ArticleBMC cancer2021
Identification of risk factors associated with oral 5-aminolevulinic acid-induced hypotension in photodynamic diagnosis for non-muscle invasive bladder cancer: a multicenter retrospective study.
Article in BMC cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Preoperative patient risk factors for intraoperative hypotension: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2025Pooled it
- Blood Pressure Changes After Oral 5-Aminolevulinic Acid Hydrochloride Administered 4-8 h Before TURBT: An Additional Analysis of a Phase III Study (SPP2C102).Life (Basel, Switzerland) · 2026Article
- 5-Aminolevulinic Acid-Based Fluorescence Guidance in Urologic Oncology: Current Status, Pitfalls, and Future Directions.Life (Basel, Switzerland) · 2026Review
- Preoperative Pyuria as a Predictor of False-Positive Rates in the Photodynamic Diagnosis of Nonmuscle-Invasive Bladder Cancer Using Oral 5-Aminolevulinic Acid.International journal of urology : official journal of the Japanese Urological Association · 2025Article
- Article
- Preoperative antihypertensives and hypotension during bladder tumor resection with oral 5-aminolevulinic acid administration.PloS one · 2025Observational
- Review
- Comparative assessment of disease recurrence after transurethral resection of non-muscle-invasive bladder cancer with and without a photodynamic diagnosis using 5-aminolevulinic acid: a propensity score-matching analysis.International journal of clinical oncology · 2024Article
- Incidence of perioperative hypotension in patients undergoing transurethral resection of bladder tumor after oral 5-aminolevulinic acid administration: a retrospective multicenter cohort study.Journal of anesthesia · 2023Article
- Effect of Arginine Vasopressin on Intraoperative Hypotension Caused by Oral Administration of 5-Aminolevulinic Acid.Case reports in anesthesiology · 2023Article
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11 authors.
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Abstract
backgroundTo investigate risk factors for orally administered 5-aminolevulinic acid (ALA)-induced hypotension for bladder cancer patients receiving photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT).
methodsPatients were categorized into two groups intraoperatively: a hypotensive group (minimum systolic blood pressure (SBP) ≤80 mmHg) and a non-hypotensive group (minimum SBP > 80 mmHg). We examined differences between the hypotensive group and non-hypotensive groups to identify clinical risk of ALA-induced hypotension using multivariate logistic regression analysis and decision tree analysis.
resultsAmong 282 cases with ALA-PDD-assisted TURBT from three institutions who were screened, 245 patients were included in the final analysis. In total, 156 patients (63.7%) showed any grade of hypotension during ALA-PDD-assisted TURBT. General anesthesia and spinal anesthesia were induced intraoperatively in 113 patients (46.1%) and 132 patients (53.9%), respectively. Median SBP at baseline (before taking ALA) and at the beginning of anesthesia was 127 mmHg (range, 69-186 mmHg) and 124 mmHg (range, 69-186 mmHg), respectively. Median minimum SBP during ALA-PDD-assisted TURBT was 75 mmHg (range, 43-140 mmHg). Multivariate logistic regression analysis revealed that history of hypertension (odds ratio (OR) 7.568, p < 0.05) and general anesthesia (OR 14.435, p < 0.05) as significantly associated with an increased risk of hypotension incidence. Use of calcium antagonist showed significant negative associations with hypotension (OR 0.183, p < 0.05). Decision tree analysis showed presence of general anesthesia, age ≥ 74 years and American Society of Anesthesiologists physical status (ASA-PS) ≥2 as the most important discriminators.
conclusionsGeneral anesthesia and hypertension were independent risk factors related to ALA-induced hypotension. In contrast, use of calcium antagonists was identified as a factor associated with reduced risk of ALA-induced hypotension.
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