Long-Term Prospective Outcomes of Patients with Non-Muscle Invasive Bladder Cancer After Holmium Laser Ablation

Darrad, Maitrey; Jah, S.H.; Ahmed, Zeba; Syed, Haider

doi:10.1089/end.2019.0253

Cited by 11 publications

(13 citation statements)

References 19 publications

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“…In this study, the overall tumor recurrence rate was 56.7% with a mean follow‐up time of 64.4 months (5.36 years), which is consistent with previously reported recurrence rates of up to 73% following laser ablation 11,12 . This is also similar to the 57.8% recurrence rate reported in the only other long‐term study of laser ablation at a follow‐up time of 69.8 months ablation 11,12 .…”

Section: Discussionsupporting

confidence: 91%

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Long‐term outcomes of outpatient laser ablation for recurrent non‐muscle invasive bladder cancer: A retrospective cohort study

et al. 2021

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Objectives The objective of this study is to determine the long‐term efficacy and safety of office‐based Holmium:YAG laser ablation for the treatment of recurrent non‐muscle‐invasive bladder cancer (NMIBC). Methods We retrospectively reviewed the medical records of all consecutive patients who underwent office‐based laser ablation for recurrent bladder cancer between 2008 and 2016. The following data were collected: original histology, date of original histology, date of laser ablation, number of repeat laser ablation procedures required, date of tumor recurrence or progression, number of general anesthesia procedures (transurethral resection or cystodiathermy) required after first laser ablation, and number and severity of complications. Kaplan–Meier survival curves were produced for recurrence‐free survival, progression‐free survival, and overall survival. Results A total of 97 patients, with an average age of 84 (62–98) years and an average Charlson Comorbidity Index of 6.9 (4–13), were included. The median follow‐up was 61 (2–150) months. Fifty‐five (56.7%) patients presented with tumor recurrence, and the median recurrence‐free survival time was 1.69 years (95% CI 1.20–2.25). Only 9 (9.3%) patients had evidence of tumor progression to a higher grade or stage, 8 (89%) of which initially had low‐grade tumors; however, no patient progressed to muscle‐invasive disease. The median progression‐free survival time was 5.70 years (95% CI 4.10–7.60), and the median overall survival time was 7.60 years (95% CI 4.90–8.70). No patient required emergency inpatient admission after laser ablation. Conclusion Office‐based Holmium:YAG laser ablation offers a safe and effective alternative method for treating low‐volume, low‐grade recurrent NMIBC, especially in elderly patients with significant co‐morbidity, while avoiding general anesthesia and inpatient admission.

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Section: Discussionsupporting

confidence: 91%

“…Few studies have assessed progression rates after laser ablation for NMIBC, but where reported, the rates of progression to muscle‐invasive disease range from 6% to 9% in a population with a similar proportion of high grade or T1 tumors to the present study. 11 , 13 …”

Section: Discussionmentioning

confidence: 99%

Long‐term outcomes of outpatient laser ablation for recurrent non‐muscle invasive bladder cancer: A retrospective cohort study

et al. 2021

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“…Hexaminolevulinate, a tumor photosensitizer, has been widely used for intravesical photodynamic therapy since 2005 . Transurethral laser treatment of bladder cancer under topical anesthesia gained growing interest of urologists for its favorable efficacy and safety . Thus photothermal therapy-based biomaterials showed great potential of wide application in clinical settings.…”

Section: Results and Discussionmentioning

confidence: 99%

“…27 Transurethral laser treatment of bladder cancer under topical anesthesia gained growing interest of urologists for its favorable efficacy and safety. 28 Thus photothermal therapy-based biomaterials showed great potential of wide application in clinical settings. In this perspective, we developed an AuNRs&IONs@Gel gel system to target-deliver a combination of photothermal, ferroptotic, and immune therapy of BCa through intravesical instillation.…”

