Clinically Relevant Reduction in Risk of Recurrence of Superficial Bladder Cancer Using 5-Aminolevulinic Acid-Induced Fluorescence Diagnosis: 8-Year Results of Prospective Randomized Study
Objectives Several studies have shown that 5-aminolevulinic acid (5-ALA)-induced fluorescence cystoscopy improves the detection of superficial bladder cancer. The results have suggested a reduced rate of recurrent tumors with the use of 5-ALA fluorescence before bladder tumor resection. We performed...
Gespeichert in:
| Veröffentlicht in: | Urology (Ridgewood, N.J.) N.J.), 2007-04, Vol.69 (4), p.675-679 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 679 |
|---|---|
| container_issue | 4 |
| container_start_page | 675 |
| container_title | Urology (Ridgewood, N.J.) |
| container_volume | 69 |
| creator | Denzinger, Stefan Burger, Maximilian Walter, Bernhard Knuechel, Ruth Roessler, Wolfgang Wieland, Wolf F Filbeck, Thomas |
| description | Objectives Several studies have shown that 5-aminolevulinic acid (5-ALA)-induced fluorescence cystoscopy improves the detection of superficial bladder cancer. The results have suggested a reduced rate of recurrent tumors with the use of 5-ALA fluorescence before bladder tumor resection. We performed a prospective, randomized trial to investigate whether the long-term tumor recurrence and residual tumor rates can be decreased using 5-ALA fluorescence diagnosis (FD). Methods A total of 301 patients with suspected superficial bladder carcinoma were randomized to transurethral resection (TUR) using conventional white light (WL) or FD. TUR was repeated to evaluate the residual tumor rate. In addition, patients were followed up for a median of 83 (WL) and 86 (FD) months to evaluate recurrence-free survival (RFS). Results Of the 301 patients, 191 were available for the efficacy analysis. The residual tumor rate was 25.2% in the WL arm versus 4.5% in the FD arm ( P |
| doi_str_mv | 10.1016/j.urology.2006.12.023 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70403083</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0090429506026471</els_id><sourcerecordid>70403083</sourcerecordid><originalsourceid>FETCH-LOGICAL-c514t-4d118762aa34bed7b0e5c2bbc4441a9ef6b6eda9dd70a6fe2440c6df67f941643</originalsourceid><addsrcrecordid>eNqFUsGO0zAUjBCILQufAPIFbgl24jgJB1ApLKy0EqhlD5wsx36p3HXtYseVyrfxcTjbSCtx4eTYmTczmnlZ9pLggmDC3u6K6J1x21NRYswKUha4rB5lC1KXTd51Xf04W2Dc4ZyWXX2RPQthhxOQseZpdkEaSmtW40X2Z2W01VIYc0JrMHAUdkwfKspRO4u0RWsd7pAb0qOM3oOVMN028QB-0FILgz4aoRR4tBLpp0e3QdstqvPlXluXGOO9AlpKrfJrm5hBoSsTnYcg7-k-abG1LujwDrX5TxA-aYVoxjAJffcuHCC5OQJaC6vcXv9OBJsxqtPz7MkgTIAX83mZ3V59_rH6mt98-3K9Wt7ksiZ0zKkipG1YKURFe1BNj6GWZd9LSikRHQysZ6BEp1SDBRugpBRLpgbWDB0ljFaX2Zsz78G7XxHCyPc6eTdGWHAx8AZTXOG2SsD6DJTJdfAw8IPXe-FPnGA-1cZ3fK6NT7VxUvJUW5p7NQvEfg_qYWruKQFezwARUlmDT1Hr8IBrG1K3ZZtwH844SHEcNXgepJ5CVtqnELly-r9W3v_DIOcNuYMThJ2L3qasOeEhDfDNtGPTimGGS0YbUv0FbRHR7Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70403083</pqid></control><display><type>article</type><title>Clinically Relevant Reduction in Risk of Recurrence of Superficial Bladder Cancer Using 5-Aminolevulinic Acid-Induced Fluorescence Diagnosis: 8-Year Results of Prospective Randomized Study</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Denzinger, Stefan ; Burger, Maximilian ; Walter, Bernhard ; Knuechel, Ruth ; Roessler, Wolfgang ; Wieland, Wolf F ; Filbeck, Thomas</creator><creatorcontrib>Denzinger, Stefan ; Burger, Maximilian ; Walter, Bernhard ; Knuechel, Ruth ; Roessler, Wolfgang ; Wieland, Wolf F ; Filbeck, Thomas</creatorcontrib><description>Objectives Several studies have shown that 5-aminolevulinic acid (5-ALA)-induced fluorescence cystoscopy improves the detection of superficial bladder cancer. The results have suggested a reduced rate of recurrent tumors with the use of 5-ALA fluorescence before bladder tumor resection. We performed a prospective, randomized trial to investigate whether the long-term tumor recurrence and residual tumor rates can be decreased using 5-ALA fluorescence diagnosis (FD). Methods A total of 301 patients with suspected superficial bladder carcinoma were randomized to transurethral resection (TUR) using conventional white light (WL) or FD. TUR was repeated to evaluate the residual tumor