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PEER-TO-PEER CLINICAL CONVERSATIONS
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Real-World Claims Analysis of Blue-Light Cystoscopy in NMIBC
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Mark Tyson II, MD, MPH
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| Mark Tyson reviews a real-world cost analysis comparing blue-light and white-light cystoscopy in NMIBC, drawing on a matched Optum database cohort of 794 blue-light and 4,764 white-light patients with a median age of 73.
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Real-World Use of a Urinary Biomarker in a Large Integrated Health System
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Christopher Filson, MD, MS
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| Christopher Filson discusses a real-world evaluation of the Cxbladder triage urinary biomarker, based on approximately 3,400 matched cases from the Kaiser Southern California system.
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Multidisciplinary Teams to Address Quality and Documentation of Bladder Tumor Resection
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Patrick Hensley, MD
Ashish Kamat hosts Patrick Hensley to discuss the IBCG 2026 focus on TURBT quality, marking the first time the retreat has centered on a procedure rather than a disease state.
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| Costs of Care and Oncologic Outcomes Associated with Blue Light Cystoscopy in an Equal Access Setting: Results from the BRAVO Study
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| Ali Nasrallah, MD
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| In the BRAVO study, blue light cystoscopy was associated with lower NMIBC recurrence, fewer inpatient and emergency room visits, and improved oncologic outcomes compared with white light cystoscopy alone. Although 5-year total costs were higher, primarily from outpatient care, recurrence-related savings brought the approach close to cost-neutral by 5 years.
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| Urinary Tumor DNA-Guided De-Escalation of Systemic Immunotherapy in Extensive Very High Risk NMIBC
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| Yunkai Qie, MD
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| In this study of extensive very high-risk NMIBC, patients who were utDNA-negative after complete response were able to stop immunotherapy early without an apparent loss of efficacy compared with longer treatment. The de-escalation group had similar recurrence-free survival, overall survival, and duration of response, with fewer and less severe adverse events, suggesting a potential role for utDNA in tailoring treatment duration.
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| Evaluation of Urinary Minimal Residual Disease and Outcomes in High-Risk NMIBC Surveilled with Blue Light Compared to White Light Cystoscopy
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| Meghan McNamara, MD
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| This randomized trial is evaluating whether blue light cystoscopy during TURBT reduces urinary genomic disease burden more than white light cystoscopy in high-risk NMIBC, using UroAmp minimal residual disease and Genomic Disease Burden as key biomarkers. The study has enrolled 59 of 200 planned patients, with recurrence-free survival by MRD risk group as a secondary focus and an interim analysis expected by the end of 2026.
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| Artificial Intelligence in Cystoscopy: Feasibility of a Computer Vision Model for Bladder Cancer Detection
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| Zorawar Singh, MD
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| This pilot study evaluated an AI computer vision model for recognizing urethral and bladder landmarks during cystoscopy and identifying bladder tumors. The model showed moderate overall landmark accuracy and high tumor detection performance in the test set, supporting further study of AI-enabled real-time procedural support in cystoscopy.
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| Real-World Patterns and Clinical Outcomes Among US Patients with NMIBC During the BCG Shortage
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| Suzanne Merrill, MD, FACS
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| In this real-world study of 3,516 NMIBC patients during the BCG shortage, only 29% of high-risk patients received BCG induction and 12% received maintenance, with a median maintenance duration of 7.7 months. High-risk patients had worse outcomes than lower-risk patients, reinforcing the need for effective alternative intravesical strategies when BCG access is limited.
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| Best Practices for Intermediate-risk NMIBC
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| Mario Fernández, MD, Joan Palou, MD, and Akshay Sood, MD
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| At AUA 2026, the debate on intermediate-risk NMIBC focused on whether recurrent low-grade disease should be managed conservatively or with repeat TURBT plus intravesical therapy. Dr. Sood argued for de-escalation in carefully selected patients using active surveillance, office fulguration, and chemoablation, while Dr. Palou emphasized the efficacy of TURBT and the role of adjuvant intravesical therapy in reducing recurrence, with management guided by risk factors, tumor burden, and patient preference.
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