Comparison of Recurrence of Non-muscle Invasive Bladder Carcinoma after Transurethral Resection with Hexaminolevulinate Photodynamic Diagnosis or Regular Cystoscopy

Purpose: Comparison of recurrence of non-muscle invasive bladder carcinoma after transurethral resection with hexaminolevulinate photodynamic diagnosis (PDD) or regular white light cystoscopy (WLC). Methods: : We included patients with newly suspected non-muscle invasive bladder carcinoma in this retrospective cohort study and compared those undergoing transurethral resection by WLC and PDD. The primary outcome was the difference in the recurrence rate after 60 months’ follow-up, but we also stratified recurrence by risk groups. The mean recurrence-free survival was compared between the cohorts. Odds ratios or hazard ratios are reported with 95% confidence intervals. Results: : The WLC and PDD cohorts comprised 124 and 91 subjects, respectively. There were no significant differences in recurrence rates at 6 months (recurrence rate 9/123; 7.3%), 12 months (17/118; 14.4%), or 60 months (39/102; 38.2%), with odds ratios of 1.23 (0.48–3.25; P=0.64), 1.32 (0.67–2.62; P=0.42), and 1.12 (0.70–1.79; P=0.65), respectively. Further analysis showed no significant effect of PDD on recurrence by risk group or on mean recurrence-free survival (hazard ratio, 1.12; 0.70–1.79). Conclusion: Photodynamic diagnosis with hexaminolevulinate did not reduce the recurrence of non-muscle invasive bladder carcinoma compared to standard white light cystoscopy when used for transurethral resection.