KEY TAKEAWAYS
- The PHOTO trial aimed to examine PDD’s effectiveness through a comprehensive randomized trial.
- The study suggested that familiarity with PDD can refine the resection technique.
The PHOTO trial involved 22 UK-based hospitals, recruiting patients (pts) newly diagnosed with medium/high-risk bladder cancer. These patients were then randomized to undergo their first resection using either white light (WL) or photodynamic diagnosis (PDD). All subsequent treatments and follow-ups were based on existing guidelines.
The PHOTO trial’s intention-to-treat analysis included 418 pts. The 3-year recurrence rates did not show notable differences between PDD and WL groups. However, an initial decline in recurrence was observed in the PDD group within the first 20 months. Further examination highlighted the surgeon’s PDD experience as a significant factor. Surgeries performed by PDD-experienced surgeons (having over 40 PDD procedures) had a reduced recurrence risk compared to those by surgeons with fewer than 10 PDD cases; HR 0.60 (95% CI: 0.40 – 0.92); p=0.019. This observation was held regardless of the use of WL or PDD during surgery. Moreover, the recurrence rates remained consistent when comparing consultant surgeons to registrars or non-consultant career grades: HR 0.94 (95% CI: 0.67-1.33); p=0.736.
The PHOTO trial’s findings suggested that surgeons with extensive PDD experience achieved better results in PDD and WL resections. Researchers theorized that familiarity with PDD refines the resection method, making it a valuable training instrument for urologists performing transurethral resection of the tumor (TURBT) frequently.
Source: https://www.auajournals.org/doi/10.1097/JU.0000000000003260.02
Clinical Trial: https://classic.clinicaltrials.gov/ct2/show/NCT02993211
Gravestock, Paul; Vadiveloo, Thenmalar; Lewis, Rebecca; Duncan, Anne; Penegar, Steven; Clark, Emma; Yu, Ge; Mariappan, Paramananthan; Cresswell, Joanne; Mcgrath, John; N’dow, James; Nabi, Ghulam; Mostafid, Hugh; Kelly, John; Ramsay, Craig; Lazarowicz, Henry; Allan, Angela; Breckons, Matthew; Campbell, Karen; Campbell, Louise; Feber, Andy; Mcdonald, Alison; Norrie, John; Orozco-Leal, Giovany; Rice, Stephen; Tandogdu, Zafer; Taylor, Ernest; Wilson, Laura; Vale, Luke; Maclennan, Graeme; Hall, Emma; Heer, Rakesh PD13-02 CAN EXPERIENCE OF BLUE LIGHT CYSTOSCOPY IMPROVE A SURGEON’S WHITE LIGHT RESECTION? DATA FROM THE PHOTO TRIAL, Journal of Urology: April 2023 – Volume 209 – Issue Supplement 4 doi: 10.1097/JU.0000000000003260.02
