Bladder Cancer (Amsterdam, Netherlands)最新文献

{"title":"Evaluation of Intraoperative Versus Postoperative Adjuvant Mitomycin C with Nephroureterectomy for Urothelial Carcinoma of the Upper Urinary Tract.","authors":"Blake Noennig,&nbsp;Shahab Bozorgmehri,&nbsp;Russell Terry,&nbsp;Brandon Otto,&nbsp;Li-Ming Su,&nbsp;Paul L Crispen","doi":"10.3233/BLC-180174","DOIUrl":"https://doi.org/10.3233/BLC-180174","url":null,"abstract":"<p><strong>Background: </strong>Results of randomized trials support a single dose of intravesical chemotherapy following radical nephroureterectomy (RNU) for urothelial carcinoma.</p><p><strong>Objective: </strong>To evaluate the impact of the timing of intravesical mitomycin C (MMC) administration on the rate of bladder tumor recurrence (BTR) following RNU.</p><p><strong>Methods: </strong>We performed a retrospective review of patients who underwent RNU for upper tract urothelial carcinoma (UTUC) and received intravesical MMC between 2008 and 2016. Patients were categorized into two separate groups based on the timing of MMC administration: patients who received MMC intraoperatively (IO) and patients who received MMC on post-operative day 1 or later (PO). Our primary endpoint was BTR rate within the first year after surgery.</p><p><strong>Results: </strong>Fifty-one patients met our inclusion criteria: (IO: <i>n</i> = 30; PO: <i>n</i> = 21). There were no statistically significant differences in baseline characteristics of age, gender, race, surgical approach, tumor grade, tumor stage, surgical margins, nodal status, concomitant CIS, or history of bladder cancer. The median length of follow-up for each group was 22 months for IO and 12 months for PO (<i>P</i> = 0.10). The estimated probability of 1-year BTR rates for the IO and PO groups were 16% and 33%, respectively (<i>p</i> = 0.09). Cox analysis noted that the IO patients had a significantly lower rate of BTR in the first year postoperatively (HR = 0.113, 95% CI = 0.28-0.63, <i>p</i> = 0.01).</p><p><strong>Conclusions: </strong>The use of intraoperative MMC at the time of RNU was associated with a decrease in the risk of 1-year recurrence within the bladder.</p>","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"389-394"},"PeriodicalIF":1.1,"publicationDate":"2018-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-180174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36667059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tertiary Lymphoid Structures Associate with Tumour Stage in Urothelial Bladder Cancer","authors":"M. Koti, A. Xu, K. Ren, Kash Visram, Runhan Ren, D. Berman, D. Siemens","doi":"10.3233/BLC-189029","DOIUrl":"https://doi.org/10.3233/BLC-189029","url":null,"abstract":"[This corrects the article DOI: 10.3233/BLC-170120.].","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130906627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High dose-rate Intra-Operative Radiation Therapy During High Risk Genitourinary Surgery: Initial Observations and a Proposal for its Study in Bladder Cancer.","authors":"Max Kates,&nbsp;Meera R Chappidi,&nbsp;Aaron Brant,&nbsp;Niv Milbar,&nbsp;Nikolai A Sopko,&nbsp;Christian Meyer,&nbsp;Stephanie A Terezakis,&nbsp;Joseph M Herman,&nbsp;Jonathan E Efron,&nbsp;Bashar Safar,&nbsp;Phuoc T Tran,&nbsp;Nita Ahuja,&nbsp;Phillip M Pierorazio,&nbsp;Trinity J Bivalacqua","doi":"10.3233/BLC-170104","DOIUrl":"https://doi.org/10.3233/BLC-170104","url":null,"abstract":"<p><strong>Background: </strong>High dose-rate Intra-Operative Radiation Therapy (HD-IORT) is used to provide effective local control for patients with high-risk locally advanced or recurrent tumors. However, the utility of HD-IORT for patients with bladder cancer has not been studied.</p><p><strong>Objective: </strong>To characterize our institutional experience with HD-IORT in patients with cancer requiring genitourinary surgery, in an effort to identify patients with bladder cancer that may benefit from HD-IORT.</p><p><strong>Methods: </strong>We performed a retrospective review of all patients who have undergone HD-IORT during genitourinary surgery at our institution. Patients were stratified by surgical margin status, and primary outcomes assessed were overall survival, recurrence free survival and 90-day complications. Patients undergoing cystectomy and HD-IORT with sarcomatoid urothelial cancer were compared to a similar cohort undergoing cystectomy alone. A sample case of one such patient is discussed in detail.