Abstract
This Practice Point commentary discusses the study by Denzinger et al. in which patients with high-grade T1 (HGT1) bladder cancer were treated by transurethral resection with either white-light cystoscopy or fluorescence cystoscopy. Over a median follow-up duration >7 years, the recurrence-free survival was significantly improved in the fluorescence cystoscopy group. No difference was observed between the two groups, however, in the rate of progression to muscle-invasive disease, although the low number of progression events limited the power of this comparison. As such, a low threshold for radical cystectomy should be maintained in transurethrally resected HGT1 disease, regardless of the visualization technique used. Importantly, fluorescence cystoscopy represents a more costly and time-consuming procedure than does white-light cystoscopy. Larger clinical trials, as well as research at the molecular level, are needed to define the potential role of fluorescence cystoscopy in the treatment of HGT1 disease.
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References
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GD Steinberg has declared that he has received grant or research support from Bioniche, Spectrum and Vysis; he has also acted as a consultant for and received speakers' honoraria from Vysis. MH Katz declared no competing interests.
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Katz, M., Steinberg, G. Should fluorescence cystoscopy be used for transurethral resection in patients with high-grade T1 bladder cancer?. Nat Rev Urol 5, 472–473 (2008). https://doi.org/10.1038/ncpuro1168
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DOI: https://doi.org/10.1038/ncpuro1168