Bladder cancer prospective cohort study on high-risk non-muscle invasive bladder cancer after photodynamic diagnosis-assisted transurethral resection of the bladder tumor (BRIGHT study).
Bladder cancer prospective cohort study on high-risk non-muscle invasive bladder cancer after photodynamic diagnosis-assisted transurethral resection of the bladder tumor (BRIGHT study).
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高危非肌肉浸润性膀胱癌光动力诊断辅助经尿道膀胱肿瘤电切术后的前瞻性队列研究(BREAT研究)。
DOI：
10.1111/iju.14854
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发表时间：
2022-07
影响因子：
2.6
通讯作者：
Kuroiwa, Hajime
中科院分区：
文献类型：
--
作者：
Kobayashi, Keita;Matsuyama, Hideyasu;Kawai, Taketo;Ikeda, Atsushi;Miyake, Makito;Nishimoto, Koshiro;Matsushita, Yuto;Komura, Kazumasa;Abe, Takashige;Kume, Haruki;Nishiyama, Hiroyuki;Fujimoto, Kiyohide;Oyama, Masafumi;Miyake, Hideaki;Inoue, Keiji;Mitsui, Takahiko;Kawakita, Mutsushi;Ohyama, Chikara;Mizokami, Atsushi;Kuroiwa, Hajime
据报道，经尿道膀胱肿瘤切除术与光动力学诊断可以降低非肌肉浸润性膀胱癌的残留肿瘤和膀胱内复发率。我们的目的是评估光动力学诊断-经尿道膀胱肿瘤切除术联合口服5 -氨基乙酰丙酸盐酸盐对高风险非肌肉浸润性膀胱癌的有效性。在2018年至2020年期间前瞻性登记了初始光动力学诊断-经尿道膀胱肿瘤切除术（光动力学诊断组）的高风险非肌肉浸润性膀胱癌患者。回顾性记录了具有初始白光经尿道膀胱肿瘤切除术史的高风险非肌肉浸润性膀胱癌病例（白光组）。使用倾向评分匹配分析来比较残留肿瘤率，并评估首次经尿道膀胱肿瘤切除术时可预测残留肿瘤的因素。分别对光动力学诊断组177例和白光组306例进行了分析。光动力诊断组和白光组的残留肿瘤率分别为25.7%和47.3%。光动力诊断组预测残留肿瘤的因子分析显示，当前/既往吸烟史、多发肿瘤、pT1/ pti患者的残留肿瘤率明显较高。将各因素设为1级时，总风险评分≤1的患者残留瘤率明显低于总风险评分≥2的患者（8.3% vs 33.3%，优势比5.46[1.81-22.28]）。在高风险的非肌肉浸润性膀胱癌病例中，初始光动力学诊断经尿道膀胱肿瘤切除术后残留肿瘤的几率是初始白光经尿道膀胱肿瘤切除术后残留肿瘤的几率的0.39倍。在27%的病例中，风险分层模型可以避免第二次经尿道膀胱肿瘤切除术。
Transurethral resection of bladder tumor with photodynamic diagnosis has been reported to result in lower residual tumor and intravesical recurrence rates in non‐muscle invasive bladder cancer. We aimed to evaluate the usefulness of photodynamic diagnosis‐transurethral resection of bladder tumor combined with oral 5‐aminolevulinic acid hydrochloride for high‐risk non‐muscle invasive bladder cancer. High‐risk non‐muscle invasive bladder cancer patients with an initial photodynamic diagnosis‐transurethral resection of bladder tumor (photodynamic diagnosis group) were prospectively registered between 2018 to 2020. High‐risk non‐muscle invasive bladder cancer cases with a history of initial white‐light transurethral resection of bladder tumor (white‐light group) were retrospectively registered. Propensity score‐matching analysis was used to compare residual tumor rates, and factors that could predict residual tumors at the first transurethral resection of bladder tumor were evaluated. Analyses were conducted with 177 and 306 cases in the photodynamic diagnosis and white‐light groups, respectively. The residual tumor rates in the photodynamic diagnosis and white‐light groups were 25.7% and 47.3%, respectively. Factor analysis for predicting residual tumors in the photodynamic diagnosis group showed that the residual tumor rate was significantly higher in cases with a current/past smoking history, multiple tumors, and pT1/pTis. When each factor was set as a risk level of 1, cases with a total risk score ≤1 showed a significantly lower residual tumor rate than cases with a total risk score ≥2 (8.3% vs 33.3%, odds ratio 5.46 [1.81–22.28]). In high‐risk non‐muscle invasive bladder cancer cases, the odds of a residual tumor after initial photodynamic diagnosis‐transurethral resection of bladder tumor were 0.39‐fold that of the odds of those after initial white‐light transurethral resection of bladder tumor. A risk stratification model could be used to omit the second transurethral resection of bladder tumor in 27% of the cases.
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影响因子：
23.4
作者：
Moch, Holger;Cubilla, Antonio L.;Ulbright, Thomas M.
通讯作者：
Ulbright, Thomas M.
影响因子：
3.3
作者：
Inoue, Keiji;Anai, Satoshi;Shuin, Taro
通讯作者：
Shuin, Taro
影响因子：
5.7
作者：
Inoue, Keiji;Fukuhara, Hideo;Shuin, Taro
通讯作者：
Shuin, Taro
影响因子：
3.3
作者：
Inoue, Keiji;Matsuyama, Hideyasu;Shuin, Taro
通讯作者：
Shuin, Taro
影响因子：
6.6
作者：
Chang, Sam S.;Boorjian, Stephen A.;McKiernan, James M.
通讯作者：
McKiernan, James M.