title: Photodynamic diagnosis for superficial bladder cancer: do all risk-groups profit equally from oncological and economic long-term results?
abstract: OBJECTIVE
  Photodynamic diagnosis (PDD) of superficial bladder cancer decreases recurrence rates. We present oncological results of a randomized, prospective study, comparing transurethral resection (TUR) performed under conventional white light (WL) with PDD. The follow-up period is the longest reported to date. As costs might be reimbursed by prolonged recurrence-free survival in certain patients cost analysis in regard to risk-groups was performed.
  
  
  METHODS
  Using chi-square test and log-rank test we compared recurrence rates of 103 patients after WL-TUR and of 88 patients after PDD-TUR. Cost analysis was performed according to risk-groups of recurrence.
  
  
  RESULTS
  Mean follow-up was 99 months. Recurrence rate was 57% in WL vs. 28% in PDD (p < 0.001). Costs incurred by subsequent TUR averaged euro 2310 per WL patient vs. euro 713 per PDD patient. Savings per patient by PDD amounted to euro 1597. PDD costs were reimbursed in low, intermediate and high risk patients, respectively.
  
  
  CONCLUSIONS
  PDD-TUR is significantly superior to conventional WL-TUR in terms of recurrence rate. While economic benefit is most prominent in intermediate risk patients, PDD related costs are reimbursed in all risk-groups.
authors.affiliation: Department of Urology, University of Regensburg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Otto
authors.forename: Maximilian
authors.initials: M
authors.lastname: Burger
authors.forename: Hans-Martin
authors.initials: HM
authors.lastname: Fritsche
authors.forename: Andreas
authors.initials: A
authors.lastname: Blana
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Roessler
authors.forename: Ruth
authors.initials: R
authors.lastname: Knuechel
authors.forename: Wolf F
authors.initials: WF
authors.lastname: Wieland
authors.forename: Stefan
authors.initials: S
authors.lastname: Denzinger