Association Between Photodynamic Diagnosis and Risk of Recurrence and Progression in Bacillus Calmette-Guérin-treated Nonmuscle Invasive Bladder Cancer Patients: A Nationwide Follow-up Study - 21/02/26

Doi : 10.1016/j.urology.2026.02.004

Peter B. Hjort ^a,^b,^⁎ , Josephine M. Hyldgaard ^a,^b, Kristine Young-Halvorsen ^c, Tanja Hüsch ^c,^d, Jørgen Bjerggaard Jensen ^a,^b, Andreas Ernst ^a,^b

^a Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark

^b Department of Urology, Aarhus University Hospital, Aarhus N, Denmark

^c Clinical Development & Medical Affairs, Photocure ASA, Oslo, Norway

^d Department of Urology and Pediatric Urology, University Medical Center of Johannes-Gutenberg University, Mainz, Germany

^⁎ Address correspondence to: Peter B. Hjort, M.D., Palle Juul-Jensens Blvd. 35, 8200 Aarhus N, Denmark. Palle Juul-Jensens Blvd. 35 Aarhus N 8200 Denmark

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Saturday 21 February 2026

ABSTRACT

Objective

To investigate whether photodynamic diagnosis (PDD) influences recurrence and progression risk in patients with nonmuscle invasive bladder cancer treated with Bacillus Calmette-Guérin (BCG).

Methods

We performed a nationwide cohort study using Danish health registries. Patients with a first-time diagnosis of nonmuscle invasive bladder cancer who received BCG between 2009 and 2022 were included. Patients were followed until death, cystectomy, or December 31, 2023. Exposure was PDD at primary transurethral resection of the bladder. We estimated cumulative incidences and relative risks for recurrence and progression, anid calculated crude and adjusted odds ratios for BCG response according to PDD status.

Results

A total of 4318 patients were included, of whom 2388 (55%) underwent PDD-assisted diagnosis. At 1 year, the age-adjusted relative risk for recurrence was 0.85 (95% CI, 0.76-0.96) in the PDD group compared with the non-PDD group. At 5 years, the relative risk was 0.94 (95% CI, 0.87-1.03). No significant differences were observed in BCG response among adequately treated patients between the PDD and non-PDD groups.

Conclusion

This large registry-based cohort study found no evidence that the use of PDD was associated with differences in BCG treatment outcomes. While PDD was associated with a modest reduction in recurrence risk at 1 year, no long-term benefit was observed regarding recurrence, progression, or BCG response.

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