Photodynamic Diagnosis in Non–Muscle-Invasive Bladder Cancer: A Systematic Review and Cumulative Analysis of Prospective Studies

摘要: Abstract Context The clinical benefit of photodynamic diagnosis (PDD) with 5-aminolevulinic acid or hexaminolevulinate in addition to white-light cystoscopy (WLC) bladder cancer has been discussed controversially. Objective To assess a systematic review the effect PDD WLC on (1) and (2) therapeutic outcome primary recurrent non–muscle-invasive investigated by transurethral resection. Evidence acquisition An electronic database search Medline, Embase, Cochrane Library, CancerLit was undertaken, plus hand searching relevant congress abstracts urologic journals. Trials were included if they prospectively compared cancer. process followed guidelines Collaboration. Two reviewers evaluated independently both trial eligibility methodological quality data extraction. synthesis end point diagnostic accuracy additional detection rate. points residual tumour at second resection recurrence-free survival (RFS). Seventeen trials identified. Twelve used same patients. Seven reported results for subgroup patients carcinoma situ (CIS). Five randomised studied outcome. combined random effects meta-analyses points, designs, populations comparable. Twenty percent (95% confidence interval [CI], 8–35) more tumour-positive detected all tumours 39% (CI, 23–57) when only CIS analysed. Heterogeneity present among studies even investigated. Residual significantly less often found after (odds ratio: 0.28; 95% CI, 0.15–0.52; p value log-rank tests RFS statistically significant (0.00002). Conclusions detects tumour–positive patients, especially CIS, than WLC. More have complete longer diagnosed PDD.