The Impact of Blue Light Cystoscopy Use Among Nonmuscle Invasive Bladder Cancer Patients in an Equal Access Setting: Implications on Recurrence and Time to Recurrence

Sanjay Das, Lin Gu, Claire Trustram Eve, Joshua Parrish, Amanda M. De Hoedt, Chad McKee, William Aronson, Stephen J. Freedland, Stephen B. Williams

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction: Prior studies suggest that white light cystoscopy (WLC) alone can fail to detect cases of non-muscle invasive bladder cancer (NMIBC) vs. blue light cystoscopy (BLC). We describe bladder cancer outcomes and the impact of BLC among NMIBC patients in an equal access setting. Materials and Methods: We assessed 378 NMIBC patients within the Veterans Affairs system that had a CPT code for BLC from December 1, 2014 to December 31, 2020. We determined recurrence rates and time to recurrence prior to BLC (ie, after previous WLC if available) and following BLC. We used the Kaplan-Meier method to estimate event-free survival and Cox regression to determine association between BLC and recurrence, progression, and overall survival; and further, whether these outcomes differed by race. Results: Of 378 patients with complete data, 43 (11%) were Black and 300 (79%) White. Median follow-up was 40.7 months from bladder cancer diagnosis. Median time to first recurrence following BLC was longer vs. WLC alone (40 [33-NE] vs. 26 [17-39] months). Recurrence risk was significantly lower following BLC (Hazard Ratio [HR] 0.70; 95% Confidence Interval [CI], 0.54-0.90). There was no significant difference in recurrence (HR 0.69; 95% CI, 0.39-1.20), progression (HR 1.13; 95% CI, 0.32-3.96), and overall survival (HR 0.74; 95% CI, 0.31-1.77) following BLC by Black vs. White race. Conclusion: In this study from an equal access setting in the VA, we observed significantly decreased recurrence risk and prolonged time interval to recurrence following BLC vs. WLC alone. There was no difference in bladder cancer outcomes by race.

Original languageEnglish (US)
Pages (from-to)711.e1-711.e6
JournalClinical Genitourinary Cancer
Volume21
Issue number6
DOIs
StatePublished - Dec 2023
Externally publishedYes

Keywords

  • Bladder cancer
  • Blue light
  • Cysview
  • Non-muscle invasive
  • Outcomes
  • Progression

ASJC Scopus subject areas

  • Oncology
  • Urology

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