Narrow-band imaging cystoscopy to evaluate the response to bacille Calmette-Guérin therapy: preliminary results.
METHODS
Diagnostic (exploratory cohort).


METHODS
2b.


OBJECTIVE
To evaluate whether narrow-band imaging cystoscopy (NBIC) can identify bladder tumour suspected on follow-up white-light cystoscopy (WLC) after intravesical bacille Calmette-Guérin (BCG) therapy, as BCG causes an intense reaction in the bladder, appearing as red lesions on WLC, which might be residual tumour or BCG-induced inflammation.


METHODS
Sixty-one patients with high-risk non-muscle-invasive bladder tumours were evaluated 3 months after starting induction BCG therapy. All patients had abnormal erythematous lesions on WLC, suspected to be residual carcinoma in situ. After WLC, they were evaluated by NBIC, urine cytology and biopsy, followed by transurethral resection of all visible lesions.


RESULTS
Of the 61 patients, 22 (36%) had residual tumour. NBIC correctly identified tumour in 21 patients, but another 10 had unnecessary biopsy (NBIC positive, negative biopsy). Only one of 30 patients who had negative NBIC findings had tumour. NBIC outperformed urine cytology in detecting residual tumour after BCG therapy.


CONCLUSIONS
NBIC appears to better identify patients who have suspected residual tumour on follow-up WLC at 3 months after BCG therapy.
Herr
Harry W
HW
Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. herrh@mskcc.org
D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000283:Administration, Intravesical; D001500:BCG Vaccine / Q000008:administration & dosage*; D003558:Cystoscopy / Q000379:methods*; D006801:Humans; D009367:Neoplasm Staging / Q000379:methods; D018365:Neoplasm, Residual / Q000473:pathology; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology
D000276:Adjuvants, Immunologic; D001500:BCG Vaccine