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A network meta-analysis of therapeutic outcomes after new image technology-assisted transurethral resection for non-muscle invasive bladder cancer: 5-aminolaevulinic acid fluorescence vs hexylaminolevulinate fluorescence vs narrow band imaging

 Joo Yong Lee  ;  Kang Su Cho  ;  Dong Hyuk Kang  ;  Hae Do Jung  ;  Jong Kyou Kwon  ;  Cheol Kyu Oh  ;  Won Sik Ham  ;  Young Deuk Choi 
 BMC CANCER, Vol.15 : 566, 2015 
Journal Title
Issue Date
Aminolevulinic Acid/analogs & derivatives* ; Aminolevulinic Acid/metabolism* ; Cystoscopy/methods ; Humans ; Image Interpretation, Computer-Assisted/methods* ; Narrow Band Imaging/methods ; Photosensitizing Agents/metabolism* ; Randomized Controlled Trials as Topic ; Treatment Outcome ; Urinary Bladder Neoplasms/metabolism ; Urinary Bladder Neoplasms/pathology ; Urinary Bladder Neoplasms/surgery*
Urinary bladder neoplasms ; Photochemotherapy ; Narrow band imaging ; Meta-analysis ; Bayes theorem
BACKGROUND: This study included a network meta-analysis of evidence from randomized controlled trials (RCTs) to assess the therapeutic outcome of transurethral resection (TUR) in patients with non-muscle-invasive bladder cancer assisted by photodynamic diagnosis (PDD) employing 5-aminolaevulinic acid (5-ALA) or hexylaminolevulinate (HAL) or by narrow band imaging (NBI). METHODS: Relevant RCTs were identified from electronic databases. The proceedings of relevant congresses were also searched. Fifteen articles based on RCTs were included in the analysis, and the comparisons were made by qualitative and quantitative syntheses using pairwise and network meta-analyses. RESULTS: Seven of 15 RCTs were at moderate risk of bias for all quality criteria and two studies were classified as having a high risk of bias. The recurrence rate of cancers resected with 5-ALA-based PDD was lower than of those resected using HAL-based PDD (odds ratio (OR) = 0.48, 95 % confidence interval (CI) [0.26-0.95]) but was not significantly different than those resected with NBI (OR = 0.53, 95 % CI [0.26-1.09]). The recurrence rate of cancers resected using HAL-based PDD versus NBI did not significantly differ (OR = 1.11, 95 % CI [0.55-2.1]). All cancers resected using 5-ALA-based PDD, HAL-based PDD, or NBI recurred at a lower rate than those resected using white light cystoscopy (WLC). No difference in progression rate was observed between cancers resected by all methods investigated. CONCLUSIONS: The recurrence rate of some bladder cancers can be decreased by the implementation of either PDD- and NBI-assisted TUR; in real settings, clinicians should consider replacing WLC as the standard imaging technology to guide TUR.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
7. Others (기타) > Dept. of Health Promotion (건강의학과) > 1. Journal Papers
Yonsei Authors
Kwon, Jong Kyou(권종규)
Lee, Joo Yong(이주용) ORCID logo https://orcid.org/0000-0002-3470-1767
Jung, Hae Do(정해도)
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Ham, Won Sik(함원식) ORCID logo https://orcid.org/0000-0003-2246-8838
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