AUA 2017: Late-Breaking Abstract- Blue Light Flexible Cystoscopy (BLFC) with Hexaminolevulinate (HAL) and White Light Flexible cystoscopy: A Prospective, Comparative, Within-Patient controlled Multi-Center Phase 3 Study in the Detection of Bladder Cancer
Boston, MA (UroToday.com) Dr. Daneshmand presented on the use of blue light flexible cystoscopy in the detection of bladder cancer during surveillance. The objective was to determine the sensitivity of flexible surveillance cystoscopy with blue light technology. Using hexaminolevulinate (HAL) with blue light cystoscopy and the Cysview system has been associated with improved detection of bladder cancer when used with a rigid cystoscopy, but this limited the office use of this technology. For patients with a high risk of bladder cancer recurrence underwent randomization to white light only or white light and blue light flexible cystoscopy. If they had a suspicious lesion, they were taken to the OR where the blue and white light exams were repeated. The study was performed at 17 US sites. There were 304 patients included, of which there was no malignancy in 117 patients and 103 were taken to the operating room for a biopsy. Of these, 65 were confirmed to have malignancy on the biopsy. The mean exposure time of the HAL was 88 minutes. The proportion of tumors detected by only the blue light was 21% (<0.001). In addition, nine of 26 CIS tumors were exclusively seen with blue light flexible cystoscopy. There was no indication that the repeat blue light cystoscopy with Cysview had any morbidity. In addition, patient reported outcomes were also investigated, 90% of patients felt it was worthwhile to undergo Cysview, would do the procedure again and would recommend the procedure to others.
As with rigid cystoscopy, blue light cystoscopy with HAL using a flexible cystoscope has demonstrated better detection of carcinoma in situ and papillary tumor than white light alone. This offers patients advanced technology in the office, should improve surveillance for bladder cancer.
Presented By: Siamak Daneschmand, MD, University of Southern California, Los Angeles, California
Written By: Janet Baack Kukreja (@janetkukreja), MD, MPH, Urologic Oncology Fellow, Department of Urology, UT MD Anderson Cancer Center, Houston, TX, Ashish M. Kamat, MD, MBBS, FACS, Wayne B. Duddlesten Professor, Department of Urology, UT MD Anderson Cancer Center, Houston TX
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA