PD30-06 PHOTODYNAMIC DIAGNOSIS (PDD) DIRECTED BIOPSIES VS WHITE LIGHT BLADDER MAPPING IN PATIENTS WITH POSITIVE CYTOLOGY AND NEGATIVE PREOPERATIVE WORKUP: AN INTERNATIONAL MULTICENTER RETROSPECTIVE STUDY

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You have accessJournal of UrologyBladder Cancer: Non-invasive II (PD30)1 May 2024PD30-06 PHOTODYNAMIC DIAGNOSIS (PDD) DIRECTED BIOPSIES VS WHITE LIGHT BLADDER MAPPING IN PATIENTS WITH POSITIVE CYTOLOGY AND NEGATIVE PREOPERATIVE WORKUP: AN INTERNATIONAL MULTICENTER RETROSPECTIVE STUDY Fulvia Colucci, Francesco Soria, Simone Livoti, Matteo Rosazza, Daniele Dutto, Gautier Marcq, Edouard Jarry, Laura Mertens, Marco Moschini, Mario Deangelis, Mattia Longoni, Rodolfo Hurle, Stefano Mancon, Renate Pichler, Felizian Lackner, Francesco Montorsi, and Paolo Gontero Fulvia ColucciFulvia Colucci , Francesco SoriaFrancesco Soria , Simone LivotiSimone Livoti , Matteo RosazzaMatteo Rosazza , Daniele DuttoDaniele Dutto , Gautier MarcqGautier Marcq , Edouard JarryEdouard Jarry , Laura MertensLaura Mertens , Marco MoschiniMarco Moschini , Mario DeangelisMario Deangelis , Mattia LongoniMattia Longoni , Rodolfo HurleRodolfo Hurle , Stefano ManconStefano Mancon , Renate PichlerRenate Pichler , Felizian LacknerFelizian Lackner , Francesco MontorsiFrancesco Montorsi , and Paolo GonteroPaolo Gontero View All Author Informationhttps://doi.org/10.1097/01.JU.0001008848.77629.6f.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: CIS is a flat, non-vegetating, high-grade tumor and is associated with a high risk of disease progression to muscle invasive cancer (MIBC), especially if not timely diagnosed and treated. Since it may be often not visible with white light cystoscopy (WL), international guidelines recommend the use of bladder mapping in case of suspected CIS (positive urine cytology and negative preoperative workup). Photodynamic diagnosis (PDD) has been shown to increase the sensitivity in the diagnosis of CIS compared to WL cystoscopy and should be used for this purpose, when available. However, a direct comparison between PDD-guided biopsies (PDD-GB) and WL bladder mapping (WL-M) is lacking. The aim of our study is therefore to compare the diagnostic ability of PDD-GB with that of WL-M in detecting CIS by using a large multicenter international cohort of patients. METHODS: A retrospective analysis was conducted from March 2018 to September 2023 at six European referral Centers. Patients with positive urinary cytology and negative flexible cystoscopy and/or negative CT scan were included for the purpose of the study. Conversely, visible lesions or areas suspicious for CIS at WL cystoscopy represented an exclusion criterion. Included patients underwent either PDD-GB or WL-M, as per international guidelines. The main endpoint of the study was the diagnostic accuracy in the detection of CIS. Recurrence-free and progression-free survival were investigated as secondary endpoint. RESULTS: Overall, 149 patients (54%) underwent PDD-GB while 126 (46%) received WL-M. No differences in baseline characteristics were observed between the two groups. Bladder CIS was found in 21 patients (14%) among the PDD-GB group and in 11 patients (9%) among the WL-M group (p=0.2). On univariable logistic regression the type of intervention (PDD-GB vs WL-M) was not associated with CIS diagnosis (HR 1.72, 95% CI 0.79-3.71). Disease recurrence was found in 64 patients (27%), but no statistically significant differences were observed among the two groups (p=0.08); disease progression was found in 18 (8%) patients and, again, no differences were observed (p=0.6). CONCLUSIONS: We did not observe statistically significant differences between the PDD-GB group and the WL-M group in the diagnosis of CIS. WL-M remains a valid alternative to PDD-GB in patients with suspected CIS, when PDD equipment is not available. The main limitations of this study are inherent its retrospective nature and possible related selection biases. Source of Funding: On behalf of the European Association of Urology Young Academic Urologist Urothelial Working Group © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e626 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Fulvia Colucci More articles by this author Francesco Soria More articles by this author Simone Livoti More articles by this author Matteo Rosazza More articles by this author Daniele Dutto More articles by this author Gautier Marcq More articles by this author Edouard Jarry More articles by this author Laura Mertens More articles by this author Marco Moschini More articles by this author Mario Deangelis More articles by this author Mattia Longoni More articles by this author Rodolfo Hurle More articles by this author Stefano Mancon More articles by this author Renate Pichler More articles by this author Felizian Lackner More articles by this author Francesco Montorsi More articles by this author Paolo Gontero More articles by this author Expand All Advertisement PDF downloadLoading ...

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