Photodynamic Diagnosis-Assisted Transurethral Resection - Lights Out?

In a randomized trial and accompanying cost-effectiveness analysis, conducted in people with suspected urothelial carcinoma of the bladder, Heer at al.¹ in this issue of NEJM Evidence compare transurethral resection aided by intravesical installation of a photosensitizer with the same procedure guided by standard white light. The study's main finding was that the photosensitizer-based approach was not associated with a reduction of time to recurrence of tumor. Moreover, patients undergoing the photosensitizer-based procedure had only a small absolute risk reduction (3.8 percentage points; 95% confidence interval [CI], -13.4 to 6.6) of tumor recurrence in the trial time frame.