rate. In addition, patients were followed up for a median of 83 (WL) and 86 (FD) months to evaluate recurrence-free survival (RFS). Results Of the 301 patients, 191 were available for the efficacy analysis. The residual tumor rate was 25.2% in the WL arm versus 4.5% in the FD arm ( P <0.0001). The RFS rate after 2, 4, 6, and 8 years was 73%, 64%, 54%, and 45% in the WL group and 88%, 84%, 79%, and 71% in the FD group, respectively, revealing a statistically significant difference in favor of fluorescent TUR ( P = 0.0003). Conclusions 5-ALA-induced FD is significantly superior statistically to conventional WL TUR with respect to the residual tumor rate and RFS. This advantage of decreased bladder tumor recurrence risk was maintained with high statistical significance for at least 8 years. The differences in RFS imply that FD offers a clinically relevant procedure to reduce the incidence of tumor recurrence.</description><identifier>ISSN: 0090-4295</identifier><identifier>EISSN: 1527-9995</identifier><identifier>DOI: 10.1016/j.urology.2006.12.023</identifier><identifier>PMID: 17445650</identifier><identifier>CODEN: URGYAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Aminolevulinic Acid ; Biological and medical sciences ; Female ; Fluorescence ; Follow-Up Studies ; Humans ; Male ; Medical sciences ; Middle Aged ; Neoplasm Recurrence, Local - diagnosis ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Recurrence, Local - prevention & control ; Nephrology. Urinary tract diseases ; Photosensitizing Agents ; Prospective Studies ; Time Factors ; Tumors of the urinary system ; Urinary Bladder Neoplasms - diagnosis ; Urinary Bladder Neoplasms - epidemiology ; Urinary Bladder Neoplasms - prevention & control ; Urinary Bladder Neoplasms - surgery ; Urinary system involvement in other diseases. Miscellaneous ; Urinary tract. Prostate gland ; Urology</subject><ispartof>Urology (Ridgewood, N.J.), 2007-04, Vol.69 (4), p.675-679</ispartof><rights>Elsevier Inc.</rights><rights>2007 Elsevier Inc.</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c514t-4d118762aa34bed7b0e5c2bbc4441a9ef6b6eda9dd70a6fe2440c6df67f941643</citedby><cites>FETCH-LOGICAL-c514t-4d118762aa34bed7b0e5c2bbc4441a9ef6b6eda9dd70a6fe2440c6df67f941643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0090429506026471$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18715828$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17445650$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Denzinger, Stefan</creatorcontrib><creatorcontrib>Burger, Maximilian</creatorcontrib><creatorcontrib>Walter, Bernhard</creatorcontrib><creatorcontrib>Knuechel, Ruth</creatorcontrib><creatorcontrib>Roessler, Wolfgang</creatorcontrib><creatorcontrib>Wieland, Wolf F</creatorcontrib><creatorcontrib>Filbeck, Thomas</creatorcontrib><title>Clinically Relevant Reduction in Risk of Recurrence of Superficial Bladder Cancer Using 5-Aminolevulinic Acid-Induced Fluorescence Diagnosis: 8-Year Results of Prospective Randomized Study</title><title>Urology (Ridgewood, N.J.)</title><addtitle>Urology</addtitle><description>Objectives Several studies have shown that 5-aminolevulinic acid (5-ALA)-induced fluorescence cystoscopy improves the detection of superficial bladder cancer. The results have suggested a reduced rate of recurrent tumors with the use of 5-ALA fluorescence before bladder tumor resection. We performed a prospective, randomized trial to investigate whether the long-term tumor recurrence and residual tumor rates can be decreased using 5-ALA fluorescence diagnosis (FD). Methods A total of 301 patients with suspected superficial bladder carcinoma were randomized to transurethral resection (TUR) using conventional white light (WL) or FD. TUR was repeated to evaluate the residual tumor rate. In addition, patients were followed up for a median of 83 (WL) and 86 (FD) months to evaluate recurrence-free survival (RFS). Results Of the 301 patients, 191 were available for the efficacy analysis. The residual tumor rate was 25.2% in the WL arm versus 4.5% in the FD arm ( P <0.0001). The RFS rate after 2, 4, 6, and 8 years was 73%, 64%, 54%, and 45% in the WL group and 88%, 84%, 79%, and 71% in the FD group, respectively, revealing a statistically significant difference in favor of fluorescent TUR ( P = 0.0003). Conclusions 5-ALA-induced FD is significantly superior statistically to conventional WL TUR with respect to the residual tumor rate and RFS. This advantage of decreased bladder tumor recurrence risk was maintained with high statistical significance for at least 8 years. The differences in RFS imply that FD offers a clinically relevant procedure to reduce the incidence of tumor recurrence.