Is a restaging TURBT necessary in high-risk NMIBC if the initial TURBT was performed with blue light?

To evaluate whether a restaging transurethral resection of bladder tumor (TURBT) is necessary in high-risk nonmuscle invasive bladder cancer (NMIBC) if the initial TURBT was performed using blue light (BL) technology.

Using the multi-institutional Cysview registry between 2014 and 2021, all consecutive adult patients with known NMIBC (Ta and T1 disease) who underwent TURBT followed by a restaging TURBT within 8 weeks were reviewed. Patients were stratified according to their initial TURBT, BL vs. white light (WL), and compared to determine rates of residual disease and upstaging. Univariate analysis was performed using Mann-Whitney U and chi-square tests, with P < 0.05 considered significant.

Overall, 115 patients had TURBT for NMIBC followed by a restaging TURBT within 8 weeks and were included in the analysis. Patients who underwent BL compared to WL for their initial TURBT had higher rates of benign pathology on restaging TURBT, although this was not statistically significant (47% vs. 30%; P = 0.08). Of patients with residual tumors on restaging TURBT, there were no differences in rates of Ta (22% vs. 26.5%; P = 0.62), T1 (22% vs. 26.5%; P = 0.62), or CIS (5.5% vs. 13%; P = 0.49) when the initial TURBT was done using BL compared to WL. Rates of upstaging to muscle invasive disease were also not different when initial TURBT was performed using BL compared to WL (3% vs. 4%; P = 0.78).

TURBT using BL does not reduce rates of residual disease or risk of upstaging on restaging TURBT in Ta or T1 disease. Thus, a restaging TURBT is still necessary even if initial TURBT was performed using BL.

Urologic oncology. 2022 Nov 23 [Epub ahead of print]

Muhannad Alsyouf, 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., Allina Health Cancer Institute, Minneapolis, MN., Ohio State University, Columbus, OH., University of Kansas, Kansas City, KS., The James Buchanan Brady Urological Institute, Johns Hopkins University, Baltimore, MD., Lexington Medical Center, Lexington, SC., Michael E. DeBakey VAMC, BCM, Houston, TX., VA Palo Alto Health Care System, Palo Alto, CA., Department of Urology, Indiana University School of Medicine, Indianapolis, IN., Department of Urology, University of California San Francisco, San Francisco, CA., Department of Urology, New York University, New York, NY., Department of Urology, Mayo Clinic Hospital, Phoenix, AZ., UT Southwestern Medical Center, Dallas, TX., Department of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA. Electronic address: .