The Clinical Research Office of the Endourological Society (CROES) Multicentre Randomised Trial of Narrow Band Imaging-Assisted Transurethral Resection of Bladder Tumour (TURBT) Versus Conventional White Light Imaging-Assisted TURBT in Primary Non-Muscle-invasive Bladder Cancer Patients: Trial Protocol and 1-year Results
Language English Country Switzerland Media print-electronic
Document type Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
PubMed
27117749
DOI
10.1016/j.eururo.2016.03.053
PII: S0302-2838(16)30031-8
Knihovny.cz E-resources
- Keywords
- Narrow band imaging, Non–muscle-invasive bladder cancer, Transurethral resection of bladder tumour, Tumour recurrence, White light imaging,
- MeSH
- Adult MeSH
- Neoplasm Invasiveness MeSH
- Single-Blind Method MeSH
- Clinical Protocols MeSH
- Middle Aged MeSH
- Humans MeSH
- Neoplasm Recurrence, Local etiology MeSH
- Adolescent MeSH
- Young Adult MeSH
- Urinary Bladder Neoplasms diagnostic imaging pathology surgery MeSH
- Prospective Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Light MeSH
- Narrow Band Imaging * MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
BACKGROUND: White light (WL) is the established imaging modality for transurethral resection of bladder tumour (TURBT). Narrow band imaging (NBI) is a promising addition. OBJECTIVES: To compare 12-mo recurrence rates following TURBT using NBI versus WL guidance. DESIGN, SETTING, AND PARTICIPANTS: The Clinical Research Office of the Endourological Society (CROES) conducted a prospective randomised single-blind multicentre study. Patients with primary non-muscle-invasive bladder cancer (NMIBC) were randomly assigned 1:1 to TURBT guided by NBI or WL. INTERVENTION: TURBT for NMIBC using NBI or WL. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Twelve-month recurrence rates were compared by chi-square tests and survival analyses. RESULTS AND LIMITATIONS: Of the 965 patients enrolled in the study, 481 patients underwent WL-assisted TURBT and 484 patients received NBI-assisted TURBT. Of these, 294 and 303 patients, respectively, completed 12-mo follow-up, with recurrence rates of 27.1% and 25.4%, respectively (p=0.585, intention-to-treat [ITT] analysis). In patients at low risk for disease recurrence, recurrence rates at 12 mo were significantly higher in the WL group compared with the NBI group (27.3% vs 5.6%; p=0.002, ITT analysis). Although TURBT took longer on average with NBI plus WL compared with WL alone (38.1 vs 35.0min, p=0.039, ITT; 39.1 vs 35.7min, p=0.047, per protocol [PP] analysis), lesions were significantly more often visible with NBI than with WL (p=0.033). Frequency and severity of adverse events were similar in both treatment groups. Possible limitations were lack of uniformity of surgical resection, data on smoking status, central pathology review, and specific data regarding adjuvant intravesical instillation therapy. CONCLUSIONS: NBI and WL guidance achieved similar overall recurrence rates 12 mo after TURBT in patients with NMIBC. NBI-assisted TURBT significantly reduced the likelihood of disease recurrence in low-risk patients. PATIENT SUMMARY: Use of a narrow band imaging technique might provide greater detection of bladder tumours and subsequent treatment leading to reduced recurrence in low-risk patients.
Centre Hospitalier de l'Université de Montréal Montreal Canada
Department of Pathology Fundació Puigvert University Autonomous Barcelona Spain
Department of Urology AMC University Hospital Amsterdam The Netherlands
Department of Urology Harasanshin Hospital Fukuoka Japan
Institute of Cancer and Genomic Sciences University of Birmingham Birmingham UK
References provided by Crossref.org
Recurrence mechanisms of non-muscle-invasive bladder cancer - a clinical perspective
