Fluorescence cystoscopy in the management of bladder cancer: a help for the urologist!
As a disease characterized by a nature polymorphic and fluctuant in its evolution, superficial transitional cell carcinoma of the bladder remains a perpetual therapeutic challenge, and raises a great interest in the development of new diagnostic and surveillance techniques. This paper reviews 10 years of experience of fluorescence cystoscopy, a simple technique perfectly adapted to the current endoscopic equipment. Its principle is to enhance the visual contrast between benign and malignant cells. Three photosensitizing agents are available, two prodrugs: delta-aminolevulinic acid or hexaminolevulinate, and a natural substance: hypericin. With a detection rate of over 90% for carcinoma in situ and a real potential for detecting small tumors overlooked by standard cystoscopy, fluorescence cystoscopy may be clearly recommended in clinical practice. This technique favors a standardization of superficial bladder cancer endoscopic management and is susceptible to have a real impact on the disease recurrence and progression rate.
Jichlinski
Patrice
P
Department of Urology, CHUV, CH-1011 Lausanne, Switzerland. Patrice.Jichlinski@chuv.hospvd.ch
Leisinger
Hans-Jurg
HJ
D003558:Cystoscopy / Q000379:methods*; D005453:Fluorescence; D006801:Humans; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis*; D014572:Urology / Q000379:methods