</p><p><strong>Results: </strong>84 patients at our institution have undergone HD-IORT with genitourinary surgery. Positive surgical margin status was the greatest predictor of both OS (HR = 3.42) and RFS (HR = 2.61). The overall 90-day complication rate was 61%, with wound infections (43%) and GI complications (21%) being most common. 4 of these patients had sarcomatoid urothelial histology, and all are still alive with >2 yrs follow up. This compares to a 52% 1 yr survival in our sarcomatoid urothelial cohort (25 pts) that did not undergo HD-IORT.</p><p><strong>Conclusions: </strong>Our institutional experience with HD-IORT has been promising, particularly among patients with locally advanced disease and sarcomatoid histology. We are currently enrolling patients in a multi-institutional registry to assess the utility of HD-IORT in high risk bladder cancer.</p>","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"191-199"},"PeriodicalIF":1.1,"publicationDate":"2017-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-170104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35285033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Trials Corner.","authors":"Piyush K Agarwal,&nbsp;Cora N Sternberg","doi":"10.3233/BLC-179022","DOIUrl":"https://doi.org/10.3233/BLC-179022","url":null,"abstract":"","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"229-230"},"PeriodicalIF":1.1,"publicationDate":"2017-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-179022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35285037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the Level of Urothelial Carcinoma Involvement of the Prostate on Survival after Radical Cystectomy.","authors":"Marco Moschini,&nbsp;Francesco Soria,&nbsp;Martin Susani,&nbsp;Stephan Korn,&nbsp;Alberto Briganti,&nbsp;Morgan Roupret,&nbsp;Christian Seitz,&nbsp;Killian Gust,&nbsp;Andrea Haitel,&nbsp;Francesco Montorsi,&nbsp;Gregory Wirth,&nbsp;Brian D Robinson,&nbsp;Pierre I Karakiewicz,&nbsp;Mehmet Özsoy,&nbsp;Michael Rink,&nbsp;Shahrokh F Shariat","doi":"10.3233/BLC-160086","DOIUrl":"https://doi.org/10.3233/BLC-160086","url":null,"abstract":"<p><strong>Objective: </strong>Urothelial prostatic involvement (UPI) at the time of radical cystoprostatectomy (RCP) was found associated with worse survival outcomes by several previous reports. Our aim is to evaluate the impact of different levels of UPI on survival outcomes using a large series of male patients treated with RCP.</p><p><strong>Methods: </strong>Whole step section specimens from 995 male BCa patients were assessed for UPI defined as: no involvement vs. prostatic urethral carcinoma <i>in situ</i> (CIS) vs. lamina propria involvement vs. ductal CIS vs. prostate stromal involvement. Primary end point of the study was predictors of prostatic involvement at RCP and its impact on overall survival after surgery.</p><p><strong>Results: </strong>Prostatic involvement was recorded in 307 (30.9%) patients: 28% with prostatic urethral CIS, 12% with lamina propria involvement, 13% with ductal CIS and 47% with stromal involvement. Median follow-up was 70 months. Patients with stromal involvement had a worse 5-year survival (12%) than those with prostatic urethra CIS (40%), lamina propria involvement (36%), and ductal CIS (35%). Considering predictors of prostatic involvement, multifocal tumor (Odds Ratio [OR]: 6.60, <i>p</i> < 0.001), lymphovascular invasion (OR: 2.61, <i>p</i> < 0.001), lymph node metastases (OR: 2.02, <i>p</i> < 0.001) and CIS (OR: 2.02, <i>p</i> < 0.001) were found associated. Similar predictors were found assessing stromal involvement.</p><p><strong>Conclusions: </strong>Approximately one third of RCP patients harbor prostatic involvement of urothelial carcinoma. While all UPI are associated with worse overall survival, stromal involvement confers the worst outcome supporting its classification as T4 in the TNM staging.