EAU 2023: Blue Light Cystoscopy Delays Time to Recurrence in Non-Muscle Invasive Bladder Cancer Patients Treated in a Real-World Setting

(UroToday.com) The 2023 European Association of Urology (EAU) annual congress held in Milan, Italy between March 10^th and 13^th, 2023 was host to an abstract session of studies addressing the treatment of non-muscle invasive bladder cancer (NMIBC). Dr. Siamak Daneshmand presented the results of a study evaluating the performance of blue light cystoscopy in delaying time to recurrence in patients with NMIBC, within the context of a real-world setting.

Patients with NMIBC are at high risk of disease recurrence, progression, and adverse oncologic outcomes. Currently, white light cystoscopy remains standard of care; however, there is accumulating evidence that enhanced endoscopic modalities, such as blue light cystoscopy, have superior sensitivity that may allow for the detection of tumor missed on while light cystoscopy.¹

The objective of the current study was to evaluate the impact of blue light cystoscopy use on recurrences rates among NMIBC patients in a real-world, clinical care setting. Accordingly, the investigators included 2,055 patients enrolled in the United States Blue Light Cystoscopy with Cysview Registry. The control group consisted of a “historical” cohort of 261 patients who underwent white light cystoscopy. These control patients were matched for age, stage, grade, and clinical management (i.e., intravesical therapy). The event-free-survival rate was estimated using a Kaplan-Meier curve, with comparisons performed using the Log-Rank sum test.

At a mean follow-up of 27.4 and 53 months in the blue and white light cystoscopy cohorts, respectively, the overall hazard of recurrence was significantly lower in the blue light cystoscopy group (hazard ratio: 0.33, 95% CI: 0.28 to 0.40, p<0.001). As demonstrated in the Kaplan Meier curve and table below, this decreased rate in the blue light group was prominent early (recurrence-free rate at 12 months: 79% versus 46%) and sustained with prolonged follow-up (60 months: 61% versus 28%).

Dr. Daneshmand’s group concluded as follows:

• In a large, multisite registry study, the authors demonstrated that blue light cystoscopy, in combination with conventional white light cystoscopy, is associated with a significantly decreased hazard of recurrence and a prolonged time interval to recurrence.
• The results suggest that enhanced tumor detection through increased sensitivity with blue light cystoscopy has the potential to translate into more favorable long-term outcomes in a real-world setting

Presented by: Siamak Daneshmand, MD, Professor of Urology, Department of Urology, University of Southern California, Los Angeles, CA

References:

1. Ahmadi H, et al. Role of blue-light cystoscopy in detecting invasive bladder tumours: data from a multi-institutional registry. BJU Int, 2021.