Narrow band imaging-assisted transurethral resection for non-muscle invasive bladder cancer significantly reduces residual tumour rate

Abstract

Purpose: To investigate whether narrow band imaging (NBI)-assisted transurethral resection (TUR) (NBI-TUR) has an impact on non-muscle invasive bladder cancer (NMIBC) residual tumour rate compared to white light (WL)-assisted TUR (WL-TUR). Methods: Patients with NMIBC treated with either NBI- or WL-TUR were compared in a frequency-matched index-control setting. During NBI-TUR, all suspicious lesions identified by either WL or NBI were resected. Index patients (NBI-TUR, n = 40) were prospectively recruited and control patients (WL-TUR, n = 120) were retrospectively collected, whilst being blinded for their first follow-up (fFU)-status. Non-radical TUR cases, patients without evidence of urothelial carcinoma in the pathology specimen and those with isolated carcinoma in situ or muscle invasive disease were excluded. Matching was based on the risk of tumour recurrence defined by (a) the EORTC risk score for recurrence and (b) the administration or not of one single chemotherapeutic intravesical instillation immediately after TUR. All patients underwent routine follow-up with WL cystoscopy supplemented with cytology at 3 months or re-TUR in selected cases. The residual tumour rates at fFU (RR-fFU) of patients with NMIBC submitted to either NBI- or WL-TUR were compared. Results: Baseline patient and tumour characteristics were comparable between groups. The RR-fFU for WL- and NBI-TUR was 30.5% (36 out of 118 patients) and 15.0% (6 out of 40 patients), respectively (OR: 2.7, one-sided 95% CI: 1.2-6.1; P = 0.03). Conclusion: NBI-TUR decreases residual tumour rate significantly when compared to a matched cohort of WL-TUR. © 2011 The Author(s).