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CA: a Cancer Journal For Clinicians 1996In superficial Ta or T1 tumors intravesical chemotherapy can eradicate existing carcinoma in one third to one half of patients and reduce tumor recurrence by 12 to 15... (Review)
Review
In superficial Ta or T1 tumors intravesical chemotherapy can eradicate existing carcinoma in one third to one half of patients and reduce tumor recurrence by 12 to 15 percent, on average. Superficial bladder cancer is remarkably sensitive to immunotherapy, particularly BCG. The use of BCG eradicates about two thirds of papillary carcinoma and nearly 90 percent of carcinoma in situ and reduces tumor recurrence by an average of 40 percent. Data now suggest that BCG immunotherapy reduces long-term tumor recurrence, disease progression, and mortality. The proclivity for tumor recurrence makes superficial bladder cancer an ideal malignancy for the evaluation of chemoprevention, and preliminary data suggest that high doses of vitamins may also reduce tumor recurrence. In locally advanced T2b to T4, N0 or N1, M0 bladder cancer, substantial clinical responses can be achieved if chemotherapy is used prior to surgical resection of muscle-invasive tumor (neoadjuvant treatment). Controlled trials are necessary to ascertain whether neoadjuvant chemotherapy improves survival. The use of CMV prior to and concomitant with bladder irradiation is also encouraging, but will require randomized trials to clarify its role in the treatment of invasive, nonmetastatic cancer. Finally, trials suggest benefit for chemotherapy used adjuvantly (after cystectomy) for muscle-invasive bladder cancer. However, further investigation is necessary to clarify and confirm the role of chemotherapy in this setting before it can be recommended routinely for patients. In metastatic disease, chemotherapy with CMV or M-VAC with surgical resection of residual masses can produce a cohort of long-term survivors with advanced bladder cancer. How to increase this small but important population of patients is a question for further research.
Topics: Administration, Intravesical; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; BCG Vaccine; Chemotherapy, Adjuvant; Humans; Neoplasm Invasiveness; Neoplasm Metastasis; Occupational Diseases; Urinary Bladder Neoplasms
PubMed: 8624800
DOI: 10.3322/canjclin.46.2.93 -
International Journal of Molecular... Aug 2022The non-muscle invasive bladder cancer tends to recur and progress. Therefore, it requires frequent follow-ups, generating costs and making it one of the most expensive... (Review)
Review
The non-muscle invasive bladder cancer tends to recur and progress. Therefore, it requires frequent follow-ups, generating costs and making it one of the most expensive neoplasms. Considering the expensive and invasive character of the current gold-standard diagnostic procedure, white-light cystoscopy, efforts to find an alternative method are ongoing. Although the last decade has seen significant advancements in urinary biomarker tests (UBTs) for bladder cancer, international guidelines have not recommended them. Currently, the paramount urgency is to find and validate the test with the best specificity and sensitivity, which would allow for the optimizing of diagnosis, prognosis, and a treatment plan. This review aims to summarise the up-to-date state of knowledge relating to UBTs and new developments in the detection, prognosis, and surveillance of bladder cancer and their potential applications in clinical practice.
Topics: Biomarkers, Tumor; Cystoscopy; Humans; Liquid Biopsy; Neoplasm Recurrence, Local; Urinary Bladder Neoplasms
PubMed: 35955727
DOI: 10.3390/ijms23158597 -
Seminars in Radiation Oncology Jan 2023Radical cystectomy is long considered as the "gold standard" in the management of localized muscle-invasive bladder cancer (MIBC), and curative intent radiotherapy is... (Review)
Review
Radical cystectomy is long considered as the "gold standard" in the management of localized muscle-invasive bladder cancer (MIBC), and curative intent radiotherapy is relegated to those with either inoperable tumors or with multiple co-morbidities precluding surgery. This is despite a large volume of data showing equal survival between the two modalities of treatment in this setting. In this work we seek to dispel some common myths surrounding curative intent radiotherapy as part of a bladder preservation strategy in MIBC. Baseless claims of inferior outcomes and perceived contraindications for bladder preservation are debunked along with unfounded doubts relating to hypofractionation. Finally, we caution against using response to neoadjuvant chemotherapy as a predictive biomarker for treatment selection and conclude by recommending that trimodality bladder preservation be offered as a therapeutic option that is in clinical equipoise with radical cystectomy.
Topics: Humans; Urinary Bladder; Neoplasm Invasiveness; Urinary Bladder Neoplasms; Cystectomy; Neoadjuvant Therapy; Muscles
PubMed: 36517194
DOI: 10.1016/j.semradonc.2022.10.007 -
Urologia Internationalis 2015Bladder cancer relapse and treatment failure in most patients have often been attributed to chemoresistance in tumor cells and metastasis. Emerging evidence indicates... (Review)
Review
Bladder cancer relapse and treatment failure in most patients have often been attributed to chemoresistance in tumor cells and metastasis. Emerging evidence indicates that tumor heterogeneity may play an equally important role and extends to virtually all measurable properties of cancer cells. Although the idea of tumor heterogeneity is not new, little attention has been paid to applying it to understand and control bladder cancer progression. With the development of biotechnology, such as Gene sequencing, recent advances in understanding its generation model, original basis, consequent problems, and derived therapies provide great potential for tumor heterogeneity to be considered a new insight in the treatment of bladder cancers.