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aminolevulinic Acid</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Fluorescence</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - diagnosis</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Recurrence, Local - prevention & control</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Photosensitizing Agents</subject><subject>Prospective Studies</subject><subject>Time Factors</subject><subject>Tumors of the urinary system</subject><subject>Urinary Bladder Neoplasms - diagnosis</subject><subject>Urinary Bladder Neoplasms - epidemiology</subject><subject>Urinary Bladder Neoplasms - prevention & control</subject><subject>Urinary Bladder Neoplasms - surgery</subject><subject>Urinary system involvement in other diseases. Miscellaneous</subject><subject>Urinary tract. Prostate gland</subject><subject>Urology</subject><issn>0090-4295</issn><issn>1527-9995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUsGO0zAUjBCILQufAPIFbgl24jgJB1ApLKy0EqhlD5wsx36p3HXtYseVyrfxcTjbSCtx4eTYmTczmnlZ9pLggmDC3u6K6J1x21NRYswKUha4rB5lC1KXTd51Xf04W2Dc4ZyWXX2RPQthhxOQseZpdkEaSmtW40X2Z2W01VIYc0JrMHAUdkwfKspRO4u0RWsd7pAb0qOM3oOVMN028QB-0FILgz4aoRR4tBLpp0e3QdstqvPlXluXGOO9AlpKrfJrm5hBoSsTnYcg7-k-abG1LujwDrX5TxA-aYVoxjAJffcuHCC5OQJaC6vcXv9OBJsxqtPz7MkgTIAX83mZ3V59_rH6mt98-3K9Wt7ksiZ0zKkipG1YKURFe1BNj6GWZd9LSikRHQysZ6BEp1SDBRugpBRLpgbWDB0ljFaX2Zsz78G7XxHCyPc6eTdGWHAx8AZTXOG2SsD6DJTJdfAw8IPXe-FPnGA-1cZ3fK6NT7VxUvJUW5p7NQvEfg_qYWruKQFezwARUlmDT1Hr8IBrG1K3ZZtwH844SHEcNXgepJ5CVtqnELly-r9W3v_DIOcNuYMThJ2L3qasOeEhDfDNtGPTimGGS0YbUv0FbRHR7Q</recordid><startdate>20070401</startdate><enddate>20070401</enddate><creator>Denzinger, Stefan</creator><creator>Burger, Maximilian</creator><creator>Walter, Bernhard</creator><creator>Knuechel, Ruth</creator><creator>Roessler, Wolfgang</creator><creator>Wieland, Wolf F</creator><creator>Filbeck, Thomas</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20070401</creationdate><title>Clinically Relevant Reduction in Risk of Recurrence of Superficial Bladder Cancer Using 5-Aminolevulinic Acid-Induced Fluorescence Diagnosis: 8-Year Results of Prospective Randomized Study</title><author>Denzinger, Stefan ; Burger, Maximilian ; Walter, Bernhard ; Knuechel, Ruth ; Roessler, Wolfgang ; Wieland, Wolf F ; Filbeck, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c514t-4d118762aa34bed7b0e5c2bbc4441a9ef6b6eda9dd70a6fe2440c6df67f941643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aminolevulinic Acid</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Fluorescence</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - diagnosis</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Recurrence, Local - prevention & control</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Photosensitizing Agents</topic><topic>Prospective Studies</topic><topic>Time Factors</topic><topic>Tumors of the urinary system</topic><topic>Urinary Bladder Neoplasms - diagnosis</topic><topic>Urinary Bladder Neoplasms - epidemiology</topic><topic>Urinary Bladder Neoplasms - prevention & control</topic><topic>Urinary Bladder Neoplasms - surgery</topic><topic>Urinary system involvement in other diseases. Miscellaneous</topic><topic>Urinary tract. Prostate gland</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Denzinger, Stefan</creatorcontrib><creatorcontrib>Burger, Maximilian</creatorcontrib><creatorcontrib>Walter, Bernhard</creatorcontrib><creatorcontrib>Knuechel, Ruth</creatorcontrib><creatorcontrib>Roessler, Wolfgang</creatorcontrib><creatorcontrib>Wieland, Wolf F</creatorcontrib><creatorcontrib>Filbeck, Thomas</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Urology (Ridgewood, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Denzinger, Stefan</au><au>Burger, Maximilian</au><au>Walter, Bernhard</au><au>Knuechel, Ruth</au><au>Roessler, Wolfgang</au><au>Wieland, Wolf F</au><au>Filbeck, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinically Relevant Reduction in Risk of Recurrence of Superficial Bladder Cancer Using 5-Aminolevulinic Acid-Induced Fluorescence Diagnosis: 8-Year Results of Prospective Randomized Study</atitle><jtitle>Urology (Ridgewood, N.J.)