Guidance
3 Committee considerations
The evidence
3.1 To inform the committee, NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 9 sources, which was discussed by the committee. The evidence included 6 case series, 2 non-randomised comparative studies and 1 case report, and is presented in table 2 of the interventional procedures overview. Other relevant literature is in the appendix of the overview.
3.2 The specialist advisers and the committee considered the key efficacy outcomes to be: patient-reported outcome measures, tumour ablation, reduction in tumour recurrence rates and survival.
3.3 The specialist advisers and the committee considered the key safety outcomes to be: bleeding, pain and bladder perforation.
3.4 Patient commentary was sought but none was received.
Committee comments
3.5 The committee was informed that this procedure is used in 2 distinct groups:
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for people with small superficial tumours, when the intention is to completely ablate the tumour
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for symptom control in people with more advanced disease who are unfit for, or unwilling to have, surgery.
3.6 The technology used in this procedure is evolving.
3.7 A chemical may be instilled into the bladder to aid with tumour detection, using a blue light.
3.8 The committee was informed that it may not always be necessary to stop anticoagulant or antiplatelet therapy before this procedure.
ISBN: 978-1-4731-3463-8