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Abstract
Objective. The aim of this study was to evaluate the effect of fluorescence cystoscopy and immediate post-transurethral resection of the bladder (TURB) chemoprophylaxis on the risk of recurrence of non-muscle-invasive bladder cancer (NMIBC) under routine clinical conditions. Materials and methods. Fluorescence cystoscopy using hexyl-aminolevulinate and post-TURB chemoprophylaxis using mitomycin C were simultaneously introduced in an effort to reduce the recurrence of NMIBC. In total, 190 consecutive patients were enrolled over a 2 year period and followed as the intervention group; 216 patients treated over a 2 year period before introduction served as controls. An intention-to-treat analysis was performed with baseline control. Results. The recurrence risk was reduced by 41% (hazard ratio 0.59, 95% confidence interval 0.45–0.78) (intention-to-treat analysis). Median recurrence-free survival was extended from 13.6 months to 36.8 months. Every third follow-up TURB was avoided. Patients with low-risk tumors and patients with primary as well as recurrent disease benefited from the treatment. Conclusions. Fluorescence cystoscopy and immediate post-TURB chemoprophylaxis effectively reduced the recurrence risk and numbers of follow-up procedures under clinical routine conditions.
Acknowledgement
This study was supported by an individual grant from the Danish Cancer Society to Malene Risager Lykke.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.