Pd18-05 a prospective clinical trial of photodynamic diagnosis with oral 5-aminolevulinic acid for upper urinary tract carcinoma

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma I (PD18)1 Apr 2020PD18-05 A PROSPECTIVE CLINICAL TRIAL OF PHOTODYNAMIC DIAGNOSIS WITH ORAL 5-AMINOLEVULINIC ACID FOR UPPER URINARY TRACT CARCINOMA Takashi Yoshida*, Tomoaki Matsuzaki, Hidefumi Kinoshita, and Tadashi Matsuda Takashi Yoshida*Takashi Yoshida* More articles by this author , Tomoaki MatsuzakiTomoaki Matsuzaki More articles by this author , Hidefumi KinoshitaHidefumi Kinoshita More articles by this author , and Tadashi MatsudaTadashi Matsuda More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000861.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The aim of this study was to compare the clinical superiority for detecting urothelial cancer between the photodynamic diagnosis-ureteroscopy using oral 5-aminolaevulinic acid and the conventional white light -ureteroscopy in patients with suspected upper urinary tract carcinoma as a prospective clinical trial. Additionally, the safety of 5-aminolaevulinic acid used as photosensitizer was also evaluated. METHODS: Prospective enrollment during May 2018 to January 2019 of consecutive adult patients who suspected upper urinary tract carcinoma based on image and urine cytology. 5-aminolevulinic acid (20 mg/kg) was orally administered 2-3 hour before diagnostic ureteroscopy. Sixty-three biopsy samples were collected from 20 eligible patients using white light and photodynamic diagnosis ureteroscopy. The primary end-point was sensitivity, and the secondary end-points were specificity, positive and negative predictive values, diagnostic accuracy, and safety. RESULTS: The sensitivity of the photodynamic ureteroscopy was significantly higher than that of the white light ureteroscopy (93.8% vs 62.5%, P = 0.0025). Although there were no difference between two procedures in the specificity and the positive predictive value, the photodynamic diagnosis ureteroscopy were significantly greater than the white light ureteroscopy in the negative predictive value (92.3% vs. 69.2%, P = 0.027) and the accuracy (0.86 vs. 0.75, P = 0.0297). For safety, there was no grade 3 or greater adverse events related to 5-aminolevulinic acid administration in all patients. CONCLUSIONS: We found that the photodynamic diagnosis ureteroscopy with oral 5-aminolevulinic acid is safe and superior diagnostic tool for detection of upper urinary tract carcinoma compared with conventional white light ureteroscopy. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e377-e377 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Takashi Yoshida* More articles by this author Tomoaki Matsuzaki More articles by this author Hidefumi Kinoshita More articles by this author Tadashi Matsuda More articles by this author Expand All Advertisement PDF downloadLoading ...