TY - JOUR
T1 - Predictors of false positives in 5-aminolevulinic acid-induced photodynamic diagnosis of bladder carcinoma
T2 - identification of patient groups that may benefit most from highly specific optical diagnostics
AU - Draga, Ronald O P
AU - Grimbergen, Matthijs C M
AU - Kok, Esther T
AU - Jonges, Trudy N
AU - Bosch, J L H Ruud
PY - 2009/10
Y1 - 2009/10
N2 - OBJECTIVES: To identify patient groups associated with a high probability of false positives in photodynamic diagnosis (PDD) of bladder cancer for which the use of highly specific optical instruments could be beneficial.METHODS: This study includes the data of 306 patients. Under white light and 5-aminolevulinic acid-induced fluorescence light guidance, tumor locations were recorded, cold-cup biopsies were taken and tumors resected. Age, gender, recent transurethral resection of bladder tumor (TURBT), previous intravesical therapy, and urinary tract infections were examined for association with the false-positive rates in fluorescence cystoscopy by performing a multivariate analysis.RESULTS: Significant univariate associations were found between false positives and gender (P = .009, odds ratio [OR] = 0.51), previous intravesical therapy (P = .03, OR = 1.78), previous BCG instillations (P = .03, OR = 2.05), and TURBT in the past 90 days (P = .01, OR = 2.37). In the multivariate regression model, female gender (male; P = .005, OR = 0.41) and TURBT within 90 days before PDD (P = .01, OR = 2.38) are significant independent predictors of false-positive findings in PDD.CONCLUSIONS: Recent TURBTs and female gender are significant independent predictors of false positives in fluorescence cystoscopy.
AB - OBJECTIVES: To identify patient groups associated with a high probability of false positives in photodynamic diagnosis (PDD) of bladder cancer for which the use of highly specific optical instruments could be beneficial.METHODS: This study includes the data of 306 patients. Under white light and 5-aminolevulinic acid-induced fluorescence light guidance, tumor locations were recorded, cold-cup biopsies were taken and tumors resected. Age, gender, recent transurethral resection of bladder tumor (TURBT), previous intravesical therapy, and urinary tract infections were examined for association with the false-positive rates in fluorescence cystoscopy by performing a multivariate analysis.RESULTS: Significant univariate associations were found between false positives and gender (P = .009, odds ratio [OR] = 0.51), previous intravesical therapy (P = .03, OR = 1.78), previous BCG instillations (P = .03, OR = 2.05), and TURBT in the past 90 days (P = .01, OR = 2.37). In the multivariate regression model, female gender (male; P = .005, OR = 0.41) and TURBT within 90 days before PDD (P = .01, OR = 2.38) are significant independent predictors of false-positive findings in PDD.CONCLUSIONS: Recent TURBTs and female gender are significant independent predictors of false positives in fluorescence cystoscopy.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Aminolevulinic Acid
KW - False Positive Reactions
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Patient Selection
KW - Photosensitizing Agents
KW - Urinary Bladder Neoplasms
U2 - 10.1016/j.urology.2009.04.095
DO - 10.1016/j.urology.2009.04.095
M3 - Article (Academic Journal)
C2 - 19683800
VL - 74
SP - 851
EP - 856
JO - Urology
JF - Urology
SN - 0090-4295
IS - 4
ER -