Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2015

Open Access 01-12-2015 | Research article

A network meta-analysis of therapeutic outcomes after new image technology-assisted transurethral resection for non-muscle invasive bladder cancer: 5-aminolaevulinic acid fluorescence vs hexylaminolevulinate fluorescence vs narrow band imaging

Authors: Joo Yong Lee, Kang Su Cho, Dong Hyuk Kang, Hae Do Jung, Jong Kyou Kwon, Cheol Kyu Oh, Won Sik Ham, Young Deuk Choi

Published in: BMC Cancer | Issue 1/2015

Login to get access

Abstract

Background

This study included a network meta-analysis of evidence from randomized controlled trials (RCTs) to assess the therapeutic outcome of transurethral resection (TUR) in patients with non-muscle-invasive bladder cancer assisted by photodynamic diagnosis (PDD) employing 5-aminolaevulinic acid (5-ALA) or hexylaminolevulinate (HAL) or by narrow band imaging (NBI).

Methods

Relevant RCTs were identified from electronic databases. The proceedings of relevant congresses were also searched. Fifteen articles based on RCTs were included in the analysis, and the comparisons were made by qualitative and quantitative syntheses using pairwise and network meta-analyses.

Results

Seven of 15 RCTs were at moderate risk of bias for all quality criteria and two studies were classified as having a high risk of bias. The recurrence rate of cancers resected with 5-ALA-based PDD was lower than of those resected using HAL-based PDD (odds ratio (OR) = 0.48, 95 % confidence interval (CI) [0.26–0.95]) but was not significantly different than those resected with NBI (OR = 0.53, 95 % CI [0.26–1.09]). The recurrence rate of cancers resected using HAL-based PDD versus NBI did not significantly differ (OR = 1.11, 95 % CI [0.55–2.1]). All cancers resected using 5-ALA-based PDD, HAL-based PDD, or NBI recurred at a lower rate than those resected using white light cystoscopy (WLC). No difference in progression rate was observed between cancers resected by all methods investigated.

Conclusions

The recurrence rate of some bladder cancers can be decreased by the implementation of either PDD- and NBI-assisted TUR; in real settings, clinicians should consider replacing WLC as the standard imaging technology to guide TUR.
Literature
1.
Bohle A, Jocham D, Bock PR. Intravesical bacillus Calmette-Guerin versus mitomycin C for superficial bladder cancer: a formal meta-analysis of comparative studies on recurrence and toxicity. J Urol. 2003;169(1):90–5.CrossRefPubMed
2.
Oh KJ, Choi YD, Chung HS, Hwang EC, Jung SI, Kwon DD, et al. A novel transurethral resection technique for superficial flat bladder tumor: grasp and bite technique. Korean J Urol. 2015;56(3):227–32.CrossRefPubMedPubMedCentral
3.
Jocham D, Witjes F, Wagner S, Zeylemaker B, van Moorselaar J, Grimm MO, et al. Improved detection and treatment of bladder cancer using hexaminolevulinate imaging: a prospective, phase III multicenter study. J Urol. 2005;174(3):862–6. discussion 866.CrossRefPubMed
4.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.CrossRefPubMedPubMedCentral
5.
Chung JH, Lee SW. Assessing the quality of randomized controlled urological trials conducted by korean medical institutions. Korean J Urol. 2013;54(5):289–96.CrossRefPubMedPubMedCentral
6.
7.
8.
Riedl CR, Daniltchenko D, Koenig F, Simak R, Loening SA, Pflueger H. Fluorescence endoscopy with 5-aminolevulinic acid reduces early recurrence rate in superficial bladder cancer. J Urol. 2001;165(4):1121–3.CrossRefPubMed
9.
Filbeck T, Pichlmeier U, Knuechel R, Wieland WF, Roessler W. Clinically relevant improvement of recurrence-free survival with 5-aminolevulinic acid induced fluorescence diagnosis in patients with superficial bladder tumors. J Urol. 2002;168(1):67–71.CrossRefPubMed
10.
Kriegmair M, Zaak D, Rothenberger KH, Rassweiler J, Jocham D, Eisenberger F, et al. Transurethral resection for bladder cancer using 5-aminolevulinic acid induced fluorescence endoscopy versus white light endoscopy. J Urol. 2002;168(2):475–8.CrossRefPubMed
11.
Babjuk M, Soukup V, Petrik R, Jirsa M, Dvoracek J. 5-aminolaevulinic acid-induced fluorescence cystoscopy during transurethral resection reduces the risk of recurrence in stage Ta/T1 bladder cancer. BJU Int. 2005;96(6):798–802.CrossRefPubMed
12.
Schumacher MC, Holmang S, Davidsson T, Friedrich B, Pedersen J, Wiklund NP. Transurethral resection of non-muscle-invasive bladder transitional cell cancers with or without 5-aminolevulinic Acid under visible and fluorescent light: results of a prospective, randomised, multicentre study. Eur Urol. 2010;57(2):293–9.CrossRefPubMed
13.
Stenzl A, Penkoff H, Dajc-Sommerer E, Zumbraegel A, Hoeltl L, Scholz M, et al. Detection and clinical outcome of urinary bladder cancer with 5-aminolevulinic acid-induced fluorescence cystoscopy : A multicenter randomized, double-blind, placebo-controlled trial. Cancer. 2011;117(5):938–47.CrossRefPubMed
14.
Dragoescu O, Tomescu P, Panus A, Enache M, Maria C, Stoica L, et al. Photodynamic diagnosis of non-muscle invasive bladder cancer using hexaminolevulinic acid. Rom J Morphol Embryo. 2011;52(1):123–7.
15.
Hermann GG, Mogensen K, Carlsson S, Marcussen N, Duun S. Fluorescence-guided transurethral resection of bladder tumours reduces bladder tumour recurrence due to less residual tumour tissue in Ta/T1 patients: a randomized two-centre study. BJU Int. 2011;108(8 Pt 2):E297–303.CrossRefPubMed
16.
Stenzl A, Burger M, Fradet Y, Mynderse LA, Soloway MS, Witjes JA, et al. Hexaminolevulinate guided fluorescence cystoscopy reduces recurrence in patients with nonmuscle invasive bladder cancer. J Urol. 2010;184(5):1907–13.CrossRefPubMedPubMedCentral
17.
Geavlete B, Multescu R, Georgescu D, Jecu M, Stanescu F, Geavlete P. Treatment changes and long-term recurrence rates after hexaminolevulinate (HAL) fluorescence cystoscopy: does it really make a difference in patients with non-muscle-invasive bladder cancer (NMIBC)? BJU Int. 2012;109(4):549–56.CrossRefPubMed
18.
Karaolides T, Skolarikos A, Bourdoumis A, Konandreas A, Mygdalis V, Thanos A, et al. Hexaminolevulinate-induced fluorescence versus white light during transurethral resection of noninvasive bladder tumor: does it reduce recurrences? Urology. 2012;80(2):354–9.CrossRefPubMed
19.
Geavlete B, Multescu R, Georgescu D, Stanescu F, Jecu M, Geavlete P. Narrow band imaging cystoscopy and bipolar plasma vaporization for large nonmuscle-invasive bladder tumors--results of a prospective, randomized comparison to the standard approach. Urology. 2012;79(4):846–51.CrossRefPubMed
20.
Montanari E, de la Rosette J, Longo F, Del Nero A, Laguna P. Narrow-band imaging (NBI) and white light (WLI) transurethral resection of the bladder in the treatment of non-muscle-invasive bladder cancer. Arch Ital Urol Androl. 2012;84(4):179–83.PubMed
21.
