title: [Usefulness of endoscopic evaluation with fluorescence after endovesical BCG in the management of non-invasive bladder tumors].
abstract: BACKGROUND
  The objective of this retrospective study was to assess the usefulness of fluorescence during cystoscopy after BCG-therapy in the management of non-invasive bladder tumors.
  
  
  METHODS
  Fifty-four patients were enrolled: Ta (15 cases), T1 (27 cases) carcinoma in situ (CIS) alone (12 cases) or associated (14 cases). Urine cytology was of high grade and a second look was systematically performed in case of lamina propria infiltration. Initial therapy with 6 intravesical BCG instillations (81 mg) was performed with histologic and endoscopic bladder evaluation 3 months after initial resection using hexylaminolevulinate fluorescence (Hexvix(®) 85 mg).
  
  
  RESULTS
  Urine cytology was negative in 27 cases, suspicious in 12 cases and positive in 15 cases. With standard endoscopy under white light, mucosal bladder was normal in 32 cases, the use of fluorescence detected 8 tumour lesions confirmed with histology (CIS). When mucosal bladder was suspect under white light (22 patients), fluorescence was positive in 16 cases with 10 matching histological analysis (CIS and/or residual tumoral lesion). Therefore, despite high false positive rate with persistent mucosal bladder inflammation (38%), fluorescence guided endoscopy has allowed the diagnosis of suspect lesions not detected with white light with negative urine cytology.
  
  
  CONCLUSIONS
  Hexvix(®) fluorescence after intravesical BCG instillations may improve persistent carcinoma in situ detection when performed 3 months after induction treatment. However, a multicenter prospective study will be necessary in future to confirm these preliminary results.
  
  
  METHODS
  5.
authors: Service d'urologie, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors: D
authors: D
authors: Charbit
authors: Service d'urologie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France.
authors: V
authors: V
authors: Arnoux
authors: Service d'anatomopathologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors: F
authors: F
authors: Gobet
authors: Service d'anatomopathologie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France.
authors: D
authors: D
authors: Pasquier
authors: Service d'urologie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France.
authors: J-L
authors: JL
authors: Descotes
authors: Service d'urologie, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France. Electronic address: christian.pfister@chu-rouen.fr.
authors: C
authors: C
authors: Pfister
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000283:Administration, Intravesical; D001500:BCG Vaccine / Q000008:administration & dosage*; D002278:Carcinoma in Situ / Q000188:drug therapy* / Q000473:pathology; D003558:Cystoscopy; D005453:Fluorescence; D006801:Humans; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000276:Adjuvants, Immunologic; D001500:BCG Vaccine
keywords: BCG-therapy; BCG-thérapie; Fluorescence; Non-invasive bladder tumors; Tumeurs de vessie