Patient-reported outcomes of blue-light flexible cystoscopy with hexaminolevulinate in the surveillance of bladder cancer: results from a prospective multicentre study

Flexible Blue Light Study Group Collaborators

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: To evaluate blue-light flexible cystoscopy (BLFC) with hexaminolevulinate in the office surveillance of patients with non-muscle-invasive bladder cancer with a high risk of recurrence by assessing its impact on pain, anxiety, subjective value of the test and patient willingness to pay. Materials and Methods: A prospective, multicentre, phase III study was conducted during which the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, Pain and ‘Was It Worth It’ questionnaires were administered at baseline, after surveillance with BLFC and after resection for those referred to the operating room. Comparisons of scores were performed between groups. Results: A total of 304 patients were enrolled, of whom 103 were referred for surgical examination. Of these, 63 were found to have histologically confirmed malignancy. Pain levels were low throughout the study. Anxiety levels decreased after BLFC (∆ = −2.6), with a greater decrease among those with negative pathology results (P = 0.051). No differences in anxiety were noted based on gender, BLFC results, or test performance (true-positive/false-positive). Most patients found BLFC ‘worthwhile’ (94%), would ‘do it again’ (94%) and ‘would recommend it to others’ (91%), with no differences based on BLFC results or test performance. Most patients undergoing BLFC (76%) were willing to pay out of pocket. Conclusions: Anxiety decreased after BLFC in patients with negative pathology, including patients with false-positive results. Most of the patients undergoing BLFC were willing to pay out of pocket, found the procedure worthwhile and would recommend it to others, irrespective of whether they had a positive BLFC result or whether this was false-positive after surgery.

Original languageEnglish (US)
JournalBJU International
DOIs
StateAccepted/In press - Jan 1 2018

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Cystoscopy
Urinary Bladder Neoplasms
Multicenter Studies
Prospective Studies
Light
Anxiety
Pain
5-aminolevulinic acid hexyl ester
Patient Reported Outcome Measures
Pathology
Operating Rooms
Information Systems
Recurrence

Keywords

  • #BladderCancer
  • #blcsm
  • CIS
  • fluorescence cystoscopy
  • patient-reported outcomes
  • PRO
  • recurrence

ASJC Scopus subject areas

  • Urology

Cite this

@article{df2845d89d7a48afaca84304db129591,
title = "Patient-reported outcomes of blue-light flexible cystoscopy with hexaminolevulinate in the surveillance of bladder cancer: results from a prospective multicentre study",
abstract = "Objective: To evaluate blue-light flexible cystoscopy (BLFC) with hexaminolevulinate in the office surveillance of patients with non-muscle-invasive bladder cancer with a high risk of recurrence by assessing its impact on pain, anxiety, subjective value of the test and patient willingness to pay. Materials and Methods: A prospective, multicentre, phase III study was conducted during which the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, Pain and ‘Was It Worth It’ questionnaires were administered at baseline, after surveillance with BLFC and after resection for those referred to the operating room. Comparisons of scores were performed between groups. Results: A total of 304 patients were enrolled, of whom 103 were referred for surgical examination. Of these, 63 were found to have histologically confirmed malignancy. Pain levels were low throughout the study. Anxiety levels decreased after BLFC (∆ = −2.6), with a greater decrease among those with negative pathology results (P = 0.051). No differences in anxiety were noted based on gender, BLFC results, or test performance (true-positive/false-positive). Most patients found BLFC ‘worthwhile’ (94{\%}), would ‘do it again’ (94{\%}) and ‘would recommend it to others’ (91{\%}), with no differences based on BLFC results or test performance. Most patients undergoing BLFC (76{\%}) were willing to pay out of pocket. Conclusions: Anxiety decreased after BLFC in patients with negative pathology, including patients with false-positive results. Most of the patients undergoing BLFC were willing to pay out of pocket, found the procedure worthwhile and would recommend it to others, irrespective of whether they had a positive BLFC result or whether this was false-positive after surgery.",
keywords = "#BladderCancer, #blcsm, CIS, fluorescence cystoscopy, patient-reported outcomes, PRO, recurrence",
author = "{Flexible Blue Light Study Group Collaborators} and Smith, {Angela B.} and Siamak Daneshmand and Sanjay Patel and Kamal Pohar and Edouard Trabulsi and Michael Woods and Tracy Downs and William Huang and Jennifer Taylor and Jeffrey Jones and Michael O'Donnell and Trinity Bivalacqua and Joel DeCastro and Gary Steinberg and Ashish Kamat and Matthew Resnick and Badrinath Konety and Schoenberg, {Mark P.} and Jones, {J. Stephen} and Yair Lotan",
year = "2018",
month = "1",
day = "1",
doi = "10.1111/bju.14481",
language = "English (US)",
journal = "BJU International",
issn = "1464-4096",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Patient-reported outcomes of blue-light flexible cystoscopy with hexaminolevulinate in the surveillance of bladder cancer

T2 - results from a prospective multicentre study

AU - Flexible Blue Light Study Group Collaborators

AU - Smith, Angela B.

