Journal article
The role of blue light cystoscopy and additional operative evaluations during first surveillance after induction therapy for high-risk NMIBC
Bladder cancer (Amsterdam, Netherlands), Vol.11(2), pp.1-10
04/2025
DOI: 10.1177/23523735251324318
PMCID: PMC12102550
PMID: 40416805
Abstract
During surveillance of high-risk non-muscle invasive bladder cancer (HR-NMIBC), occult disease can be missed by standard cystoscopy.
To determine the utility of enhanced restaging procedures.
We retrospectively reviewed 297 patients with HR-NMIBC who underwent enhanced restaging procedures during the first surveillance following induction intravesical therapy between 2010-2021. Patients were stratified by number of induction treatments with unique agents (161, 63, and 73 patients with 1, 2, and 3+ treatments) and analyzed using exact logistic regression models. Enhanced restaging procedures included standard cystoscopy (white-light cystoscopy with bladder wash cytology) plus additional components including blue-light cystoscopy, mapping bladder biopsies, retrograde pyelograms, upper tract cytologies, and prostatic urethral biopsies.
When standard cystoscopy was negative, blue light cystoscopy detected occult bladder cancer in 6.0%, 7.4%, and 19% of patients in the 1, 2, and 3+ treatment groups. History of CIS was associated with increased detection with blue light (p = 0.03). Extravesical (upper tract or prostatic urethral) cancer was detected by additional restaging components in 0.6%, 1.7%, and 15% of patients with 1, 2, and 3+ intravesical treatments. On multivariable analysis, receipt of 3+ intravesical inductions increased the odds of having at least one additional restaging component identify cancer (HR 3.76; p < .01).
Blue light cystoscopy improves surveillance of HR-NMIBC, particularly in those with CIS. Additional restaging procedures improved detection of extravesical disease in patients with heavier pre-treatment history. Risk-adapted utilization of enhanced restaging procedures requires further study.
Details
- Title: Subtitle
- The role of blue light cystoscopy and additional operative evaluations during first surveillance after induction therapy for high-risk NMIBC
- Creators
- Ian M McElree - University of IowaRyan L Steinberg - University of IowaSarah L Mott - University of IowaHelen Y Hougen - University of IowaMichael A O'Donnell - Department of Urology, University of Iowa, Iowa City, IA, USAVignesh T Packiam - Rutgers, The State University of New Jersey
- Resource Type
- Journal article
- Publication Details
- Bladder cancer (Amsterdam, Netherlands), Vol.11(2), pp.1-10
- DOI
- 10.1177/23523735251324318
- PMID
- 40416805
- PMCID
- PMC12102550
- NLM abbreviation
- Bladder Cancer
- ISSN
- 2352-3727
- eISSN
- 2352-3735
- Publisher
- SAGE PUBLICATIONS INC
- Grant note
- The John & Carol Walter Family Foundation
The authors have no acknowledgments.
- Language
- English
- Date published
- 04/2025
- Academic Unit
- Urology
- Record Identifier
- 9984824181902771
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