</p>","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"161-169"},"PeriodicalIF":1.1,"publicationDate":"2017-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-160086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35334157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Bacillus Calmette-Guerin (BCG) Treatment Failures with Non-Muscle Invasive Bladder Cancer: A Data-Driven Definition for BCG Unresponsive Disease.","authors":"Roger Li, Richard Sylvester, Colin P Dinney, Ashish M Kamat","doi":"10.3233/BLC-179020","DOIUrl":"10.3233/BLC-179020","url":null,"abstract":"","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"147-148"},"PeriodicalIF":0.0,"publicationDate":"2017-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/e7/blc-3-blc179020.PMC5545908.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35334156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Proliferation as Independent Predictor of Disease Recurrence in Initial Stage pTa Urothelial Bladder Cancer.","authors":"Johannes Breyer,&nbsp;Sanzhar Shalekenov,&nbsp;Atiqullah Aziz,&nbsp;Bastiaan W G van Rhijn,&nbsp;Johannes Bründl,&nbsp;Eva Lausenmeyer,&nbsp;Julius Schäfer,&nbsp;Stefan Denzinger,&nbsp;Christian Giedl,&nbsp;Maximilian Burger,&nbsp;Arndt Hartmann,&nbsp;Matthias Evert,&nbsp;Wolfgang Otto","doi":"10.3233/BLC-170103","DOIUrl":"https://doi.org/10.3233/BLC-170103","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the predictive impact of the proliferation biomarker Ki-67 on the clinical course of patients with initial stage pTa urothelial carcinoma of the bladder (UCB).</p><p><strong>Methods: </strong>We retrospectively analyzed all patients treated by transurethral resection of bladder tumors (TUR-B) for UCB between 1992-2004 in a single-center. Disease recurrence (≥pTa UCB) and absent tumor in histopathology, assessed by TUR-B with a non-malignant result for endoscopic suspect bladder lesion displayed endpoints. Immunohistochemical (IHC) analysis of formalin-fixed and paraffin-embedded tissue blocks was performed with an immunostainer using a primary antibody for Ki-67. Semiquantitative evaluation of Ki-67 was performed by three reviewers. Increased proliferation was defined with a cut-off value of ≥50%. Uni- and multivariable binary regression analyses were applied to address prediction of disease recurrence.</p><p><strong>Results: </strong>215 patients (84% male, median age 69 years at first diagnosis) were evaluable and included to the study. 89 patients stayed disease-free (41%), 126 patients showed recurrence (59%). Recurrence rates of patients with Ki-67 expression <10%, 10-24%, 25-49% and ≥50% were 14.8% vs. 30.8% vs. 63.9% and 80.7%, respectively (<i>p</i> < 0.001). In Kaplan-Meier analysis patients with increased proliferation ≥50% showed a statistically significant worse 10-year recurrence-free survival (19% vs. 57%, <i>p</i> < 0.001). Multivariable regression analysis revealed instillation treatment (<i>p</i> = 0.001) and high proliferation of Ki-67 (<i>p</i> < 0.001) to be independent predictors of recurrence in stage pTa UCB.</p><p><strong>Conclusions: </strong>High proliferation with Ki-67 expression ≥50% was strongly associated with worse recurrence-free survival in patients with initial stage pTa UCB. Stage pTa UCB patients with increased Ki-67 expression should undergo a strictly follow-up regime comparable to stage pT1 bladder carcinoma, while at least patients with Ki-67 expression <10% might be feasible for more liberate follow-up regime after evaluation of our data in randomized, prospective and multicenter studies.</p>","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"173-180"},"PeriodicalIF":1.1,"publicationDate":"2017-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-170103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35334160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Sister Journal <i>Kidney Cancer</i>.","authors":"Seth P Lerner,&nbsp;Dan Theodorescu","doi":"10.3233/BLC-179021","DOIUrl":"https://doi.org/10.3233/BLC-179021","url":null,"abstract":"","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"143"},"PeriodicalIF":1.1,"publicationDate":"2017-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-179021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35334213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proceedings of the 3rd Annual