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Article

Perioperative Outcomes and Trends in Transurethral Resection of Bladder Tumors with Photodynamic Diagnosis: Results from the GeRmAn Nationwide Inpatient Data Study

by
Nikolaos Pyrgidis
1,*,
Marco Moschini
2,
Lazaros Tzelves
3,
Bhaskar K. Somani
4,
Patrick Juliebø-Jones
5,
Francesco Del Giudice
6,
Laura S. Mertens
7,
Renate Pichler
7,
Yannic Volz
1,
Benedikt Ebner
1,
Lennert Eismann
1,
Marie Semmler
1,
Benjamin Pradere
8,
Francesco Soria
9,
Christian G. Stief
1 and
Gerald B. Schulz
1
1
Department of Urology, University Hospital, Ludwig Maximilian University Munich, 81377 Munich, Germany
2
Department of Urology, Urological Research Institute, San Raffaele Scientific Institute, 20132 Milan, Italy
3
2nd Department of Urology, Sismanoglio General Hospital of Athens, 15126 Athens, Greece
4
Department of Urology, University of Hospital Southampton NHS Trust, Southampton SO16 6YD, UK
5
Department of Urology, Haukeland University Hospital, 5009 Bergen, Norway
6
Department of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, Italy
7
Department of Urology, Medical University Innsbruck, 6020 Innsbruck, Austria
8
Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria
9
Department of Surgical Sciences, University of Turin, Città della Salute e della Scienza, 10126 Turin, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(12), 3531; https://doi.org/10.3390/jcm13123531
Submission received: 10 May 2024 / Revised: 30 May 2024 / Accepted: 13 June 2024 / Published: 17 June 2024
(This article belongs to the Special Issue Clinical Trends and Prospects in Urology Surgery)
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Abstract

Background: Photodynamic diagnosis (PDD) during transurethral resection of bladder tumor (TURBT) is guideline recommended, as it improves bladder cancer detection rates. However, the extent to which PDD is implemented in everyday clinical practice has not been thoroughly assessed. We aimed to evaluate the current trends and major perioperative outcomes of TURBT with PDD. Methods: The present study evaluated the GeRmAn Nationwide inpatient Data (GRAND) from 2010 (the year when PDD started to be coded separately in Germany) to 2021, which were made available from the Research Data Center of the German Bureau of Statistics. We undertook numerous patient-level and multivariable logistic regression analyses. Results: Overall, 972,208 TURBTs [228,207 (23%) with PDD and 744,001 (77%) with white light] were performed. Patients offered PDD during TURBT were younger (p < 0.001), presented fewer comorbidities (p < 0.001) and were discharged earlier from hospital (p < 0.001). PDD was associated with additional costs of about EUR 500 compared to white-light TURBT (p < 0.001). The yearly TURBT cases remained relatively stable from 2010 to 2021, whereas utilization of PDD underwent a 2-fold increase. After adjusting for major risk factors in the multivariate regression analysis, PDD was related to lower rates of transfusion (1.4% vs. 5.6%, OR: 0.29, 95% CI: 0.28 to 0.31, p < 0.001), intensive care unit admission (0.7% vs. 1.4%, OR: 0.56, 95% CI: 0.53 to 0.59, p < 0.001) and 30-day in-hospital mortality (0.1% vs. 0.7%, OR: 0.24, 95% CI: 0.22 to 0.27, p < 0.001) compared to white-light TURBT. On the contrary, PDD was related to clinically insignificant higher rates of bladder perforation (0.6% versus 0.5%, OR: 1.3, 95% CI: 1.2 to 1.4, p < 0.001), and reoperation (2.6% versus 2.3%, OR: 1.2, 95% CI: 1.1 to 1.2, p < 0.001). Conclusions: The utilization of PDD with TURBT is steadily increasing. Nevertheless, the road toward the establishment of PDD as the standard of care for TURBT is still long, despite of the advantages of PDD.
Keywords: transurethral resection of bladder tumors; bladder cancer; photodynamic diagnosis; perioperative outcomes; cohort study transurethral resection of bladder tumors; bladder cancer; photodynamic diagnosis; perioperative outcomes; cohort study

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MDPI and ACS Style

Pyrgidis, N.; Moschini, M.; Tzelves, L.; Somani, B.K.; Juliebø-Jones, P.; Del Giudice, F.; Mertens, L.S.; Pichler, R.; Volz, Y.; Ebner, B.; et al. Perioperative Outcomes and Trends in Transurethral Resection of Bladder Tumors with Photodynamic Diagnosis: Results from the GeRmAn Nationwide Inpatient Data Study. J. Clin. Med. 2024, 13, 3531. https://doi.org/10.3390/jcm13123531

AMA Style

Pyrgidis N, Moschini M, Tzelves L, Somani BK, Juliebø-Jones P, Del Giudice F, Mertens LS, Pichler R, Volz Y, Ebner B, et al. Perioperative Outcomes and Trends in Transurethral Resection of Bladder Tumors with Photodynamic Diagnosis: Results from the GeRmAn Nationwide Inpatient Data Study. Journal of Clinical Medicine. 2024; 13(12):3531. https://doi.org/10.3390/jcm13123531

Chicago/Turabian Style

Pyrgidis, Nikolaos, Marco Moschini, Lazaros Tzelves, Bhaskar K. Somani, Patrick Juliebø-Jones, Francesco Del Giudice, Laura S. Mertens, Renate Pichler, Yannic Volz, Benedikt Ebner, and et al. 2024. "Perioperative Outcomes and Trends in Transurethral Resection of Bladder Tumors with Photodynamic Diagnosis: Results from the GeRmAn Nationwide Inpatient Data Study" Journal of Clinical Medicine 13, no. 12: 3531. https://doi.org/10.3390/jcm13123531

APA Style

Pyrgidis, N., Moschini, M., Tzelves, L., Somani, B. K., Juliebø-Jones, P., Del Giudice, F., Mertens, L. S., Pichler, R., Volz, Y., Ebner, B., Eismann, L., Semmler, M., Pradere, B., Soria, F., Stief, C. G., & Schulz, G. B. (2024). Perioperative Outcomes and Trends in Transurethral Resection of Bladder Tumors with Photodynamic Diagnosis: Results from the GeRmAn Nationwide Inpatient Data Study. Journal of Clinical Medicine, 13(12), 3531. https://doi.org/10.3390/jcm13123531

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