Evidence map›Paper›PMID 41784721›Full record

ArticleAnnals of surgical oncology2026

Fluorescent Ureterorenoscopy-Assisted Thulium:YAG and Holmium:YAG Dual-Laser Ablation for Upper Urinary Tract Urothelial Carcinoma: Results of the FLUAM Trial.

Makito Miyake, Nobutaka Nishimura, Yuki Oda, Mitsuru Tomizawa, Takuto Shimizu, Takuya Owari, Daisuke Gotoh, Yoshitaka Itami, Tomonori Nakahama, Motokiyo Yoshikawa and 5 more

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Makito MiyakeDepartment of Urology, Nara Medical University, Kashihara, Nara, Japan. makitomiyake@yahoo.co.jp.
Nobutaka NishimuraDepartment of Urology, Nara Medical University, Kashihara, Nara, Japan.
Yuki OdaDepartment of Urology, Nara Medical University, Kashihara, Nara, Japan.
Mitsuru TomizawaDepartment of Urology, Nara Medical University, Kashihara, Nara, Japan.
Takuto ShimizuDepartment of Urology, Nara Medical University, Kashihara, Nara, Japan.
Takuya OwariDepartment of Urology, Nara Medical University, Kashihara, Nara, Japan.
Daisuke GotohDepartment of Urology, Nara Medical University, Kashihara, Nara, Japan.
Yoshitaka ItamiDepartment of Urology, Tane General Hospital, Osaka, Japan.
Tomonori NakahamaDepartment of Urology, Hirao Hospital, Kashihara, Nara, Japan.
Motokiyo YoshikawaDepartment of Urology, Nara Prefecture General Medical Center, Nara, Nara, Japan.
Ken FujimotoDepartment of Urology, Okanami General Hospital, Iga, Japan.
Atsushi TomiokaDepartment of Urology, Saiseikai Chuwa Hospital, Sakurai, Nara, Japan.
Satoshi AnaiDepartment of Urology, Nara Prefecture Seiwa Medical Center, Ikoma, Nara, Japan.
Tomomi FujiiDivision of Fostering Required Medical Human Resources, Center for Infectious Disease Education and Research (CiDER), Osaka University, Osaka, Japan.
Kiyohide FujimotoDepartment of Urology, Nara Medical University, Kashihara, Nara, Japan.

Funding

Clinical Research Promotion Program grant of Nara Medical University JHR2100001
6 · The paper itself

Abstract

backgroundThe guidelines recommend kidney-sparing surgery as the primary treatment for selected patients with low-risk upper urinary tract urothelial carcinoma (UTUC). An important issue with ureteroscopic laser ablation (ULA) is the high rate of surgical-site recurrence, largely attributable to residual lesions at the initial ULA. This trial aimed to investigate the efficacy and safety of oral 5-aminolevulinic acid hydrochloride-mediated photodynamic diagnosis (ALA-PDD)-assisted ULA for UTUC.

methodsThe study evaluated 20 patients with cTa-1N0M0 UTUC who underwent ALA-PDD-assisted ULA using thulium-holmium:YAG dual lasers. The primary endpoint was the 2-year progression-free survival rate. Treatment-related adverse events (AEs), usefulness of the UroVysion test combined with conventional urinary cytology for detecting recurrent tumors, and longitudinal changes in patient-reported health-related quality of life (HRQoL) after ULA were evaluated.

resultsOf the 20 patients, 3 (15 %) experienced disease progression, and the 2-year progression-free survival rate was 82 % (95 % confidence interval [CI], 54-93 %). The lower limit of the 95 % CI for the 2-year PFS rate was less than the prespecified threshold survival rate of 58 %. The most common AEs were transient urinary-related symptoms. No grade ≥3 AEs were observed throughout the trial. Due to the low positivity rate of pretreatment UroVysion testing, the study could not evaluate its usefulness for monitoring post-ULA recurrence. Most domains and scales of HRQoL showed acceptable changes during treatment and follow-up evaluation. In particular, the intervention positively affected mental and emotional conditions.

conclusionsThis study provided evidence for the potential benefits and efficacy of this treatment option for selected patients with UTUC.

Indexed as

Carcinoma, Transitional CellLasers, Solid-StateLaser TherapyThuliumUreteral NeoplasmsUreteroscopyUrologic NeoplasmsAgedAged, 80 and overAminolevulinic AcidFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm Recurrence, LocalAminolevulinic AcidThulium5-aminolevulinic acidCytologyPhotodynamic diagnosisProgressionRecurrenceTransurethral surgeryUpper urinary tract cancerUroVysion

Identifiers

PMID41784721

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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.