Blue light flexible cystoscopy with hexaminolevulinate in non-muscle-invasive bladder cancer: review of the clinical evidence and consensus statement on optimal use in the USA — update 2018

Yair Lotan, Trinity J. Bivalacqua, Tracy Downs, William Huang, Jeffrey Jones, Ashish M. Kamat, Badrinath Konety, Per Uno Malmström, James McKiernan, Michael O’Donnell, Sanjay Patel, Kamal Pohar, Matthew Resnick, Alexander Sankin, Angela Smith, Gary Steinberg, Edouard Trabulsi, Michael Woods, Siamak Daneshmand

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations

Abstract

Blue light cystoscopy (BLC) with hexaminolevulinate (HAL) during transurethral resection of bladder cancer improves detection of non-muscle-invasive bladder cancer (NMIBC) and reduces recurrence rates. Flexible BLC was approved by the FDA in 2018 for use in the surveillance setting and was demonstrated to improve detection. Results of a phase III prospective multicentre study of blue light flexible cystoscopy (BLFC) in surveillance of intermediate-risk and high-risk NMIBC showed that 20.6% of malignancies were identified only by BLFC. Improved detection rates in the surveillance setting are anticipated to lead to improved clinical outcomes by reducing future recurrences and earlier identification of tumours that are unresponsive to therapy. Thus, BLFC has a role in surveillance cystoscopy, and determining which patients will benefit from BLFC and optimal and cost-effective ways of incorporating this technology into surveillance cystoscopy must be developed.

Original languageEnglish (US)
Pages (from-to)377-386
Number of pages10
JournalNature Reviews Urology
Volume16
Issue number6
DOIs
StatePublished - Jun 1 2019

ASJC Scopus subject areas

  • Urology

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