Zusammenfassung
Purpose: Transurethral resection (TUR) of bladder cancer supported by 5 aminolevulinic acid (ALA) induced fluorescence diagnosis (FD) is considered to be a very sensitive procedure. In this unicentric prospective trial, the sensitivity of FD was compared to conventional white light TUR. Materials and Methods: A total of 787 biopsies or tumors could be obtained from 310 patients. For fluorescence ...
Zusammenfassung
Purpose: Transurethral resection (TUR) of bladder cancer supported by 5 aminolevulinic acid (ALA) induced fluorescence diagnosis (FD) is considered to be a very sensitive procedure. In this unicentric prospective trial, the sensitivity of FD was compared to conventional white light TUR. Materials and Methods: A total of 787 biopsies or tumors could be obtained from 310 patients. For fluorescence 50 ml of 5-ALA 3% solution was instilled intravesically 2 hours prior to resection. Excitation was achieved using a special diagnostic light emitting blue light with wave lengths of 375 - 440 nm. Results: The sensitivity of FD (97.6%) was significantly higher (p<0.0001) than white light cystoscopy (77.2%). In 43 patients, 62 carcinomas and dysplasias overlooked by white light could be detected exclusively by FD (n = 26 pTa/1G1 - 2, n - 2 pT1G2, n = 3 pT1G3, n - 16 CIS, n = 2 > pT1 and n = 13 dysplasia H). Additional carcinomas in situ (CIS) were detected in 53.3% of the cases using FD. Conclusions: These data confirm that FD is a procedure with a very high sensitivity and clearly improves detection of tumours overlooked under conventional white light, especially CIS.
Altmetric