EAU 2023: Blue Light Cystoscopy Delays Time to Recurrence in Non-Muscle Invasive Bladder Cancer Patients Treated in a Real-World Setting

(UroToday.com) The 2023 European Association of Urology (EAU) annual congress held in Milan, Italy between March 10th and 13th, 2023 was host to an abstract session of studies addressing the treatment of non-muscle invasive bladder cancer (NMIBC). Dr. Siamak Daneshmand presented the results of a study evaluating the performance of blue light cystoscopy in delaying time to recurrence in patients with NMIBC, within the context of a real-world setting.

Patients with NMIBC are at high risk of disease recurrence, progression, and adverse oncologic outcomes. Currently, white light cystoscopy remains standard of care; however, there is accumulating evidence that enhanced endoscopic modalities, such as blue light cystoscopy, have superior sensitivity that may allow for the detection of tumor missed on while light cystoscopy.1

The objective of the current study was to evaluate the impact of blue light cystoscopy use on recurrences rates among NMIBC patients in a real-world, clinical care setting. Accordingly, the investigators included 2,055 patients enrolled in the United States Blue Light Cystoscopy with Cysview Registry. The control group consisted of a “historical” cohort of 261 patients who underwent white light cystoscopy. These control patients were matched for age, stage, grade, and clinical management (i.e., intravesical therapy). The event-free-survival rate was estimated using a Kaplan-Meier curve, with comparisons performed using the Log-Rank sum test.

At a mean follow-up of 27.4 and 53 months in the blue and white light cystoscopy cohorts, respectively, the overall hazard of recurrence was significantly lower in the blue light cystoscopy group (hazard ratio: 0.33, 95% CI: 0.28 to 0.40, p<0.001). As demonstrated in the Kaplan Meier curve and table below, this decreased rate in the blue light group was prominent early (recurrence-free rate at 12 months: 79% versus 46%) and sustained with prolonged follow-up (60 months: 61% versus 28%).

blue light cystoscopy.jpg

Dr. Daneshmand’s group concluded as follows:

  • In a large, multisite registry study, the authors demonstrated that blue light cystoscopy, in combination with conventional white light cystoscopy, is associated with a significantly decreased hazard of recurrence and a prolonged time interval to recurrence.
  • The results suggest that enhanced tumor detection through increased sensitivity with blue light cystoscopy has the potential to translate into more favorable long-term outcomes in a real-world setting

blue light cystoscopy EAU.jpg

Presented by: Siamak Daneshmand, MD, Professor of Urology, Department of Urology, University of Southern California, Los Angeles, CA

Written by: Rashid K. Sayyid, MD, MSc – Society of Urologic Oncology (SUO) Clinical Fellow at The University of Toronto, @rksayyid on Twitter during the 2023 European Association of Urology (EAU) 38th annual congress held in Milan, Italy between March 10th and 13th, 2023 


  1. Ahmadi H, et al. Role of blue-light cystoscopy in detecting invasive bladder tumours: data from a multi-institutional registry. BJU Int, 2021.