Photodynamic diagnosis for follow-up of carcinoma in situ of the bladder

Renzo Colombo, Richard Naspro, Piera Bellinzoni, Fabio Fabbri, Giorgio Guazzoni, Vincenzo Scattoni, Andrea Losa, Patrizio Rigatti

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: A prospective study to evaluate the reliability of cystoscopy was performed with fluorescence (photodynamic diagnosis, PDD) compared with standard white light (WL) cystoscopy in patients with solitary carcinoma in situ (CIS), undergoing BCG treatment. Materials and methods: Between February 2004 and March 2006, 49 patients suffering from CIS were enrolled in the study. Patients age was 68.5 ± 13.5 years (mean ± SD) and all presented CIS alone at inclusion. All suspicious areas were biopsied either under white light or blue light. Urine cytology was peformed on each patient before endoscopy. Results: Out of 49 patients enrolled, 15 (30.6%) presented with positive urinary cytology. Out of 18 patients positive to CIS at biopsy, 14 (77.7%) could be diagnosed exclusively by means of PDD cystoscopy and transurethral bladder resection and 4 (22.3%) during both standard and PDD cystoscopy. No additional CIS could be diagnosed by standard WL cystoscopy alone. The overall false positive rate for PDD accounted for 33.3% compared with 7.1% for WL cytoscopy. A statistical correlation was documented between the number of CIS findings and PDD (r = 0.6976, p = 0.0002) while WL cystoscopy (r = 0.1870, p = 0.3816) and urinary cytology (r = 0.4965, p = 0.0136) correlated only weakly with CIS. The overall side effects related to the drugs were negligible overall. Conclusions: These data show that PDD cystoscopy is more reliable than WL cytoscopy for the follow-up of CIS patients during BCG treatment. Long-term data and multicenter prospective data are needed to assess the true impact on tumor recurrence and progression.

Original languageEnglish
Pages (from-to)1003-1007
Number of pages5
JournalTherapeutics and Clinical Risk Management
Volume3
Issue number6
Publication statusPublished - 2007

Keywords

  • Bladder cancer
  • Carcinoma in situ
  • Endoscopy
  • Fluorescence

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Medicine(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Safety Research
  • Chemical Health and Safety

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