Impact of photodynamic diagnosis-assisted transurethral resection of bladder tumors on the prognostic outcome after radical cystectomy: results from PROMETRICS 2011

Results of a retrospective single-institution study recently suggested improved prognostic outcomes in patients undergoing photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT) prior to radical cystectomy (RC). We sought to validate the prognostic influence of PDD-assisted TURBT on survival after RC by relying on a multi-institutional dataset.

To provide a homogeneous study population, patients with organ metastasis at the time of RC and/or after neoadjuvant chemotherapy were excluded from analysis, which resulted in overall 549 bladder cancer (BC) patients from 18 centers of the Prospective Multicenter Radical Cystectomy Series 2011 (PROMETRICS 2011). To evaluate the influence of PDD conducted during primary or final TURBT on cancer-specific mortality (CSM) and overall mortality (OM) after RC, bootstrap-corrected multivariate Cox proportional-hazards regression models were applied (median follow-up: 25 months; IQR: 19-30). Sensitivity analyses were performed for both patients with pure urothelial carcinoma and patients undergoing one single TURBT only.

In 88 (16.0 %) and 100 (18.2 %) patients, PDD was used in primary and final TURBTs, respectively. In 335 (61.0 %) patients, a single TURBT was performed prior to RC; in 194 patients (35.3 %), TURBT had been performed in a different center. CSM and OM rates at 3 years were 32 and 40 %, respectively. Use of PDD during primary or final TURBT was no independent predictor of CSM or OM. These results were internally valid and were confirmed in sensitivity analyses.

PDD utilization during TURBT prior to RC does not independently impact the prognosis of BC patients after RC.

World journal of urology. 2016 Jun 14 [Epub ahead of print]

Matthias May, Hans-Martin Fritsche, Malte W Vetterlein, Patrick J Bastian, Michael Gierth, Philipp Nuhn, Atiqullah Aziz, Margit Fisch, Christian G Stief, Markus Hohenfellner, Manfred P Wirth, Vladimir Novotny, Oliver W Hakenberg, Joachim Noldus, Christian Gilfrich, Christian Bolenz, Maximilian Burger, Sabine D Brookman-May, PROMETRICS 2011 Research Group

Department of Urology, St. Elisabeth-Hospital Straubing, St. Elisabeth-Straße 23, 94315, Straubing, Germany. ., Department of Urology, Caritas-Hospital St. Josef, University of Regensburg, Regensburg, Germany., Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Department of Urology, Marien-Hospital Düsseldorf, Düsseldorf, Germany., Department of Urology, Caritas-Hospital St. Josef, University of Regensburg, Regensburg, Germany., Department of Urology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany., Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Department of Urology, Ludwig-Maximilians-University Munich, Munich, Germany., Department of Urology, University of Heidelberg, Heidelberg, Germany., Department of Urology, University Hospital 'Carl Gustav Carus', Dresden University of Technology, Dresden, Germany., Department of Urology, University Hospital 'Carl Gustav Carus', Dresden University of Technology, Dresden, Germany., Department of Urology, University of Rostock, Rostock, Germany., Department of Urology, Marien-Hospital Herne, Ruhr-University of Bochum, Herne, Germany., Department of Urology, St. Elisabeth-Hospital Straubing, St. Elisabeth-Straße 23, 94315, Straubing, Germany., Department of Urology, University of Ulm, Ulm, Germany., Department of Urology, Caritas-Hospital St. Josef, University of Regensburg, Regensburg, Germany., Department of Urology, Ludwig-Maximilians-University Munich, Munich, Germany.

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