and safety of a newly introduced endoscopic technique, the bipolar transurethral resection in saline-plasma vaporization of bladder tumors (TURis-PVBT)., Materials and Methods: Between May and October 2009, 57 consecutive patients presenting papillary bladder tumors larger than 1 cm underwent TURis-PVBT and a 3 months follow-up. Initial tumor biopsy, followed by plasma vaporization of the tumor and biopsies of the tumoral bed were performed in all cases. Complementary treatment was applied according to risk indications. The follow-up protocol included abdominal ultrasonography, cytology and cystoscopy at 3 months., Results: TURis-PVBT was successfully performed in all cases. Multiple tumors were found in 45.6% of the cases and 50.9% of the patients presented tumors larger than 3 cm. The mean tumoral volume was of 11 ml. The mean operative time was of 17 minutes, the mean hemoglobin decrease was of 0.4 g/dl, the mean catheterization period was of 2.5 days and the mean hospital stay was of 3.5 days. The pathological exam diagnosed 57.9% pTa cases, 31.6% pT1 cases and 10.5% pT2 cases. No tumoral base biopsies were positive for malignancy. The recurrence rate at 3 months for the 51 NMIBT patients was of 15.7%. Orthotopic recurrent tumors were encountered in 5.9% of the cases., Conclusions: TURis-PVBT seems to represent a promising endoscopic treatment alternative for NMIBT patients, with good efficacy, reduced morbidity, fast postoperative recovery and satisfactory follow-up parameters.

Purpose: We compared hexaminolevulinate (HAL) blue light cystoscopy (BLC) with standard white light cystoscopy (WLC) in the diagnosis of noninvasive bladder tumors (NIBT) and analyzed the efficiency of blue light transurethral resection of the bladder (BL-TURB)., Materials and Methods: WLC and BLC were performed in 64 cases. BL-TURB was applied for lesions that were detected only by BLC. Patients who received a diagnosis of NIBT were followed up after 18 weeks by WLC and BLC. The control group included the same number of consecutive patients with NIBT, diagnosed only by WLC and treated by WL-TURB., Results: WLC correctly diagnosed 66.4%, with a 9.7% rate of false-positive results, while BLC diagnosed 95.7%, but had a 13.5% rate of false-positive results. The study group had a recurrence rate of 5.3% vs 23.2% in the control group., Conclusions: HAL fluorescence cystoscopy is a valuable diagnostic method, with considerably improved accuracy. BL-TURB represents a superior treatment modality, with significant impact on the recurrence rate.

Hexaminolevulinate blue light cystoscopy (HAL-BLC) represents an increasingly acknowledged method in bladder cancer diagnostic. We aimed to evaluate the importance of this procedure in cases of non-invasive bladder tumors (NIBT), to compare it with standard white light cystoscopy (WLC), and to establish the efficiency of blue light transurethral bladder resection (BL-TURB). Between December 2007 and December 2008, WLC and BLC were performed in 70 cases. WL-TURB was performed for all lesions visible in WL, and BL-TURB for those only detected in BL. Patients diagnosed with NIBT were followed-up after an average period of 5 months (between 18 and 22 weeks) by WLC and BLC. The control group included the same number of consecutive cases of NIBT, which underwent only WLC and WL-TURB, as well as the same follow-up protocol as the study group. WLC correctly identified 115 tumors, and BLC, 157 tumors. The detection rate was 68.8% for WLC, with a 9.4% rate of false-positive results, and 94% for BLC, with a 14.6% rate of false-positive results. The diagnostic accuracy in CIS lesions was 57.3% for WLC and 95% for BLC, while in pTa tumors; it was 68.8% for WLC and 94% for BLC. 62 cases of the study group diagnosed with NIBT emphasized a recurrence rate of 6.4% after 5 months. The control group described a recurrence rate of 24.2%. HAL fluorescence cystoscopy is a valuable diagnostic method for patients with NIBT, with considerably improved accuracy by comparison to WLC, and a significant impact upon the short-term recurrence rate.

Introduction: The aim of our study was to establish the place of Hexvix blue light cystoscopy (BLC) in superficial bladder tumors (SBT) diagnosis and to compare it with standard white light cystoscopy (WLC)., Material and Methods: Between December 2007 and February 2008, WLC and BLC and transurethral bladder resection (TURB) of all apparent detected lesions were performed in 25 cases. The patients diagnosed with superficial bladder tumors have been followed-up after 18 weeks by WLC and BLC. The control group included the same number of consecutive patients with SBT, diagnosed only by WLC, which underwent the same treatment and follow-up protocol as the study group., Results: WLC identified 40 suspicious lesions (37 pathologically confirmed), while BLC detected 58 apparent tumors (52 pathologically confirmed). So, from the 54 tumors with positive histology, WLC correctly diagnosed 68.5%, with a rate of 7.5% false-positive results, while BLC diagnosed 96.3%, presenting a 10.3% rate of false-positive results. 22 cases of the study group diagnosed with SBT were followed. The tumor recurrence rate after 18 weeks was 4.5% for the study group and 22.7% for the control group., Conclusions: Hexvix fluorescence cystoscopy is a valuable diagnostic method, with considerably better results by comparison to WLC. The improved diagnostic accuracy may have a significant impact upon the recurrence rate.

Introduction: Nowadays, Hexvix blue light cystoscopy (BLC) represents an increasingly acknowledged diagnostic method for patients with bladder cancer. The aim of our study was to establish the place of this procedure in superficial bladder tumors diagnosis and to compare it with standard white light cystoscopy (WLC)., Material and Methods: Between December 2007 and January 2008, WLC and BLC were performed in 20 cases. Transurethral bladder resection (TURB) was performed for all apparent detected lesions. The patients diagnosed with superficial bladder tumors have been followed-up after 3 months by WLC and BLC. The control group included the same number of consecutive patients with superficial bladder tumors, diagnosed only by WLC, which underwent the same treatment and follow-up protocol as the study group., Results: WLC identified 30 suspicious lesions (28 pathologically confirmed), while BLC identified 41 apparent tumors (39 pathologically confirmed). So, from the total number of 40 tumors with positive histology, WLC correctly diagnosed 70% of them, with a rate of 6.7% false-positive results, while BLC diagnosed 97.5%, however presenting a 4.9% rate of false-positive results. 17 cases of the study group diagnosed with superficial bladder tumors were followed. The tumor recurrence rate after 3 months was 5.9% for the study group and 23.5% for the control group., Conclusions: Hexvix fluorescence cystoscopy is a valuable diagnostic method, with considerably better results by comparison to WLC. The improved diagnostic may have a significant impact upon the recurrence rate.