The quality of 5-aminolevulinic acid-induced photodynamic diagnosis and transurethral resection of bladder tumors: does the urologist play a role?

Ronald O P Draga, Matthijs C M Grimbergen, Esther T Kok, Trudy N Jonges, Christiaan F P van Swol, Ruud J L H Bosch

Research output: Contribution to journalArticle (Academic Journal)

5 Citations (Scopus)

Abstract

INTRODUCTION: The aim of this study is to evaluate the quality of photodynamic diagnosis (PDD) and transurethral resection of bladder tumors (TURBT) among different urologists.

PATIENTS AND METHODS: The selected data consists of 194 patients, 268 5-aminolevulinic acid (5-ALA)-induced PDD procedures and 934 biopsies. Tumors were resected and biopsies were taken from suspicious areas under guidance of white light endoscopy and 5-ALA-induced fluorescence cystoscopy. The quality of PDD was determined by evaluating the mean number of tumors resected by 5 urologists and, thereafter, assessing the time to recurrence between groups.

RESULTS: Urologist 1 took 37% more biopsies (p < 0.001) and diagnosed 42% more tumors (p = 0.005) and 46% more false positives (p < 0.001) from bladders compared to urologists 2, 3, 4 and 5 together. The mean time to bladder cancer recurrence for all recurrences within 0-18 months was 11.0 months for operator 1 and 8.3 months for the other urologists (p = 0.01).

CONCLUSIONS: The resecting urologist appears to be an important factor for the quality of standard and PDD-assisted TURBT. Learning curve programs may be required with experienced surgeons accompanying those with less experience.

Original languageEnglish
Pages (from-to)326-31
Number of pages6
JournalUrologia Internationalis
Volume89
Issue number3
DOIs
Publication statusPublished - 2012

Bibliographical note

Copyright © 2012 S. Karger AG, Basel.

Keywords

  • Aged
  • Aminolevulinic Acid
  • Biopsy
  • Cystoscopy
  • False Positive Reactions
  • Female
  • Humans
  • Male
  • Medical Oncology
  • Middle Aged
  • Photochemotherapy
  • Recurrence
  • Reproducibility of Results
  • Time Factors
  • Urinary Bladder Neoplasms
  • Urology

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