Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Photodiagnosis Photodyn Ther. 2023 Jun;42:103574. doi: 10.1016/j.pdpdt.2023.103574. Epub 2023 Apr 18.
Intravesical Bacille Calmette-Guerin (BCG) therapy has been reported to be effective in preventing recurrence and progression in non-muscle invasive bladder cancer. Furthermore, photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT) improves the accuracy of cancer diagnosis and contributes to lower recurrence rates. The purpose of this study is to investigate whether more tumor resection with PDD-TURBT rather than conventional TURBT before BCG therapy outweighs the benefit of BCG therapy alone.
Patients who underwent intravesical BCG therapy following TURBT in our institution from 2010 to 2021 were included. They were divided into the following two groups: those who received PDD-TURBT before BCG treatment (PDD + BCG group) and those who received conventional TURBT before BCG treatment (WL + BCG group). The 2-year recurrence-free survival (RFS) and progression-free survival (PFS) of the two groups were retrospectively analyzed and compared.
The 2-year RFS was significantly improved in the PDD + BCG group (hazard ratio [HR]: 2.41, 95% confidence interval [CI]: 1.26-4.60; p = 0.025). No significant difference in 2-year PFS was noted between the two groups. Analysis of prognostic factors for RFS showed that PDD-TURBT w We think that this text does not adequately express the meaning that we want to deliver to the reader.as a significant prognostic factor in univariate analysis (HR: 0.41, 95% CI: 0.18-0.92; p = 0.03).
BCG treatment following PDD-TURBT significantly improved RFS more than BCG therapy following WL-TURBT. More accurate tumor localization and more efficient tumor resection by PDD-TURBT may have a positive impact on subsequent BCG treatments even if the treatment is administered postoperatively.
膀胱内卡介苗（BCG）治疗已被报道可有效预防非肌肉浸润性膀胱癌的复发和进展。此外，光动力诊断（PDD）辅助经尿道膀胱肿瘤切除术（TURBT）可提高癌症诊断的准确性，降低复发率。本研究旨在探讨与单独使用 BCG 治疗相比，BCG 治疗前进行 PDD-TURBT 切除更多肿瘤是否优于单纯 TURBT。
纳入 2010 年至 2021 年期间在我院接受 TURBT 后行膀胱内 BCG 治疗的患者。将其分为以下两组：BCG 治疗前接受 PDD-TURBT（PDD+BCG 组）和 BCG 治疗前接受常规 TURBT（WL+BCG 组）。回顾性分析比较两组患者的 2 年无复发生存率（RFS）和无进展生存率（PFS）。
PDD+BCG 组的 2 年 RFS 显著提高（风险比 [HR]：2.41，95%置信区间 [CI]：1.26-4.60；p=0.025）。两组 2 年 PFS 无显著差异。RFS 的预后因素分析显示，PDD-TURBT 是单因素分析中的显著预后因素（HR：0.41，95%CI：0.18-0.92；p=0.03）。
与 WL-TURBT 后 BCG 治疗相比，PDD-TURBT 后 BCG 治疗显著提高了 RFS。PDD-TURBT 可更准确地定位肿瘤并更有效地切除肿瘤，即使在术后进行治疗，也可能对后续 BCG 治疗产生积极影响。
