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

Abstract Background To 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). Methods Patients were categorized into two groups intr...

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Autores principales:	Hideo Fukuhara, Takahiro Nohara, Koshiro Nishimoto, Yutaka Hatakeyama, Yuki Hyodo, Yoshiyasu Okuhara, Masafumi Oyama, Atsushi Mizokami, Keiji Inoue, Hideyasu Matsuyama, on behalf of the Japan Urological Photodynamic Society
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	5-aminolevulinic acid Photodynamic diagnosis Hypotension Non-muscle invasive bladder cancer Transurethral resection of bladder tumor Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/b765102c94db4282a59ab0dcca0747cb
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spelling	oai:doaj.org-article:b765102c94db4282a59ab0dcca0747cb2021-11-14T12:30:21ZIdentification of risk factors associated with oral 5-aminolevulinic acid-induced hypotension in photodynamic diagnosis for non-muscle invasive bladder cancer: a multicenter retrospective study10.1186/s12885-021-08976-11471-2407https://doaj.org/article/b765102c94db4282a59ab0dcca0747cb2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12885-021-08976-1https://doaj.org/toc/1471-2407Abstract Background To 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). Methods Patients 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. Results Among 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. Conclusions General 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.Hideo FukuharaTakahiro NoharaKoshiro NishimotoYutaka HatakeyamaYuki HyodoYoshiyasu OkuharaMasafumi OyamaAtsushi MizokamiKeiji InoueHideyasu Matsuyamaon behalf of the Japan Urological Photodynamic SocietyBMCarticle5-aminolevulinic acidPhotodynamic diagnosisHypotensionNon-muscle invasive bladder cancerTransurethral resection of bladder tumorNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBMC Cancer, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	5-aminolevulinic acid Photodynamic diagnosis Hypotension Non-muscle invasive bladder cancer Transurethral resection of bladder tumor Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	5-aminolevulinic acid Photodynamic diagnosis Hypotension Non-muscle invasive bladder cancer Transurethral resection of bladder tumor Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Hideo Fukuhara Takahiro Nohara Koshiro Nishimoto Yutaka Hatakeyama Yuki Hyodo Yoshiyasu Okuhara Masafumi Oyama Atsushi Mizokami Keiji Inoue Hideyasu Matsuyama on behalf of the Japan Urological Photodynamic Society 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
description	Abstract Background To 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). Methods Patients 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. Results Among 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. Conclusions General 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.
format	article
author	Hideo Fukuhara Takahiro Nohara Koshiro Nishimoto Yutaka Hatakeyama Yuki Hyodo Yoshiyasu Okuhara Masafumi Oyama Atsushi Mizokami Keiji Inoue Hideyasu Matsuyama on behalf of the Japan Urological Photodynamic Society
author_facet	Hideo Fukuhara Takahiro Nohara Koshiro Nishimoto Yutaka Hatakeyama Yuki Hyodo Yoshiyasu Okuhara Masafumi Oyama Atsushi Mizokami Keiji Inoue Hideyasu Matsuyama on behalf of the Japan Urological Photodynamic Society
author_sort	Hideo Fukuhara
title	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
title_short	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
title_full	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
title_fullStr	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
title_full_unstemmed	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
title_sort	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
publisher	BMC
publishDate	2021
url	https://doaj.org/article/b765102c94db4282a59ab0dcca0747cb
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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

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