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Randomized Controlled Trial
. 2018 Mar;59(2):98-105.
doi: 10.4111/icu.2018.59.2.98. Epub 2018 Feb 8.

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

Seung Bin Kim  1 , Sung Goo Yoon  1 , Jonghyun Tae  1 , Jae Yoon Kim  1 , Ji Sung Shim  1 , Sung Gu Kang  1 , Jun Cheon  1 , Jeong Gu Lee  1 , Je Jong Kim  1 , Seok Ho Kang  1
Affiliations
Randomized Controlled Trial

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

Seung Bin Kim et al. Investig Clin Urol. 2018 Mar.

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.

Keywords: Narrow band imaging; Urinary bladder neoplasms.

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Conflict of interest statement

CONFLICTS OF INTEREST: The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1. Flow chart. WLC, white light cystoscopy; NBI, narrow-band imaging; MIBC, muscle-invasive bladder cancer; f/u, follow-up.
Fig. 2
Fig. 2. Recurrence-free rate in each group. Kaplan-Meier analysis was performed. WLC, white light cystoscopy; NBI, narrow-band imaging.
Fig. 3
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.
See this image and copyright information in PMC

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