Hexaminolevulinate guided fluorescence cystoscopy reduces recurrence in patients with nonmuscle invasive bladder cancer.
Hexaminolevulinate guided fluorescence cystoscopy reduces recurrence in patients with nonmuscle invasive bladder cancer.
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DOI：
10.1016/j.juro.2010.06.148
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发表时间：
2010-11
期刊：
影响因子：
--
通讯作者：
Grossman HB
中科院分区：
文献类型：
--
作者：
Stenzl A;Burger M;Fradet Y;Mynderse LA;Soloway MS;Witjes JA;Kriegmair M;Karl A;Shen Y;Grossman HB
目的：评估六氨基乙酰丙酸(HAL)荧光膀胱镜检查对非肌肉浸润性膀胱癌早期复发率的影响。这项前瞻性随机研究招募了814名怀疑患有膀胱癌复发风险增加的患者。所有患者都接受了白光膀胱镜检查和病变标测，然后在有需要的情况下行经尿道膀胱电切术(TURB)。荧光组患者在膀胱镜检查前至少1h给予六氨基乙酰丙酸溶液膀胱内注射，以诱导癌变的荧光，并在TURB术前、后加用蓝光检查。辅助性膀胱内治疗是基于风险的。分别于术后3、6、9个月行白光膀胱镜检查。在荧光组中进行检测作为患者内部比较。在这组患者中，286名患者被发现至少有一个Ta或T1肿瘤(ITT)。在47例(16%)中，至少有一个肿瘤仅见荧光(p=0.001)。随访9个月，荧光组肿瘤复发率为47%，白光组为56%(P=0.026)。复发率相对降低16%。HAL荧光膀胱镜检查显著提高了对Ta和T1病变的检测，并显著降低了9个月后肿瘤复发率。
To assess the impact that improved detection of non-muscle invasive bladder cancer with hexaminolevulinate (HAL) fluorescence cystoscopy may have on early recurrence rates. This prospective, randomized study enrolled 814 patients suspected of having bladder cancer at increased risk for recurrence. All patients underwent white light cystoscopy and mapping of lesions, followed by transurethral resection of the bladder (TURB) where indicated. Patients in the fluorescence group also received intravesical hexaminolevulinate solution at least one hour before cystoscopy to induce fluorescence of cancerous lesions, and underwent additional inspection with blue light before and after TURB. Adjuvant intravesical therapy was based on risk. Follow up cystoscopies at 3, 6 and 9 months were conducted with white light. Detection was carried out as a within-patient comparison in the fluorescence group. In this group, 286 patients were found to have at least one Ta or T1 tumor (ITT). In 47 (16%), at least one of the tumors was seen only with fluorescence (p=0.001). During the 9 month follow-up period (ITT), there were tumor recurrences in 128/271 patients (47%) in the fluorescence group and 157/280 patients (56%) in the white light group (p=0.026). The relative reduction in recurrence rate was 16%. HAL fluorescence cystoscopy significantly improves detection of Ta and T1 lesions and significantly reduces the rate of tumor recurrence at 9 months.
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影响因子：
3.4
作者：
Sievert, K. D.;Amend, B.;Nagele, U.;Schilling, D.;Bedke, J.;Horstmann, M.;Hennenlotter, J.;Kruck, S.;Stenzl, A.
通讯作者：
Stenzl, A.
影响因子：
6.6
作者：
Schmidbauer, J;Witjes, F;Marberger, M
通讯作者：
Marberger, M
影响因子：
2.7
作者：
Geavlete, Bogdan;Multescu, Razvan;Geavlete, Petrisor
通讯作者：
Geavlete, Petrisor
DOI：
10.1016/1011-1344(90)85083-9
发表时间：
1990-06-01
影响因子：
5.4
作者：
KENNEDY, JC;POTTIER, RH;PROSS, DC
通讯作者：
PROSS, DC
影响因子：
4.5
作者：
Babjuk, M;Soukup, V;Dvorácek, J
通讯作者：
Dvorácek, J