Blue Light TURBT May Reduce Recurrence and Progression in Non-Muscle Invasive Bladder Cancer: Cochrane Review
USA: A new systematic review published in the Cochrane Database of Systematic Reviews suggests that blue light-enhanced transurethral resection of bladder tumors (TURBT) may help reduce disease recurrence and progression in patients with non-muscle invasive bladder cancer (NMIBC), particularly those at intermediate or high risk of disease recurrence.
The review was led by Philipp Maisch from the Department of Urology and Pediatric Urology, University of Ulm, Germany, and colleagues.
Non-muscle invasive bladder cancer accounts for the majority of newly diagnosed bladder cancers. Although transurethral resection remains the standard treatment, disease recurrence and progression continue to pose significant clinical challenges. Blue light-enhanced TURBT has been developed to improve tumor visualization and facilitate more complete tumor removal compared with conventional white light-guided surgery.
To evaluate the comparative effectiveness of these approaches, the researchers conducted a comprehensive review of randomized controlled trials published through March 2026. The analysis included 17 trials involving 4,890 adults with suspected or confirmed primary or recurrent urothelial bladder cancer undergoing TURBT.
The review assessed key outcomes including disease recurrence, disease progression, surgical complications, bladder cancer-specific mortality, and treatment-related adverse events.
The researchers reported the following findings:
- Blue light-enhanced TURBT was associated with a 32% lower risk of disease recurrence compared with white light TURBT (HR 0.68).
- The reduction in recurrence risk was most evident among patients with intermediate- and high-risk non-muscle invasive bladder cancer.
- Blue light TURBT was associated with a 30% lower risk of disease progression compared with white light TURBT (HR 0.70).
- The benefit in reducing disease progression was greatest among patients with high-risk disease, while effects were limited in low-risk patients and less certain in intermediate-risk patients.
- Blue light TURBT showed little to no effect on the risk of serious surgical complications compared with white light TURBT.
- Rates of overall adverse events and non-serious surgical complications were similar between the two treatment approaches.
- Blue light TURBT showed little to no effect on bladder cancer-specific mortality.
- Current evidence does not demonstrate a clear survival advantage of blue light TURBT over conventional white light TURBT.
The authors noted that most evidence was of low to moderate certainty, reflecting limitations such as variations across studies, methodological concerns, and imprecise estimates. As a result, future research could alter the current understanding of the treatment's benefits and risks.
Overall, the investigators concluded that blue light-enhanced TURBT may provide clinical advantages over conventional white light TURBT by lowering the long-term risk of recurrence and progression in selected patients with non-muscle invasive bladder cancer. However, its effects on survival and treatment-related complications remain uncertain, underscoring the need for additional high-quality studies.
Reference:
Maisch P, Hamidi Madani M, Koziarz A, Narayan VM, Kim MH, Dahm P. Blue versus white light for transurethral resection of non-muscle invasive bladder cancer. Cochrane Database Syst Rev. 2026 Jun 11;6(6):CD013776. doi: 10.1002/14651858.CD013776.pub3. PMID: 42274003; PMCID: PMC13255099.
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