Naselli A, Introini C, Timossi L, Spina B, Fontana V, Pezzi R, et al. A randomized prospective trial to assess the impact of transurethral resection in narrow band imaging modality on non-muscle-invasive bladder cancer recurrence. Eur Urol. 2012;61(5):908–13.CrossRefPubMed
22.
Lee JY, Choi JH, Kim IK DJH, KH W, LK S, Yoon YE, et al. Recurrence rate of transurethral resection of bladder tumor using narrow band imaging: A randomized control trial, pilot study. J Urol. 2014;191(Supplement(4S):e240–1.CrossRef
23.
Goh AC, Lerner SP. Application of new technology in bladder cancer diagnosis and treatment. World J Urol. 2009;27(3):301–7.CrossRefPubMed
24.
Ku JH, Lerner SP. Strategies to prevent progression of high-risk bladder cancer at initial diagnosis. Curr Opin Urol. 2012;22(5):405–14.CrossRefPubMed
25.
Kausch I, Sommerauer M, Montorsi F, Stenzl A, Jacqmin D, Jichlinski P, et al. Photodynamic diagnosis in non-muscle-invasive bladder cancer: a systematic review and cumulative analysis of prospective studies. Eur Urol. 2010;57(4):595–606.CrossRefPubMed
26.
Lerner SP, Liu H, Wu MF, Thomas YK, Witjes JA. Fluorescence and white light cystoscopy for detection of carcinoma in situ of the urinary bladder. Urol Oncol. 2012;30(3):285–9.CrossRefPubMed
27.
Yuan H, Qiu J, Liu L, Zheng S, Yang L, Liu Z, et al. Therapeutic outcome of fluorescence cystoscopy guided transurethral resection in patients with non-muscle invasive bladder cancer: a meta-analysis of randomized controlled trials. PLoS One. 2013;8(9):e74142.CrossRefPubMedPubMedCentral
28.
Zheng C, Lv Y, Zhong Q, Wang R, Jiang Q. Narrow band imaging diagnosis of bladder cancer: systematic review and meta-analysis. BJU Int. 2012;110(11 Pt B):E680–7.CrossRefPubMed
29.
Li K, Lin T, Fan X, Duan Y, Huang J. Diagnosis of narrow-band imaging in non-muscle-invasive bladder cancer: a systematic review and meta-analysis. Int J Urol. 2013;20(6):602–9.CrossRefPubMed
30.
Shen YJ, Zhu YP, Ye DW, Yao XD, Zhang SL, Dai B, et al. Narrow-band imaging flexible cystoscopy in the detection of primary non-muscle invasive bladder cancer: a “second look” matters? Int Urol Nephrol. 2012;44(2):451–7.CrossRefPubMed
31.
Isfoss BL. The sensitivity of fluorescent-light cystoscopy for the detection of carcinoma in situ (CIS) of the bladder: a meta-analysis with comments on gold standard. BJU Int. 2011;108(11):1703–7.CrossRefPubMed
32.
Mowatt G, N’Dow J, Vale L, Nabi G, Boachie C, Cook JA, et al. Photodynamic diagnosis of bladder cancer compared with white light cystoscopy: Systematic review and meta-analysis. Int J Technol Assess Health Care. 2011;27(1):3–10.CrossRefPubMed
33.
Lee JS, Lee SY, Kim WJ, Seo SI, Jeon SS, Lee HM, et al. Efficacy and safety of hexaminolevulinate fluorescence cystoscopy in the diagnosis of bladder cancer. Korean J Urol. 2012;53(12):821–5.CrossRefPubMedPubMedCentral
34.
Rink M, Babjuk M, Catto JW, Jichlinski P, Shariat SF, Stenzl A, et al. Hexyl aminolevulinate-guided fluorescence cystoscopy in the diagnosis and follow-up of patients with non-muscle-invasive bladder cancer: a critical review of the current literature. Eur Urol. 2013;64(4):624–38.CrossRefPubMed
35.
Grimbergen MC, van Swol CF, Jonges TG, Boon TA, van Moorselaar RJ. Reduced specificity of 5-ALA induced fluorescence in photodynamic diagnosis of transitional cell carcinoma after previous intravesical therapy. Eur Urol. 2003;44(1):51–6.CrossRefPubMed
36.
Metadata
Title
A network meta-analysis of therapeutic outcomes after new image technology-assisted transurethral resection for non-muscle invasive bladder cancer: 5-aminolaevulinic acid fluorescence vs hexylaminolevulinate fluorescence vs narrow band imaging
Authors
Joo Yong Lee
Kang Su Cho
Dong Hyuk Kang
Hae Do Jung
Jong Kyou Kwon
Cheol Kyu Oh
Won Sik Ham
Young Deuk Choi
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2015
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-015-1571-8

Other articles of this Issue 1/2015

BMC Cancer 1/2015 Go to the issue

Research article

Extracellular vesicle-mediated phenotype switching in malignant and non-malignant colon cells

Research article

Capecitabine in combination with either cisplatin or weekly paclitaxel as a first-line treatment for metastatic esophageal squamous cell carcinoma: a randomized phase II study

Research article

Alterations in anatomic and functional imaging parameters with repeated FDG PET-CT and MRI during radiotherapy for head and neck cancer: a pilot study

Research article

Androgen-regulation of the protein tyrosine phosphatase PTPRR activates ERK1/2 signalling in prostate cancer cells

Research article

The effectiveness and safety of platinum-based pemetrexed and platinum-based gemcitabine treatment in patients with malignant pleural mesothelioma

Research article

Estrogen receptor α enhances the transcriptional activity of ETS-1 and promotes the proliferation, migration and invasion of neuroblastoma cell in a ligand dependent manner
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits