To evaluate the role of blue light (BL) cystoscopy in detecting invasive tumors that were not visible on white light (WL) cystoscopy.
Using the multi-institutional Cysview registry database, patients who had at least one white light negative/blue light positive lesion with invasive pathology (≥T1) as highest stage tumor were identified. All white light negative/blue light positive lesions and all invasive tumors in the database were used as denominators. Relevant baseline and outcome data were collected.
Of the 3514 lesions (1257 unique patients), 818 (23.2%) lesions were WL negative (WL-)/BL positive (BL+), of those, 55 (7%) lesions were invasive (48 T1,7 T2) (47 unique patients) including 28/55 (51%) de novo invasive lesions (26 unique patients). 21/47 (45%) patients had WL-/BL+ concommitant CIS and/or another T1 lesions. Of 22 patients with WL-/BL+ lesion who underwent cystectomy, high risk pathologic features leading to cystectomy was only visible on BL cystoscopy in 18 (82%) patients. At time of cystectomy, 11/22 (50%) patients showed pathologic upstaging including 4/22 (18%) patients with node positive disease.
A considerable proportion of invasive lesions are only detectable by BL cystoscopy and rate of pathologic upstaging is significant. Our findings suggest an additional benefit of BL cystoscopy in detection of invasive bladder tumors that has implications for treatment approach.
BJU international. 2021 Oct 12 [Epub ahead of print]
Hamed Ahmadi, Seyedeh Sanam Ladi-Seyedian, Badrinath Konety, Kamal Pohar, Jeffrey M Holzbeierlein, Max Kates, Brian Willard, Jennifer M Taylor, Joseph C Liao, Hristos Z Kaimakliotis, Sima P Porten, Gary D Steinberg, Mark D Tyson, Yair Lotan, Siamak Daneshmand, Blue Light Cystoscopy with Cysview Registry Group
Department of Urology, USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA., University of Minnesota, Minneapolis, MN, USA., Ohio State University, Columbus, OH, USA., University of Kansas, Kansas City, KS, USA., The James Buchanan Brady Urological Institute, Johns Hopkins University, Baltimore, MD, USA., Lexington Medical Center, Lexington, SC, USA., Michael E. DeBakey VAMC, BCM, Houston, TX, USA., VA Palo Alto Health Care System, Palo Alto, CA, USA., Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA., Department of Urology, University of California San Francisco, San Francisco, CA, USA., Department of Urology, New York University, New York, NY, USA., Department of Urology, Mayo Clinic Hospital, Phoenix, AZ, USA., UT Southwestern Medical Center, Dallas, TX, USA.