AU - Daneshmand, Siamak

AU - Patel, Sanjay

AU - Pohar, Kamal

AU - Trabulsi, Edouard

AU - Woods, Michael

AU - Downs, Tracy

AU - Huang, William

AU - Taylor, Jennifer

AU - Jones, Jeffrey

AU - O'Donnell, Michael

AU - Bivalacqua, Trinity

AU - DeCastro, Joel

AU - Steinberg, Gary

AU - Kamat, Ashish

AU - Resnick, Matthew

AU - Konety, Badrinath

AU - Schoenberg, Mark P.

AU - Jones, J. Stephen

AU - Lotan, Yair

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective: To evaluate blue-light flexible cystoscopy (BLFC) with hexaminolevulinate in the office surveillance of patients with non-muscle-invasive bladder cancer with a high risk of recurrence by assessing its impact on pain, anxiety, subjective value of the test and patient willingness to pay. Materials and Methods: A prospective, multicentre, phase III study was conducted during which the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, Pain and ‘Was It Worth It’ questionnaires were administered at baseline, after surveillance with BLFC and after resection for those referred to the operating room. Comparisons of scores were performed between groups. Results: A total of 304 patients were enrolled, of whom 103 were referred for surgical examination. Of these, 63 were found to have histologically confirmed malignancy. Pain levels were low throughout the study. Anxiety levels decreased after BLFC (∆ = −2.6), with a greater decrease among those with negative pathology results (P = 0.051). No differences in anxiety were noted based on gender, BLFC results, or test performance (true-positive/false-positive). Most patients found BLFC ‘worthwhile’ (94%), would ‘do it again’ (94%) and ‘would recommend it to others’ (91%), with no differences based on BLFC results or test performance. Most patients undergoing BLFC (76%) were willing to pay out of pocket. Conclusions: Anxiety decreased after BLFC in patients with negative pathology, including patients with false-positive results. Most of the patients undergoing BLFC were willing to pay out of pocket, found the procedure worthwhile and would recommend it to others, irrespective of whether they had a positive BLFC result or whether this was false-positive after surgery.

AB - Objective: To evaluate blue-light flexible cystoscopy (BLFC) with hexaminolevulinate in the office surveillance of patients with non-muscle-invasive bladder cancer with a high risk of recurrence by assessing its impact on pain, anxiety, subjective value of the test and patient willingness to pay. Materials and Methods: A prospective, multicentre, phase III study was conducted during which the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, Pain and ‘Was It Worth It’ questionnaires were administered at baseline, after surveillance with BLFC and after resection for those referred to the operating room. Comparisons of scores were performed between groups. Results: A total of 304 patients were enrolled, of whom 103 were referred for surgical examination. Of these, 63 were found to have histologically confirmed malignancy. Pain levels were low throughout the study. Anxiety levels decreased after BLFC (∆ = −2.6), with a greater decrease among those with negative pathology results (P = 0.051). No differences in anxiety were noted based on gender, BLFC results, or test performance (true-positive/false-positive). Most patients found BLFC ‘worthwhile’ (94%), would ‘do it again’ (94%) and ‘would recommend it to others’ (91%), with no differences based on BLFC results or test performance. Most patients undergoing BLFC (76%) were willing to pay out of pocket. Conclusions: Anxiety decreased after BLFC in patients with negative pathology, including patients with false-positive results. Most of the patients undergoing BLFC were willing to pay out of pocket, found the procedure worthwhile and would recommend it to others, irrespective of whether they had a positive BLFC result or whether this was false-positive after surgery.

KW - #BladderCancer

KW - #blcsm

KW - CIS

KW - fluorescence cystoscopy

KW - patient-reported outcomes

KW - PRO

KW - recurrence

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DO - 10.1111/bju.14481

M3 - Article

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AN - SCOPUS:85052631225

JO - BJU International

JF - BJU International

SN - 1464-4096

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