[Fluorescence diagnosis in patients with non-muscle invasive bladder cancer: results of a metaanalysis].
OBJECTIVE
Heterogeneous results of single studies with photodynamic diagnosis (PDD) in bladder cancer have been reported. A metaanalysis of prospective studies has now been performed.


METHODS
The effect of PDD in addition to WLC on a) the diagnosis and b) the therapeutic outcome of primary or recurrent non-muscle invasive bladder cancer (NMIBC) investigated by cystoscopy or transurethral resection was analysed. An electronic database search was performed. Trials were included if they prospectively compared WLC with PDD in bladder cancer. Primary endpoints were additional detection rate, residual tumour at second resection and recurrence-free survival.


RESULTS
Significantly more tumour-positive patients were detected with PDD in all patients with non-muscle invasive tumours (= 20 %) [95 % confidence interval (CI): 8 to 35 %] and in CIS patients (= 39 %) (CI: 23 to 57 %). Residual tumour was significantly less often found after PDD (odds ratio 0.28, CI: 0.15 to 0.52, p < 0.0001). Recurrence-free survival was significantly higher at 12 and 24 months in the PDD groups than in WLC only groups.


CONCLUSIONS
More bladder tumour-positive patients are detected by PDD. Best results were found in CIS patients. Diagnosis with PDD results in a more complete resection and a longer recurrence-free survival.
Kausch
I
I
Klinik für Urologie, Universität zu Lübeck, Universitätsklinikum Schleswig- Holstein, Campus Lübeck, Lübeck, Deutschland. Ingo.Kausch@uk-sh.de
Sommerauer
M
M
Montorsi
F
F
Stenzl
A
A
Jacqmin
D
D
Jichlinski
P
P
Jocham
D
D
Ziegler
A
A
Vonthein
R
R
D000622:Aminolevulinic Acid / Q000031:analogs & derivatives*; D003558:Cystoscopy; D018572:Disease-Free Survival; D005453:Fluorescence; D006801:Humans; D009361:Neoplasm Invasiveness; D017319:Photosensitizing Agents; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D001743:Urinary Bladder / Q000473:pathology / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery
D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid; C419924:5-aminolevulinic acid hexyl ester