Objective: To assess the feasibity and efficacy of narrow band imaging (NBI) cystoscopy assisted holmium laser resection of primary non-muscle invasive bladder cancer (HoLRBt).
Methods: During the period of May 2013 to December 2014, 150 cases of primary non-muscle invasive bladder cancer (NMIBC) admitted in our hospital were randomly divided into NBI-HoLRBt and WLI-TURBt group. In NBI-HoLRBt group, all suspicious lesion identified by either WLI or NBI were resected during the surgery with WLI and in NBI mode for lesion only visible with NBI. At the end of the procedure, NBI cystoscopic examination was performed again to identify whether there was residual lesions at the margins of the resection areas. In WLI-TURBt group, only WLI and TURBt were applied. All patients from the two groups underwent routine intravesical instillation after surgery. A total of 124 patients were diagnosed NMIBC by pathological findings (NBI-HoLRBt group: n=60, WLI-TURBt group: n=64), they were followed-up at 3 months, at which both WLI and NBI cystoscopy were performed to examine the residual tumor, and cytology was checked for all patients. The residual tumor rates at the first follow-up (RR-fFU) were recorded and compared.
Results: Baseline characteristics of the patient and the tumor were comparable between the two groups. The overall detection rate of NMIBC and carcinoma in situ (CIS) were significantly higher with NBI than WLI (94.5% (137/145) vs 75.8% (110/145), 16/17 vs 10/17, both P<0.05). The RR-fFU for NBI-HoLRBt and WLI-TURBt was 3.3% (2/60) and 17.2% (11/64), respectively (P<0.05).
Conclusion: NBI-HoLRBt was feasible, and more effective for identification of NMIBC as well as for the reduction of residual tumor rate compared with WLI-TURBt.