</jtitle><addtitle>Urology</addtitle><date>2007-04-01</date><risdate>2007</risdate><volume>69</volume><issue>4</issue><spage>675</spage><epage>679</epage><pages>675-679</pages><issn>0090-4295</issn><eissn>1527-9995</eissn><coden>URGYAZ</coden><abstract>Objectives Several studies have shown that 5-aminolevulinic acid (5-ALA)-induced fluorescence cystoscopy improves the detection of superficial bladder cancer. The results have suggested a reduced rate of recurrent tumors with the use of 5-ALA fluorescence before bladder tumor resection. We performed a prospective, randomized trial to investigate whether the long-term tumor recurrence and residual tumor rates can be decreased using 5-ALA fluorescence diagnosis (FD). Methods A total of 301 patients with suspected superficial bladder carcinoma were randomized to transurethral resection (TUR) using conventional white light (WL) or FD. TUR was repeated to evaluate the residual tumor rate. In addition, patients were followed up for a median of 83 (WL) and 86 (FD) months to evaluate recurrence-free survival (RFS). Results Of the 301 patients, 191 were available for the efficacy analysis. The residual tumor rate was 25.2% in the WL arm versus 4.5% in the FD arm ( P <0.0001). The RFS rate after 2, 4, 6, and 8 years was 73%, 64%, 54%, and 45% in the WL group and 88%, 84%, 79%, and 71% in the FD group, respectively, revealing a statistically significant difference in favor of fluorescent TUR ( P = 0.0003). Conclusions 5-ALA-induced FD is significantly superior statistically to conventional WL TUR with respect to the residual tumor rate and RFS. This advantage of decreased bladder tumor recurrence risk was maintained with high statistical significance for at least 8 years. The differences in RFS imply that FD offers a clinically relevant procedure to reduce the incidence of tumor recurrence.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>17445650</pmid><doi>10.1016/j.urology.2006.12.023</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0090-4295 |
| ispartof | Urology (Ridgewood, N.J.), 2007-04, Vol.69 (4), p.675-679 |
| issn | 0090-4295 1527-9995 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_70403083 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Aged Aged, 80 and over Aminolevulinic Acid Biological and medical sciences Female Fluorescence Follow-Up Studies Humans Male Medical sciences Middle Aged Neoplasm Recurrence, Local - diagnosis Neoplasm Recurrence, Local - epidemiology Neoplasm Recurrence, Local - prevention & control Nephrology. Urinary tract diseases Photosensitizing Agents Prospective Studies Time Factors Tumors of the urinary system Urinary Bladder Neoplasms - diagnosis Urinary Bladder Neoplasms - epidemiology Urinary Bladder Neoplasms - prevention & control Urinary Bladder Neoplasms - surgery Urinary system involvement in other diseases. Miscellaneous Urinary tract. Prostate gland Urology |
| title | Clinically Relevant Reduction in Risk of Recurrence of Superficial Bladder Cancer Using 5-Aminolevulinic Acid-Induced Fluorescence Diagnosis: 8-Year Results of Prospective Randomized Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T12%3A26%3A49IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Clinically%20Relevant%20Reduction%20in%20Risk%20of%20Recurrence%20of%20Superficial%20Bladder%20Cancer%20Using%205-Aminolevulinic%20Acid-Induced%20Fluorescence%20Diagnosis:%208-Year%20Results%20of%20Prospective%20Randomized%20Study&rft.jtitle=Urology%20(Ridgewood,%20N.J.)&rft.au=Denzinger,%20Stefan&rft.date=2007-04-01&rft.volume=69&rft.issue=4&rft.spage=675&rft.epage=679&rft.pages=675-679&rft.issn=0090-4295&rft.eissn=1527-9995&rft.coden=URGYAZ&rft_id=info:doi/10.1016/j.urology.2006.12.023&rft_dat=%3Cproquest_cross%3E70403083%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=70403083&rft_id=info:pmid/17445650&rft_els_id=S0090429506026471&rfr_iscdi=true |