title: Is photodynamic diagnosis ready for introduction in urological clinical practice?
abstract: The aim of this review is to provide an up-to-date review of the available literature on photodynamic diagnosis (PDD) for nonmuscle-invasive bladder cancer, to present the technique in a comprehensive approach and, finally, to discuss the relevance of PDD in clinical practice in terms of indications, outcomes and its development trend. A literature search was conducted up to July 2012, using MEDLINE and EMBASE via Ovid databases to identify published studies on PDD for nonmuscle-invasive bladder cancer. Only English-language and human-based full manuscripts that reported on case series and studies with >40 participants, concerning clinical evidence of the technique, its efficacy and safety data were included. Evidence showed that PDD significantly improves detection of bladder cancer compared with standard white-light cystoscopy, having proven to be more effective for the diagnosis of carcinoma in situ. This condition seems to facilitate more complete resections, resulting in a lower residual tumor rate, which, in turn consecutively leads to higher recurrence-free survival rates. The literature search demonstrated that for mid- and long-term follow-up, PDD showed acceptable outcomes in terms of tumor detection, as well as lower residual tumor and lower recurrence rates compared with white-light cystoscopy. It has proven to be safe and well tolerated; the major limitations of PDD are its low specificity and elevated costs.
authors.affiliation: Academic Medical Center, Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. ercordeiro@hotmail.com
authors.forename: Ernesto R
authors.initials: ER
authors.lastname: Cordeiro
authors.forename: Anastasios
authors.initials: A
authors.lastname: Anastasiadis
authors.forename: Mieke T J
authors.initials: MT
authors.lastname: Bus
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Alivizatos
authors.forename: Jean Jmch
authors.initials: JJ
authors.lastname: de la Rosette
authors.forename: Theo M
authors.initials: TM
authors.lastname: de Reijke
mesh_terms: D000622:Aminolevulinic Acid; D003558:Cystoscopy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010778:Photochemotherapy / Q000379:methods; D017319:Photosensitizing Agents; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid