Evidence map›Paper›PMID 39375287›Full record

Trial reportInternational journal of clinical oncology2025

Effect of extending the period from oral administration of 5-aminolevulinic acid hydrochloride to photodynamic diagnosis during transurethral resection for non-muscle invasive bladder cancer on diagnostic accuracy and safety: a single-arm multicenter phase III trial.

Rikiya Taoka, Hideo Fukuhara, Makito Miyake, Keita Kobayashi, Atsushi Ikeda, Kent Kanao, Yoshinobu Komai, Ryo Fujiwara, Yusuke Sato, Mikio Sugimoto and 4 more

Erratum issuedAbstract readMulticenter StudyClinical Trial, Phase III
In one paragraph

Trial report in International journal of clinical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Rikiya TaokaDepartment of Urology, Kagawa University Hospital, 1750-1, Ikenobe, Miki-Cho, Kita-Gun, Kagawa, 761-0793, Japan. taoka.rikiya@kagawa-u.ac.jp.ORCID http://orcid.org/0000-0003-3243-499X
Hideo FukuharaDepartment of Urology, Kochi Medical School Hospital, Kochi, Japan.
Makito MiyakeDepartment of Urology, Nara Medical University Hospital, Kashihara, Nara, Japan.
Keita KobayashiDepartment of Urology, Yamaguchi University Hospital, Ube, Yamaguchi, Japan.
Atsushi IkedaDepartment of Urology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.
Kent KanaoDepartment of Uro-Oncology, Saitama Medical University International Medicine Center, Hidaka, Saitama, Japan.
Yoshinobu KomaiDepartment of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Ryo FujiwaraDepartment of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Yusuke SatoDepartment of Urology, The University of Tokyo Hospital, Bunkyo, Tokyo, Japan.
Mikio SugimotoDepartment of Urology, Kagawa University Hospital, 1750-1, Ikenobe, Miki-Cho, Kita-Gun, Kagawa, 761-0793, Japan.
Toyonori TsuzukiDepartment of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Aichi, Japan.
Kiyohide FujimotoDepartment of Urology, Nara Medical University Hospital, Kashihara, Nara, Japan.
Keiji InoueCenter for Photodynamic Medicine, Kochi Medical School, Kochi University, Kochi, Japan.
Mototsugu OyaDepartment of Urology, Keio University Hospital, Shinjuku, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn Japan, the authorized period (2-4 h) between oral administration of 5-aminolevulinic acid hydrochloride (5-ALA) and transurethral resection for non-muscle invasive bladder cancer (NMIBC) may restrict photodynamic diagnosis (PDD) usage. Therefore, this prospective, single-arm, phase III study aimed to evaluate the diagnostic accuracy and safety of PDD at an extended administration period (4-8 h).

methodsFrom January 2022 to May 2023, 161 patients with NMIBC were enrolled from eight hospitals. The primary endpoint was the blue light (BL) sensitivity of pathologically positive biopsies. The secondary endpoints were a comparison of the specificity and positive and negative prediction rates under BL and white light (WL) conditions.

resultsA total of 1242 specimens comprising 337 histological NMIBC specimens were analyzed. BL-sensitivity was 95.3%. Its lower limit of 95% confidence interval (92.4-97.3%) exceeded the threshold (70%) of non-inferiority to authorized usage. Sensitivity and specificity were significantly higher and lower for BL than those for WL (95.3% vs. 61.1%, P < 0.001; 52.7% vs. 95.2%, P < 0.001), respectively. The positive and negative predictive rates were significantly lower and higher for BL than those for WL (42.9% vs. 82.7%, P < 0.001; 96.8% vs. 86.8%, P < 0.001), respectively. Of the 145 patients receiving 5-ALA, 136 (93.8%) and 75 (51.7%) experienced 377 adverse events and 95 adverse reactions, respectively, most of which were grade 1 or 2.

conclusionFor extended period, the efficacy of PDD for NMIBC was similar to that of authorized period, in terms of higher sensitivity and lower specificity compared with WL, and the safety was acceptable.

Indexed as

Aminolevulinic AcidPhotosensitizing AgentsUrinary Bladder NeoplasmsAdministration, OralAgedAged, 80 and overFemaleHumansJapanMaleMiddle AgedNon-Muscle Invasive Bladder NeoplasmsProspective StudiesSensitivity and SpecificityAminolevulinic AcidPhotosensitizing Agents5-Aminolevulinic acidMulticenter single-arm phase III trialNon-muscle invasive bladder cancerPhotodynamic diagnosis

Identifiers

PMID39375287
PMCPMC11700051

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.