Prevention of bladder tumor implantation after fluorescence guided TUR with photodynamic therapy
Résumé
Background Fluorescence guided TUR has become a routine procedure. This has already decreased recurrence rate of superficial bladder cancer due to incomplete resection through lack of visualisation. Implantation of viable tumor cells seeded during TUR is another reason for recurrence.Objective To apply PDT immediately post TUR and evaluate the effect on the amount of viable tumor cells and tumor take rates in two rat models. Design Two models were designed to mimic the situation post fluorescence guided TUR: partly or fully desepithelialized bladders and circulating tumor cells loaded with PpIX. PDT was preformed and controls consisted of no drug no light, light only and drug only. Immediately post PDT urine was retrieved and clonogenic assays were performed on cells. Bladders were harvested at 10 days following cell administration and subjected to pathological analysis.Results Clonogenic assays showed cell reduction to 20% and tumor take rates were comparably reduced to 20%. Conclusions PDT can effectively reduce the amount of viable tumor cell within the bladder lumen. This results in a significant reduction of tumor implantation. This technique could be applied to further reduce recurrence rate of superficial bladder cancer.