DURHAM, NC — White light cystoscopy has been found less effective in detecting cases of nonmuscle-invasive bladder cancer (NMIBC) than blue light cystoscopy.
A recent study in Urologic Oncology pointed out, “White light cystoscopy (WLC) represents the traditional approach to NMIBC disease surveillance, though physicians utilizing WLC alone may fail to detect all cancerous lesions. The approval of blue light cystoscopy (BLC) as an adjunct to WLC enhances the urologist’s ability to more readily detect cancerous tissue.”1
How much of a difference does it make? A study led by the Durham, NC, VA Healthcare System and Cedars-Sinai Medical Center at UCLA sought to describe bladder cancer outcomes and the impact of BLC among NMIBC patients in an equal-access setting. Results were published in Clinical Genitourinary Cancer.2
To accomplish that, the researchers reviewed records of 378 NMIBC patients within the VA system that had a CPT code for BLC from Dec. 1, 2014 to Dec. 31, 2020. The study team determined recurrence rates and time to recurrence prior to BLC (i.e., after previous WLC if available) and following BLC. The focus was on the association between BLC and recurrence, progression and overall survival and whether these outcomes differed by race.
Of 378 patients with complete data, 43 (11%) were Black and 300 (79%) white, according to the report. Median follow-up was 40.7 months from bladder cancer diagnosis.
Results indicated that median time to first recurrence following BLC was longer vs. WLC alone (40 [33-NE] vs. 26 [17-39] months). “Recurrence risk was significantly lower following BLC (Hazard Ratio [HR] 0.70; 95% Confidence Interval [CI], 0.54-0.90),” the authors pointed out. “There was no significant difference in recurrence (HR 0.69; 95% CI, 0.39-1.20), progression (HR 1.13; 95% CI, 0.32-3.96), and overall survival (HR 0.74; 95% CI, 0.31-1.77) following BLC by Black vs. white race.”
The authors concluded that their study from an equal access setting in the VA observed significantly decreased recurrence risk and prolonged time interval to recurrence following BLC vs. WLC alone.
- Shore ND, Gavaghan MB. Clinical and economic impact of blue light cystoscopy in the management of NMIBC at US ambulatory surgical centers: what is the site-of-service disparity? Urol Oncol. 2023 Apr;41(4):207.e9-207.e16. doi: 10.1016/j.urolonc.2022.11.014. Epub 2022 Dec 22. PMID: 36564259.
- Das S, Gu L, Eve CT, Parrish J, De Hoedt AM, McKee C, Aronson W, Freedland SJ, Williams SB. The Impact of Blue Light Cystoscopy Use Among Nonmuscle Invasive Bladder Cancer Patients in an Equal Access Setting: Implications on Recurrence and Time to Recurrence. Clin Genitourin Cancer. 2023 Apr 28:S1558-7673(23)00098-8. doi: 10.1016/j.clgc.2023.04.011. Epub ahead of print. PMID: 37198099.
