Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Gakis, G; Ngamsri, T; Rausch, S; Mischinger, J; Todenhöfer, T; Schwentner, C; Schmid, MA; Hassan, FA; Renninger, M; Stenzl, A.
Fluorescence-guided bladder tumour resection: impact on survival after radical cystectomy.
World J Urol. 2015; 33(10):1429-1437
Doi: 10.1007/s00345-015-1485-8
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PubMed
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- Co-Autor*innen der Med Uni Graz
- Mischinger Johannes
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- Abstract:
- To investigate whether photodynamic diagnosis (PDD)-guided bladder tumour resection (TUR-BT) is of prognostic value in patients undergoing subsequent radical cystectomy (RC) for bladder cancer (BC). In 224 consecutive patients who underwent RC and bilateral pelvic lymphadenectomy for BC between 2002 and 2010 (median follow-up 29 months [IQR 8-59]), we retrospectively investigated whether patients had previously undergone PDD-guided (hexaminolevulinate [HAL] vs. 5-aminolevulinate [ALA]) versus white light (WL)-TUR-BT. Kaplan-Meier analysis was used to estimate recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS) using log-rank and Cox regression model for uni- and multivariable analysis. Of the 224 patients, 66 (29.5 %) underwent HAL-, 23 (10.3 %) ALA- and 135 (60.2 %) WL-TUR-BT before RC. The 3-year RFS/CSS/OS was 77.8/83.9/74.0 % for HAL-, 53.6/74.5/60.9 % for ALA- and 52.4/59.7/56.5 % for WL-TUR-BT (p = 0.002/0.023/0.037 for HAL vs. WL/ALA). PDD-TUR-BT was associated with a higher number of TUR-BTs before RC (p < 0.001) and re-resections (p = 0.015), a longer time between the first TUR-BT and RC (p = 0.044) and a lower rate of post-operative systemic chemotherapy (p = 0.001). In multivariable analysis, performance of HAL-TUR-BT, pathologic tumour and nodal stage as well as soft tissue surgical margin status were independent predictors for RFS, CSS and OS. This series indicates for the first time that HAL-guided TUR-BT is an independent predictor for improved survival after RC.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Cystectomy - methods
- Disease-Free Survival -
- Female -
- Fluorescence -
- Follow-Up Studies -
- Follow-Up Studies - epidemiology
- Humans -
- Male -
- Middle Aged -
- Retrospective Studies -
- Surgery, Computer-Assisted - methods
- Survival Rate - trends
- Treatment Outcome -
- Urinary Bladder Neoplasms - diagnosis
- Urinary Bladder Neoplasms - mortality
- Urinary Bladder Neoplasms - surgery
- Find related publications in this database (Keywords)
- Aminolevulinate
- Bladder cancer
- Hexaminolevulinate
- Radical cystectomy
- Survival
- Transurethral bladder tumour resection