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    Fluorescent cystoscopy outperforms white light method

    Researchers reviewing trials looking at the effectiveness of fluorescent compared to white light cystoscopy for bladder cancer outcomes report fluorescent cystoscopy is superior to standard white light cystoscopy for reducing risk of bladder cancer recurrence.

    “Fluorescent cystoscopy was also superior to white light cystoscopy for reducing risk of progression in studies that used [hexaminolevulinic acid] HAL as the photosensitizer,” said lead author Roger Chou, MD, of Oregon Health and Science University and Pacific Northwest Evidence-based Practice Center, Portland. “There were no effects on mortality, but data were limited.”

    Also see: Chemotherapy may harness immune system in bladder Ca

    Dr. Chou and colleagues reported that compared to white light cystoscopy, fluorescent cystoscopy was linked to a 41% decreased risk of bladder cancer recurrence at less than 3 months; a 30% lower risk of recurrence at 3 months to less than a year; and a 19% reduced risk at the long-term follow-up of a year or more.

    But the findings from the systematic review and meta-analysis, published in the Journal of Urology (2017; 197:548-58), were inconsistent. The paper, reflecting findings of 14 randomized trials, suggests more research is needed to confirm these findings. One issue with the studies, according to Dr. Chou, is that most were not effectively blinded to the cystoscopic methods, which could have resulted in performance bias. There also was evidence of publication bias, as there were some negative trials that weren’t published, he said.

    Next: A surprising finding

    Lisette Hilton
    Lisette Hilton, president of Words Come Alive, has written about health care, the science and business of medicine, fitness and wellness ...

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