THE USE OF NBI TECHNIQUE AFTER WL-TURBT INCREASE ABILITY TO IDENTIFY THE PERSISTENCE OF HIGH GRADE DISEASE? RUA’S EXPERIENCE
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INTRODUCTION
The purpose of this study is to assess whether, after white light (WL) TURBT, the use of narrow-band imaging (NBI), used during a repeat TURBT bipolar Gyrus-PK (NBI bipolar Gyrus-PK repeat TURBT), allows to increase our ability to detect persistence of High Grade lesions not otherwise viewable with the standard method.
MATERIALS AND METHODS
From June 2010 to April 2012, 797 patients affected by bladder lesions, underwent WL plus NBI cystoscopy, WL Bipolar Gyrus-PK TURBT and then a repeat TURBT using NBI.
RESULTS
All patients were subjected to Bipolar Gyrus-PK WL-TURBT, identifying, in 512 patients, 1051 oncological bladder lesions. After repeat NBI-TURBT on the margins and on the bottom of resection, we observed the presence of 526 neoplastic lesions (50.04%) and 525 non-neoplastic lesions (49,95%). The use of NBI has allowed us to increase the ability of detecting lesions, reaching approximately a 50% (p <0.05) of lesions not visible only with the use of the WL, in more than 30% of patients.
We noted that the greater distribution of the lesions is located on the margins of resection after repeat NBI TURBT (28.8%).
In the 526 lesions (33.46%) highlighted as oncologically significant, only after repeat NBI-TURBT 509 lesions (32.3%) had lesions that persisted after WL-TURBT (incidence exposed=0.484), while the remaining 17 lesions (1.08%) had lesions that were negative after WL-TURBT, instead were oncologically positive (incidence not exposed=0.032).
Thanks to the use of repeat NBI-TURBT, we have detected a greater number of High Grade (HG) lesions compared to the ones identified after WL-TURBT: pT1HG identified on the bed of resection (+13.22%, p<0.05) and pTaHG identified on the same sites (+2.07%, p>0.05).
CONCLUSIONS
The use of NBI (repeat NBI-TURBT) is a clear advantage in identifying persistent lesions after WL-TURBT.
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