EAU 2023 | Photodynamic diagnosis in NMIBC: insights and impact of blue light surgery on recurrence rates

Rakesh Heer, PhD, FRCS(Urol), Newcastle University. Newcastle upon Tyne, London, discusses the th significance of results on the clinical effectiveness and cost-effectiveness of photodynamic diagnosis (PDD)-guided transurethral resection of bladder tumor (TURBT) compared to standard white light (WL)-guided TURBT in patients with non-muscle-invasive bladder cancer (NMIBC) at intermediate or high risk for recurrence. In conclusion, PDD did not show superiority in reducing recurrence rates or cost-effectiveness when compared to WL in NMIBC patients at 3 years of follow-up. In this study, urologists gained valuable insights into bladder cancer care and the impact of blue light surgery on recurrence rates. The findings revealed the importance of adhering to national guidelines for delivering appropriate treatments, such as BCG completion. Interestingly, it was shown that blue light surgery initially reduced recurrence rates up to 12 months, but thereafter the rates became similar to white light surgery. This suggests that factors beyond tumor resection, such as changes within the bladder, may contribute to ongoing recurrences. It also highlights a potential bystander effect, where improved resections with blue light prompt surgeons to be more thorough in white light resections. These findings underscore the need for enhanced training and higher quality resections under white light, potentially improving outcomes for patients. This interview took place at the EAU congress in Milan, Italy.

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