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Role of hexaminolevulinate-guided fluorescence cystoscopy in bladder cancer: critical analysis of the latest data and European guidance

Malmstrom, Per-Uno; Grabe, Magnus LU ; Haug, Erik Skaaheim; Hellstrom, Pekka; Hermann, Gregers G.; Mogensen, Karin; Raitanen, Mika and Wahlqvist, Rolf (2012) In Scandinavian Journal of Urology and Nephrology1967-01-01+01:002013-01-01+01:00 46(2). p.108-116
Abstract
Objective. Hexaminolevulinate (HAL) is an optical imaging agent used with fluorescence cystoscopy (FC) for the detection of non-muscle-invasive bladder cancer (NMIBC). Guidelines from the European Association of Urology (EAU) and a recent, more detailed European expert consensus statement agree that HAL-FC has a role in improving detection of NMIBC and provide recommendations on situations for its use. Since the publication of the EAU guidelines and the European consensus statement, new evidence on the efficacy of HAL-FC in reducing recurrence of NMIBC, compared with white light cystoscopy (WLC), have been published. Material and methods. To consider whether these new trials have an impact on the expert guidelines and on clinical practice... (More)
Objective. Hexaminolevulinate (HAL) is an optical imaging agent used with fluorescence cystoscopy (FC) for the detection of non-muscle-invasive bladder cancer (NMIBC). Guidelines from the European Association of Urology (EAU) and a recent, more detailed European expert consensus statement agree that HAL-FC has a role in improving detection of NMIBC and provide recommendations on situations for its use. Since the publication of the EAU guidelines and the European consensus statement, new evidence on the efficacy of HAL-FC in reducing recurrence of NMIBC, compared with white light cystoscopy (WLC), have been published. Material and methods. To consider whether these new trials have an impact on the expert guidelines and on clinical practice (e. g. supporting existing recommendations or providing evidence for a change or expansion of practice), a group of bladder cancer experts from Denmark, Finland, Norway and Sweden met to address the following questions: What is the relevance of the new data on HAL-FC for clinical practice in managing NMIBC? What impact do the new data have on European guidelines? How could HAL-FC be used in clinical practice? and What further information on HAL-FC is required to optimize the management of NMIBC? Results and conclusions. This article reports the outcomes of the discussion at the Nordic expert panel meeting, concluding that, in line with European guidance, HAL-FC has an important role in the initial detection of NMIBC and for follow-up of patients to assess tumour recurrence after WLC. It provides practical advice, with an algorithm on the use of this diagnostic procedure for urologists managing NMIBC. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
TURBT, tumour recurrence, transurethral resection of bladder tumour, residual tumour, photosensitizer, non-muscle-invasive bladder cancer, hexaminolevulinate, cystoscopy, fluorescence cystoscopy, bladder cancer
in
Scandinavian Journal of Urology and Nephrology1967-01-01+01:002013-01-01+01:00
volume
46
issue
2
pages
108 - 116
publisher
Taylor & Francis
external identifiers
  • wos:000301539200006
  • scopus:84858407865
ISSN
0036-5599
DOI
10.3109/00365599.2011.633279
language
English
LU publication?
yes
id
d26f61ee-e463-4bef-aba1-a9daec2b00a9 (old id 2515397)
date added to LUP
2012-05-07 09:20:10
date last changed
2017-08-27 04:28:17
@article{d26f61ee-e463-4bef-aba1-a9daec2b00a9,
  abstract     = {Objective. Hexaminolevulinate (HAL) is an optical imaging agent used with fluorescence cystoscopy (FC) for the detection of non-muscle-invasive bladder cancer (NMIBC). Guidelines from the European Association of Urology (EAU) and a recent, more detailed European expert consensus statement agree that HAL-FC has a role in improving detection of NMIBC and provide recommendations on situations for its use. Since the publication of the EAU guidelines and the European consensus statement, new evidence on the efficacy of HAL-FC in reducing recurrence of NMIBC, compared with white light cystoscopy (WLC), have been published. Material and methods. To consider whether these new trials have an impact on the expert guidelines and on clinical practice (e. g. supporting existing recommendations or providing evidence for a change or expansion of practice), a group of bladder cancer experts from Denmark, Finland, Norway and Sweden met to address the following questions: What is the relevance of the new data on HAL-FC for clinical practice in managing NMIBC? What impact do the new data have on European guidelines? How could HAL-FC be used in clinical practice? and What further information on HAL-FC is required to optimize the management of NMIBC? Results and conclusions. This article reports the outcomes of the discussion at the Nordic expert panel meeting, concluding that, in line with European guidance, HAL-FC has an important role in the initial detection of NMIBC and for follow-up of patients to assess tumour recurrence after WLC. It provides practical advice, with an algorithm on the use of this diagnostic procedure for urologists managing NMIBC.},
  author       = {Malmstrom, Per-Uno and Grabe, Magnus and Haug, Erik Skaaheim and Hellstrom, Pekka and Hermann, Gregers G. and Mogensen, Karin and Raitanen, Mika and Wahlqvist, Rolf},
  issn         = {0036-5599},
  keyword      = {TURBT,tumour recurrence,transurethral resection of bladder tumour,residual tumour,photosensitizer,non-muscle-invasive bladder cancer,hexaminolevulinate,cystoscopy,fluorescence cystoscopy,bladder cancer},
  language     = {eng},
  number       = {2},
  pages        = {108--116},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology and Nephrology1967-01-01+01:002013-01-01+01:00},
  title        = {Role of hexaminolevulinate-guided fluorescence cystoscopy in bladder cancer: critical analysis of the latest data and European guidance},
  url          = {http://dx.doi.org/10.3109/00365599.2011.633279},
  volume       = {46},
  year         = {2012},
}