Albert Institute for Bladder Cancer Research Symposium.","authors":"Thomas W Flaig,&nbsp;Ashish M Kamat,&nbsp;Donna Hansel,&nbsp;Molly A Ingersoll,&nbsp;H Barton Grossman,&nbsp;Cathy Mendelsohn,&nbsp;David DeGraff,&nbsp;Joseph C Liao,&nbsp;John A Taylor","doi":"10.3233/BLC-170111","DOIUrl":"https://doi.org/10.3233/BLC-170111","url":null,"abstract":"<p><p>The Third Annual Albert Institute Bladder Symposium was held on September 8-10th, 2016, in Denver Colorado. Participants discussed several critical topics in the field of bladder cancer: 1) Best practices for tissue analysis and use to optimize correlative studies, 2) Modeling bladder cancer to facilitate understanding and innovation, 3) Targeted therapies for bladder cancer, 4) Tumor phylogeny in bladder cancer, 5) New Innovations in bladder cancer diagnostics. Our understanding of and approach to treating urothelial carcinoma is undergoing rapid advancement. Preclinical models of bladder cancer have been leveraged to increase our basic and mechanistic understanding of the disease. With the approval of immune checkpoint inhibitors for the treatment of advanced urothelial carcinoma, the treatment approach for these patients has quickly changed. In this light, molecularly-defined subtypes of bladder cancer and appropriate pre-clinical models are now essential to the further advancement and appropriate application of these therapeutic improvements. The optimal collection and processing of clinical urothelial carcinoma tissues samples will also be critical in the development of predictive biomarkers for therapeutic selection. Technological advances in other areas including optimal imaging technologies and micro/nanotechnologies are being applied to bladder cancer, especially in the localized setting, and hold the potential for translational impact in the treatment of bladder cancer patients. Taken together, advances in several basic science and clinical areas are now converging in bladder cancer. These developments hold the promise of shaping and improving the clinical care of those with the disease.</p>","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"211-223"},"PeriodicalIF":1.1,"publicationDate":"2017-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-170111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35285036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image-Guided Transurethral Resection of Bladder Tumors - Current Practice and Future Outlooks.","authors":"Timothy C Chang,&nbsp;Gautier Marcq,&nbsp;Bernhard Kiss,&nbsp;Dharati R Trivedi,&nbsp;Kathleen E Mach,&nbsp;Joseph C Liao","doi":"10.3233/BLC-170119","DOIUrl":"https://doi.org/10.3233/BLC-170119","url":null,"abstract":"<p><p>Transurethral resection of bladder tumor (TURBT) under white light cystoscopy (WLC) is the cornerstone for the diagnosis, removal and local staging of non-muscle invasive bladder cancer (NMIBC). Despite technological improvements over the decades, significant shortcomings remain with WLC for tumor detection, thereby impacting the surgical quality and contributing to tumor recurrence and progression. Enhanced cystoscopy modalities such as blue light cystoscopy (BLC) and narrow band imaging (NBI) aid resections by highlighting tumors that might be missed on WLC. Optical biopsy technologies such as confocal laser endomicroscopy (CLE) and optical coherence tomography (OCT) characterize tissue in real-time to ensure a more thorough resection. New resection techniques, particularly en bloc resection, are actively under investigation to improve the overall quality of resections and aid pathologic interpretation. Moreover, new image processing computer algorithms may improve perioperative planning and longitudinal follow-up. Clinical translation of molecular imaging agents is also on the horizon to improve optical diagnosis of bladder cancer. This review focuses on emerging technologies that can impact the quality of TURBT to improve the overall management of NMIBC.</p>","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"149-159"},"PeriodicalIF":1.1,"publicationDate":"2017-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-170119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35334159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}