Value of photodynamic diagnosis (PDD) in bladder cancer patients qualification to the method of treatment
Article published in Urologia Polska 2008/61/Supl. 1.

authors

Michał Markowski, Marek Lipiński, Waldemar Różański

II Klinika Urologii Katedry Urologii UM w Łodzi

summary

Introduction.

95% of bladder tumors are Transitional cell carcinomas (TCC), among these 80% are non infiltrative tumors (Cis, Ta, T1). Carcinoma in situ exist in 25% with high grade tumors (G3). Patients (pts) with Cis are in high progression risk group (risk of progression 41.6%). PDD is a tool of most precise way of picturing neoplastic tissue in urinary bladder. PDD is recommended by EAU to diagnose a Cis.

Objectives.

Aim of the study is to evaluate value of PDD in bladder cancer patients qualification to the method of treatment.

Materials and methods.

In years 2006-2007 at the 2nd Clinic of Urology PDD was performed in 47 pts (35 men and 12 women) with non infiltrative tumors Ta low and high grade and T1 low and high grade. All pts were treated by transurethral resection (TURBT), 10 pts had additional intravesical chemotherapy (Mitomycin C) and 31 had additional intravesical immunotherapy (BCG). In all pts 3 months after TURBT white light and PDD was performed.

Results.

In white light cystoscopy neoplastic lesions were observed in 7 pts (3 PUNLMP, and 4 pts T1 high grade). In PDD suspected neoplastic lesions were observed in 16 pts. Cis was detected in 11 pts (1 PUNLMP +Cis, 2 pts T1 high grade +Cis, and 8 pts isolated Cis). All pts were treated by TURBT. In 3 pts immediately Mitomicyn C instillation was used and then immunotherapy with BCG. In 7 pts with multifocal refractory G3 lesions after immunotherapy and coexisted Cis cystectomies were performed.

Conclusions.

PDD allows for Cis recognition which independently exists with other forms of bladder cancer. Use of PDD allows for carcinoma recognition and pts qualification for risk groups of progression and recurrences of bladder tumors and adequate choice of method of treatment.