Section: ■ Results and Discussionmentioning

confidence: 99%

Intravesical In Situ Immunostimulatory Gel for Triple Therapy of Bladder Cancer

Guo

Wang

Shang

et al. 2020

ACS Appl. Mater. Interfaces

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Bladder cancer displays multiple biological features aided in drug resistance; therefore, single therapy fails to induce complete tumor regression.To address this issue, various kinds of cell death of cancer cells as well as restoring tumor immune microenvironment need to be taken into consideration. Here, we introduce a gel system termed AuNRs&IONs@Gel, which targetdelivers a combination of photothermal, ferroptotic, and immune therapy through intravesical instillation. AuNRs&IONs@Gel consists of a gel delivery platform, embedded gold nanorods (AuNRs), and iron oxide nanoparticles (IONs). The targeted delivery gel platform provides dextran aldehyde-selective adhesion with cancer collagen. In this condition, photothermal therapy can be performed by gold nanorods (AuNRs) under imaging-guided near-infrared radiation. Local high concentrations of IONs can be absorbed by cancer cell to induce ferroptosis. Moreover, tumor-associated macrophages which often display an immune-suppressive M2-like phenotype will be repolarized by IONs into the antitumor M1-like phenotype, exerting a direct antitumor effect and professional antigen presentation of dead cancer cells. This process triggers a potent immune response of innate and adapt immunities to protect tumor rechallenge in long terms. Our tripletherapy strategy employs FDA-approved nanoparticles to inhibit bladder cancer which may possess great potential for clinical translation.

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“…3 Our series showed comparable results for low-risk NMIBC patients when compared with other studies. 9,10 The 10-year OS 47.4% can be explained by an elderly population with significant co-morbidities and often deemed too unfit for standard follow up. At 13 years follow up there were no significant differences in OS between the different groups.…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up of Holmium-YAG laser vaporisation of bladder urothelial carcinoma

Bazo

Gowda

Yao

et al. 2020

Journal of Clinical Urology

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Introduction: Many patients with non-muscle invasive bladder cancer (NMIBC) will develop recurrences of their tumour after their first resection. Flexible cystoscopy under local anaesthesia with Holmium-YAG laser ablation of tumour (FHoLAT) is safe, well tolerated procedure with significant cost savings when compared to cystoscopy under general or regional anaesthesia. We retrospectively analysed the outcomes of a large series of patients undergoing FHoLAT at our institution between April 2006 and September 2013. Patients and methods: Patients were offered FHoLAT if the tumour recurrence was small and/or they were deemed unfit for regional or general anaesthesia. Patient data was extracted from medical records. The primary outcomes were overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS) and recurrence-free survival (RFS). Results: 232 patients with a total 522 FHoLAT procedures were included. The median follow-up was 74.8 (43.5–101) months; 18% were discharged after a recurrence free follow-up duration; 52.2% had one FHoLAT, 19.8% had two FHoLATs, 11.2% had three FHoLATs and 16.8% had four or more FHoLAT. At initial diagnosis 24.1% of patients had G1pTa, 47% G2pTa, 9.9% G3pTa and T1 in 18.9%. 4.3% had concurrent carcinoma in situ. At 10 years, OS was 47.4%, CSS was 94.1%, PFS was 82.1%, RFS was 15.8%. Conclusions: FHoLAT for bladder tumour recurrences has an acceptable CSS and PFS for patients with small low-grade tumours or patients with high-grade or T1 tumours who are unfit for regional or general anaesthesia. The role of FHoLAT in unfit patients seems clear, but further prospective trials are needed to define its role in other patient groups, particularly high-grade NMIBC. Level of evidence: 3b-4

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Long-Term Prospective Outcomes of Patients with Non-Muscle Invasive Bladder Cancer After Holmium Laser Ablation

Cited by 11 publications

References 19 publications

Long‐term outcomes of outpatient laser ablation for recurrent non‐muscle invasive bladder cancer: A retrospective cohort study

Long‐term outcomes of outpatient laser ablation for recurrent non‐muscle invasive bladder cancer: A retrospective cohort study

Intravesical In Situ Immunostimulatory Gel for Triple Therapy of Bladder Cancer

Long-term follow-up of Holmium-YAG laser vaporisation of bladder urothelial carcinoma

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