Variations in the diagnostic performance of transurethral resection of bladder tumor with photodynamic diagnosis according to surgical experience: A retrospective, single-center study

IF 3.1 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-02-01 DOI:10.1016/j.pdpdt.2024.104429

Shuhei Suzuki , Yoshiyuki Nagumo , Kosuke Kojo , Atsushi Ikeda , Bunpei Isoda , Akane Yamaguchi , Kozaburo Tanuma , Satoshi Nitta , Masanobu Shiga , Takashi Kawahara , Shuya Kandori , Akio Hoshi , Hiromitsu Negoro , Bryan J. Mathis , Hiroyuki Nishiyama

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引用次数: 0

Abstract

Background

To investigate variations in diagnostic performance of photodynamic diagnosis (PDD) according to surgical experience.

Methods

Data were extracted from patients having pT1 or lower primary tumors that underwent PDD-assisted transurethral resection of bladder tumors (TURBT) with orally 5-amibolevulinic acid at our institute. Surgical experience was categorized by urological experience (first-year and second-year) and PDD experience (<10, 10–19, and ≥20 cases). Sensitivity, specificity, and accuracy rates were calculated based on PDD or white light (WL) findings and pathologic diagnosis. The bladder neck, trigone, and prostatic urethra were defined as areas with a high probability of tangential effect.

Results

A total of 108 patients and 343 specimens were extracted. The second-year surgeons had significantly higher accuracy rates than first-year surgeons (81.5 % vs. 69.0 %, p = 0.013), while PDD experience did not significantly affect accuracy rates (76.5, 75.5, and 69.0 %). In addition, the accuracy rate was also significantly lower in tangential effect areas (59.6 % vs. 80.8 %). Multivariate analysis identified urological experience as a significant factor improving accuracy rate (odds ratio [OR] 2.14) while tangential effects substantially reduced accuracy rate (OR 0.37). Notably, combining both PDD and WL resulted in a sensitivity exceeding 94 %, even in first-year urology residents and tangential effect areas.

Conclusions

Urological experience had a greater impact on diagnostic performance of PDD compared to PDD experience. The combination of PDD and WL findings may improve sensitivity and reduce the possibility of missed diagnoses for less experienced urology residents.

查看原文本刊更多论文

基于手术经验的经尿道膀胱肿瘤光动力学诊断的差异：一项回顾性单中心研究。

背景：探讨不同手术经验光动力诊断（PDD）诊断效能的差异。方法：数据来自我院经pdd辅助经尿道膀胱肿瘤切除术（TURBT）的pT1或下原发肿瘤患者，这些患者口服5-氨基乙酰丙酸。手术经验按泌尿外科经验（第一年和第二年）和PDD经验进行分类。结果：共提取108例患者和343例标本。第二年外科医生的准确率明显高于第一年外科医生（81.5%比69.0%,p=0.013），而PDD经验对准确率没有显著影响（76.5、75.5和69.0%）。此外，切向效应区的准确率也明显较低（59.6%比80.8%）。多因素分析表明，泌尿外科经验是提高准确率的重要因素（比值比[OR] 2.14），而切向效应显著降低准确率（比值比[OR] 0.37）。值得注意的是，PDD和WL联合使用导致敏感性超过94%，即使在泌尿外科第一年住院医师和切线影响区域也是如此。结论：泌尿外科经验对PDD诊断效能的影响大于PDD经验。对于经验不足的泌尿外科患者，PDD和WL结合检查可以提高敏感性，减少漏诊的可能性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.