Blue Light Flexible Cystoscopy with Hexaminolevulinate in Non- Muscle-Invasive Bladder Cancer: Review of the Clinical Evidence and Consensus Statement on Optimal Use in the USA — Update 2018
Blue light cystoscopy (BLC) with hexaminolevulinate (HAL) during transurethral resection of bladder cancer improves detection of non- muscle-invasive bladder cancer (NMIBC) and reduces recurrence rates. Flexible BLC was approved by the FDA in 2018 for use in the surveillance setting and was demonstrated to improve detection.
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Evaluation of Cxbladder and Adjudication of Atypical Cytology and Equivocal Cystoscopy
Background: Cxbladder diagnostic tests combine genomic information from urinary mRNA with phenotypic information to either rule out low-risk individuals or identify patients at a high risk of urothelial carcinoma (UC).
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Diagnosis and Pathology of Bladder Cancer
Diagnosis:
Clinical Presentation
There are no reliable screening tests available for detecting bladder cancer; hence the diagnosis is usually made based on clinical signs and symptoms. Painless hematuria – microscopic or gross – is the most common presentation and a hematuria investigation in an otherwise asymptomatic patient detects bladder neoplasm in roughly 20% of gross and 5% of microscopic cases.
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The Efficacy of a Second BCG Induction Course for Non-Muscle Invasive Bladder Cancer - Expert Commentary
The American Urological Association (AUA) recommends that non-muscle invasive bladder cancer (NMIBC) patients with persistent or recurrent Ta or CIS should receive a second induction course of Bacillus Calmette-Guerin (BCG) after the first course. However, a significant number of patients decline. Real-world data evaluating the efficacy of a second BCG induction course is needed.
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Urinary Biomarkers in Bladder Cancer: A Review of the Current Landscape and Future Directions - Beyond the Abstract
Nearly 80% of patients presenting with bladder cancer (BC) present with nonmuscle-invasive bladder cancer (NMIBC). Despite radical treatment, many of these patients experience disease progression. A surveillance program combining regular cystoscopy, upper urinary tract imaging, and urine cytology is typically instated to detect recurrence after radical treatment of NMIBC. This surveillance program has several shortcomings; amongst them the invasive nature of cystoscopy alongside the limited sensitivity (approximately 48%) of urine cytology.
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An evaluation of the real world use and clinical utility of the Cxbladder Monitor assay in the follow-up of patients previously treated for bladder cancer.
Surveilling recurrent urothelial carcinoma (UC) requires frequent cystoscopy, which is invasive, expensive and time-consuming. An accurate urinary biomarker has the potential to reduce the number of cystoscopies required during post-treatment surveillance.
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Non-muscle Invasive Bladder Cancer: Overcoming Diagnostic and Therapeutic Challenges
Published Date: October 2020In 2020, approximately 81,000 cases of urothelial carcinoma of the bladder will be diagnosed in the United States, with nearly 18,000 associated deaths.
1 Bladder cancer disproportionally affects men and is associated with well-defined environmental risk factors—tobacco use underlies approximately 50% of cases.
2 Nonmuscle-invasive bladder cancer (NMIBC) is primarily managed by transurethral resection, risk-stratified use of intravesical chemotherapeutic or immunotherapeutic agents, and close surveillance.
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Blue Light Cystoscopy: Insights on Recurrence, Progression, and Clinical Management
Published Date: September 2018
More than 81,000 individuals are diagnosed with bladder cancer in the United States every year, of whom 75% have non-muscle invasive disease.1,2 Unfortunately, half these cases recur despite transurethral resection of bladder tumor (TURBT), and from 5% to 25% of repeated recurrences progress to muscle-invasive disease.3,4,5
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Blue light cystoscopy for the diagnosis of bladder cancer: Results from the US prospective multicenter registry
Blue light cystoscopy (BLC) using hexaminolevulinate (HAL/Cysview/Hexvix) has been previously shown to improve detection of non-muscle-invasive bladder cancer (NMIBC). Herein, we evaluated the detection of malignant lesions in a heterogenous group of patients in the real world setting and documented the change in risk category due to upstaging or upgrading.
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Detecting Invisible Bladder Cancers with Blue Light Cystoscopy - Beyond the Abstract
Blue-light cystoscopy (BLC) is a photodynamic diagnostic technique that augments the detection of occult disease missed under traditional white light. Instillation of hexaminolevulinate, a heme precursor, causes preferential accumulation of protoporphyrin IX and other photoactive porphyrins in neoplastic cells, which are then excited under the wavelength of blue light (~450 nm) to fluoresce red. The sensitivity of BLC in detecting cancerous lesions is much higher than that of white-light alone (91% vs. 76%) and used together, BLC plus WLC has a sensitivity of 98.5%.
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Detecting Invisible Bladder Cancers with Blue Light Cystoscopy.
A 90-year old man with no significant past medical history presented to urology clinic complaining of gross hematuria, urinary frequency, and dysuria. Previous urine cytology was atypical but two white-light cystoscopies failed to show any lesions.
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