Reduced bladder tumour recurrence rate associated with narrow-band imaging surveillance cystoscopy


Harry W. Herr, 1275 York Avenue, New York, NY 10021, USA.


Study Type – Diagnostic (exploratory cohort)
Level of Evidence 2b

What’s known on the subject? and What does the study add?

Narrow-band imaging cystoscopy is a new imaging modality developed to enhance conventional standard white-light cystoscopy to evaluate bladder tumors. The current paper suggests that fulguration of low-risk papillary bladder tumours using NBI cystoscopy results in fewer subsequent tumour recurrences than fulguration using standard cystoscopy. How, or if, NBI cystoscopy will become integrated into routine management of non-invasive bladder tumours remains for further study.


To evaluate frequency of recurrences among patients with papillary bladder tumours followed sequentially with conventional white-light (WLI) cystoscopy and narrow-band imaging (NBI) cystoscopy.


A cohort of 126 patients with recurrent low-grade papillary bladder tumours were followed every 6 months for 3 years by conventional WLI cystoscopy, and then over the next 3 consecutive years by NBI cystoscopy.

Recurrent tumours detected were treated by outpatient fulguration or transurethral resection.

We compared the tumour recurrence rate during follow-up with WLI and NBI cystoscopy, using patients as their own controls.


Of the 126 patients, 94% had tumour recurrences during WLI cystoscopy vs 62% during NBI cystoscopy.

The mean number of recurrent tumours was 5.2 with WLI cystoscopy vs 2.8 with NBI cystoscopy, and the median recurrence-free survival time was 13 vs 29 months (P= 0.001).


Compared with follow-up with WLI cystoscopy, NBI cystoscopy was associated with fewer patients having tumour recurrences, fewer numbers of recurrent tumours, and a longer recurrence-free survival time.