Investig Clin Urol.  2018 Mar;59(2):98-105. 10.4111/icu.2018.59.2.98.

Detection and recurrence rate of transurethral resection of bladder tumors by narrow-band imaging: Prospective, randomized comparison with white light cystoscopy

• Kim SB
• Yoon SG
• Tae J
• Kim JY
• Shim JS
• Kang SG
• Cheon J
• Lee JG
• Kim JJ
• Kang SH

• KMID: 2404978
• DOI: http://doi.org/10.4111/icu.2018.59.2.98

Abstract

PURPOSE
The purpose of this study was to evaluate the efficacy of narrow-band imaging (NBI) as a diagnostic tool for detecting bladder tumors during cystoscopy compared with white light cystoscopy (WLC).
MATERIALS AND METHODS
From December 2013 to June 2017, a randomized prospective study was conducted on 198 patients underwent transurethral resection of bladder tumor by a single surgeon. The patients were divided into two groups according to diagnostic method. In Group I, WLC only was performed. In Group II, NBI was additionally performed after WLC. We analyzed the rate of detection of bladder tumors as a primary endpoint. In addition, we evaluated rates of recurrence in each group.
RESULTS
There were no significant differences between the two groups in characteristics except hypertension. In the analysis of rates of detection, the probability of diagnosing cancer was 80.9% (114/141) in the WLC group, and the probability of diagnosing cancer using WLC in the NBI group was 85.5% (159/186). After switching from WLC to NBI for second-look cystoscopy in the NBI group, NBI was shown to detect additional tumors with a detection rate of 35.1% (13/37) from the perspective of the patients and 42.2% (27/64) from the perspective of the tumors. The 1-year recurrence-free rate was 72.2% in the WLC group and 85.2% in the NBI group (p=0.3).
CONCLUSIONS
NBI had benefits for detecting tumors overlooked by WLC. Although the difference in the 1-year recurrence-free rate was not statistically significant, our results showed a trend for higher recurrence in the NBI group.

Keyword

Narrow band imaging; Urinary bladder neoplasms

MeSH Terms

Cystoscopy*
Humans
Hypertension
Methods
Narrow Band Imaging
Prospective Studies*
Recurrence*
Urinary Bladder Neoplasms*
Urinary Bladder*

Figure

• 

  Fig. 1 Flow chart. WLC, white light cystoscopy; NBI, narrow-band imaging; MIBC, muscle-invasive bladder cancer; f/u, follow-up.

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  Fig. 2 Recurrence-free rate in each group. Kaplan-Meier analysis was performed. WLC, white light cystoscopy; NBI, narrow-band imaging.

• 

  Fig. 3 The figure on the left (A, C, E) is from the white light cystoscopy group and that on the right (B, D, F) is from the narrow-band imaging group. The four top photographs (A~D) are carcinoma in situ and the two bottom photographs (E, F) are Ta.

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