Blue light flexible cystoscopy with hexaminolevulinate in non-muscle-invasive bladder cancer: review of the clinical evidence and consensus statement on optimal use in the USA - update 2018.,Nature Reviews Urology

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Blue light flexible cystoscopy with hexaminolevulinate in non-muscle-invasive bladder cancer: review of the clinical evidence and consensus statement on optimal use in the USA - update 2018.
Nature Reviews Urology ( IF 12.1 ) Pub Date : 2019-06-01 , DOI: 10.1038/s41585-019-0184-4
Yair Lotan ₁ , Trinity J Bivalacqua ₂ , Tracy Downs ₃ , William Huang ₄ , Jeffrey Jones ₅ , Ashish M Kamat ₆ , Badrinath Konety ₇ , Per-Uno Malmström ₈ , James McKiernan ₉ , Michael O'Donnell ₁₀ , Sanjay Patel ₁₁ , Kamal Pohar ₁₂ , Matthew Resnick ₁₃ , Alexander Sankin ₁₄ , Angela Smith ₁₅ , Gary Steinberg ₁₆ , Edouard Trabulsi ₁₇ , Michael Woods ₁₈ , Siamak Daneshmand ₁₉

Affiliation

UT Southwestern Medical Center, Dallas, TX, USA.
James Buchanan Brady Urological Institute, Johns Hopkins University, Baltimore, MD, USA.
Department of Urology, University of Wisconsin, Madison, WI, USA.
Department of Urology, New York University School of Medicine, New York, NY, USA.
Genitourinary Surgery Section, Michael E. DeBakey VA Medical Center, Houston, TX, USA.
Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Urology, University of Minnesota, Minneapolis, MN, USA.
Department of Urology, Institute of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Department of Urology, Columbia University Medical Center, New York City, NY, USA.
Department of Urology, University of Iowa, Iowa City, IA, USA.
Department of Urology, University of Oklahoma, Oklahoma City, OK, USA.
Department of Urology, Ohio State University, Columbus, OH, USA.
Department of Urologic Surgery, Vanderbilt University, Nashville, TX, USA.
Department of Urology, Montefiore Medical Center, New York, NY, USA.
Department of Urology, University of North Carolina, Chapel Hill, NC, USA.
Department of Urology, University of Chicago, Chicago, IL, USA.
Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
Department of Urology, Loyola University Chicago, Chicago, IL, USA.
Department of Urology, University of Southern California, Los Angeles, CA, USA.

Blue light cystoscopy (BLC) with hexaminolevulinate (HAL) during transurethral resection of bladder cancer improves detection of non-muscle-invasive bladder cancer (NMIBC) and reduces recurrence rates. Flexible BLC was approved by the FDA in 2018 for use in the surveillance setting and was demonstrated to improve detection. Results of a phase III prospective multicentre study of blue light flexible cystoscopy (BLFC) in surveillance of intermediate-risk and high-risk NMIBC showed that 20.6% of malignancies were identified only by BLFC. Improved detection rates in the surveillance setting are anticipated to lead to improved clinical outcomes by reducing future recurrences and earlier identification of tumours that are unresponsive to therapy. Thus, BLFC has a role in surveillance cystoscopy, and determining which patients will benefit from BLFC and optimal and cost-effective ways of incorporating this technology into surveillance cystoscopy must be developed.

中文翻译：

蓝光柔性膀胱镜检查六氨基乙酰丙酸盐治疗非肌层浸润性膀胱癌：美国最佳使用临床证据和共识声明回顾 - 2018 年更新。

在经尿道膀胱癌切除术中使用六氨基乙酰丙酸 (HAL) 进行蓝光膀胱镜检查 (BLC) 可提高非肌层浸润性膀胱癌 (NMIBC) 的检出率并降低复发率。灵活的 BLC 于 2018 年获得 FDA 批准用于监测环境，并被证明可以改善检测。蓝光软性膀胱镜 (BLFC) 监测中危和高危 NMIBC 的 III 期前瞻性多中心研究结果表明，20.6% 的恶性肿瘤仅通过 BLFC 即可发现。监测环境中检出率的提高预计将通过减少未来的复发和早期识别对治疗无反应的肿瘤来改善临床结果。因此，BLFC 在监视膀胱镜检查中发挥作用，确定哪些患者将从 BLFC 中受益，并且必须开发将该技术纳入监视膀胱镜检查的最佳且经济有效的方法。

更新日期：2019-05-16

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