Value of Fluorescence Cystoscopy in High Risk Non-muscle Invasive Bladder Cancer
Value of Fluorescence Cystoscopy in High Risk Non-muscle Invasive Bladder Cancer
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DOI：
10.1007/s11934-013-0306-0
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发表时间：
2013-04-01
影响因子：
2.6
通讯作者：
Burger, Maximilian
中科院分区：
文献类型：
--
作者：
Mayr, Roman;Burger, Maximilian
光动力学诊断（PDD）是白色光膀胱镜检查的辅助手段，与单独使用标准白色光膀胱镜检查相比，已证明通过增强经尿道膀胱肿瘤切除术（TURBT）期间恶性病变的可视化，可提高膀胱癌切除术的检出率和彻底性。PDD也已被证明可以改善非肌层浸润性膀胱癌的复发率。然而，关于其对高进展风险的非肌层浸润性膀胱癌预后影响的数据很少。现有的少数试验和研究表明，提高了诊断的准确性，特别是对平坦的恶性病变。此外，已表明复发率改善，而对早期浸润性膀胱癌的进展率没有影响，表明在这些肿瘤阶段，切除的彻底性对肿瘤生物学的影响很小。虽然迄今为止还没有关于PDD对癌症特异性生存期影响的具体和更大的数据，并且少数长期数据表明影响很小，但建议提高诊断准确性有利于临床决策，因此假定PDD在管理高风险非肌肉浸润性膀胱癌中具有价值。
Photodynamic Diagnosis (PDD), an adjunct to white light cystoscopy, has been shown to improve detection and thoroughness of resection of bladder cancer by enhancing visualisation of malign lesions during transurethral resection of bladder tumours (TURBT) compared to the sole use of standard white light cystoscopy. The PDD also has been shown to improve recurrence of free survival in non-muscle invasive bladder cancer. Little data on its impact on outcome in nonmuscle invasive bladder cancer of high risk of progression is available however. The few trials and studies available demonstrate improved accuracy of diagnosis especially of flat malign lesions. In addition, improved recurrence rates have been suggested without an impact on progression rates in early invasive bladder cancer indicating little influence of thoroughness of resection on the tumour biology in those tumour stages. While no specific and larger data on impact of PDD on cancer specific survival exist to date and the few long-term data suggest little impact, improved accuracy of diagnosis is suggested to be beneficial for clinical decision making and thus a value of PDD is postulated in the management of high-risk non-muscle invasive bladder cancer.