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You have accessJournal of UrologyBladder Cancer: Invasive VI (MP77)1 May 2024MP77-20 DIAGNOSTIC ACCURACY OF FLUORESCENCE CYSTOSCOPY USING ORAL 5-AMINOLEVULINIC ACID IN TRANSURETHRAL RESECTION OF BLADDER TUMOR AFTER CHEMORADIATION THERAPY FOR MUSCLE INVASIVE BLADDER CANCER Kotaro Suzuki, Yudai Ishikawa, Hajime Tanaka, Bo Fan, Masaki Kobayashi, Motohiro Fujiwara, Yuki Nakamura, Shohei Fukuda, Yuma Waseda, Soichiro Yoshida, and Yasuhisa Fujii Kotaro SuzukiKotaro Suzuki , Yudai IshikawaYudai Ishikawa , Hajime TanakaHajime Tanaka , Bo FanBo Fan , Masaki KobayashiMasaki Kobayashi , Motohiro FujiwaraMotohiro Fujiwara , Yuki NakamuraYuki Nakamura , Shohei FukudaShohei Fukuda , Yuma WasedaYuma Waseda , Soichiro YoshidaSoichiro Yoshida , and Yasuhisa FujiiYasuhisa Fujii View All Author Informationhttps://doi.org/10.1097/01.JU.0001009404.49693.12.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Fluorescence cystoscopy (FL) using oral 5-aminolevulinic acid (ALA) generally has higher sensitivity and lower specificity for the detection of urothelial carcinoma (UC) than white-light endoscopy (WL). However, its usefulness in preserved bladder after chemoradiation therapy (CRT) for muscle invasive bladder cancer (MIBC) has never been evaluated. We examined the diagnostic performance of FL using ALA in transurethral resection of bladder tumor (TURBT) after CRT for MIBC. METHODS: Between January 2020 and May 2023, 33 patients who received FL using oral ALA in TURBT after CRT for MIBC were analyzed. Among them, 16 patients underwent TURBT for the routine evaluation of CRT response, while 17 patients did for suspected recurrence after CRT. CRT consisted of 40-60 Gy of radiation for the small pelvis with concurrent cisplatin. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the detection of UC were compared between WL and FL using lesion-based analysis. The diagnostic impact of FL on UC was further explored on a per-patient basis. This study was approved by the institutional review board (M2000-1268). RESULTS: Median age was 71 years (range: 43-85), and 30 patients (91 %) were male. Among 267 collected tissues, 33 lesions were diagnosed as cancer (T1/a/is: n=9/12/12). In patients suspected recurrence after CRT, the median time from CRT to TURBT was 66 months (range: 14-196). In those with routine evaluation of CRT response, it was 1.3 months (range: 0.7-2.9). Overall, sensitivity and specificity for detecting UC by WL/FL were 55/70 % (p=0.10) and 87/81% (p<0.01), respectively. In patients suspected recurrence after CRT, sensitivity and specificity for detecting UC by WL/FL were 60/70% (p=0.26) and 55/51% (p=0.48), respectively. In the patient-based analysis, UC was diagnosed in 15 patients, of whom 1 patient undergoing the routine evaluation of CRT response had positive findings only in FL. CONCLUSIONS: FL using ALA may contribute to the improved cancer detection in the preserved bladder after CRT for MIBC. Further studies in more patients are needed. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1261 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kotaro Suzuki More articles by this author Yudai Ishikawa More articles by this author Hajime Tanaka More articles by this author Bo Fan More articles by this author Masaki Kobayashi More articles by this author Motohiro Fujiwara More articles by this author Yuki Nakamura More articles by this author Shohei Fukuda More articles by this author Yuma Waseda More articles by this author Soichiro Yoshida More articles by this author Yasuhisa Fujii More articles by this author Expand All Advertisement PDF downloadLoading ...
Suzuki et al. (Mon,) studied this question.