Topics: Disease Progression; Drug Resistance, Neoplasm; Evolution, Molecular; Humans; Mutation; Neoplasm Recurrence, Local; Neoplastic Stem Cells; Tumor Microenvironment; Urinary Bladder Neoplasms
PubMed: 25823547
DOI: 10.1159/000370165 -
International Braz J Urol : Official... 2022Bladder cancer (BCa) is one of the most common cancers worldwide and is also considered to be one of the most relapsing and aggressive neoplasms. About 30% of patients... (Review)
Review
Bladder cancer (BCa) is one of the most common cancers worldwide and is also considered to be one of the most relapsing and aggressive neoplasms. About 30% of patients will present with muscle invasive disease, which is associated with a higher risk for metastatic disease. The aim of this article is to review the state of art imaging in Radiology, while providing a complete guide to urologists, with case examples, for the rationale of the development of the Vesical Imaging Reporting and Data System (VI-RADS), a scoring system emphasizing a standardized approach to multiparametric Magnetic Resonance Imaging (mpMRI) acquisition, interpretation, and reporting for BCa. Also, we examine relevant external validation studies and the consolidated literature of mpMRI for bladder cancer. In addition, this article discusses some of the potential clinical implications of this scoring system for disease management and follow-up.
Topics: Humans; Magnetic Resonance Imaging; Multiparametric Magnetic Resonance Imaging; Neoplasm Recurrence, Local; Urinary Bladder; Urinary Bladder Neoplasms; Urologists
PubMed: 35195385
DOI: 10.1590/S1677-5538.IBJU.2021.0560 -
Biosensors Sep 2022Bladder cancer is a common malignant tumor of the urinary system. Cystoscopy, urine cytology, and CT are the routine diagnostic methods. However, there are some problems... (Review)
Review
Bladder cancer is a common malignant tumor of the urinary system. Cystoscopy, urine cytology, and CT are the routine diagnostic methods. However, there are some problems such as low sensitivity and difficulty in staging, which must be urgently supplemented by novel diagnostic methods. Surgery, intravesical instillation, systemic chemotherapy, and radiotherapy are the main clinical treatments for bladder cancer. It is difficult for conventional treatment to deal with tumor recurrence, progression and drug resistance. In addition, the treatment agents usually have the defects of poor specific distribution ability to target tumor tissues and side effects. The rapid development of nanomedicine has brought hope for the treatment of bladder cancer in reducing side effects, enhancing tumor inhibition effects, and anti-drug resistance. Overall, we review the new progression of nano-platforms in the diagnosis and treatment of bladder cancer.
Topics: Humans; Urinary Bladder Neoplasms; Nanomedicine; Neoplasm Recurrence, Local; Administration, Intravesical; Cystoscopy
PubMed: 36290934
DOI: 10.3390/bios12100796 -
Scandinavian Journal of Urology Apr 2017The management of non-muscle-invasive bladder cancer (NMIBC) has evolved from the first reports on bladder endoscopy and transurethral resection to the introduction of... (Review)
Review
The management of non-muscle-invasive bladder cancer (NMIBC) has evolved from the first reports on bladder endoscopy and transurethral resection to the introduction of adjuvant intravesical treatment. However, disease recurrence and progression remain an ongoing risk, placing a heavy burden on healthcare resources and on patients' quality of life. Deeper understanding of the molecular basis of the disease and developments in optics, lasers and computer science are already offering opportunities to revolutionize care and improve long-term prognosis. This article discusses developments likely to cause a paradigm shift towards the delivery of personalized care and reduced burden of disease in NMIBC.
Topics: Cystoscopy; Humans; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Staging; Radiography; Urinalysis; Urinary Bladder Neoplasms
PubMed: 28535714
DOI: 10.1080/21681805.2017.1283359 -
International Journal of Molecular... Mar 2021Exosomes are extracellular vesicles, enriched in biomolecular cargo consisting of nucleic acids, proteins, and lipids, which take part in intercellular communication and... (Review)
Review
Exosomes are extracellular vesicles, enriched in biomolecular cargo consisting of nucleic acids, proteins, and lipids, which take part in intercellular communication and play a crucial role in both physiologic functions and oncogenesis. Bladder cancer is the most common urinary malignancy and its incidence is steadily rising in developed countries. Despite the high five-year survival in patients diagnosed at early disease stage, survival substantially drops in patients with muscle-invasive or metastatic disease. Therefore, early detection of primary disease as well as recurrence is of paramount importance. The role that exosomal biomarkers could play in bladder cancer patient diagnosis and surveillance, as well as their potential therapeutic applications, has not been extensively studied in this malignancy. In the present review, we summarize all relevant data obtained so far from cell lines, animal models, and patient biofluids and tissues. Current literature suggests that urine is a rich source of extracellular vesicle-derived biomarkers, compared with blood and bladder tissue samples, with potential applications in bladder cancer management. Further studies improving sample collection procedures and optimizing purification and analytical methods should augment bladder cancer diagnostic, prognostic, and therapeutic input of extracellular vesicles biomarkers in the future.
Topics: Biomarkers, Tumor; Exosomes; Humans; Neoplasm Metastasis; Urinary Bladder Neoplasms
PubMed: 33803085
DOI: 10.3390/ijms22052744 -
The Journal of Urology Jun 2022
Topics: Female; Humans; Male; Neoplasm Recurrence, Local; Risk Factors; Smoking; Smoking Cessation; Urinary Bladder Neoplasms
PubMed: 35289696
DOI: 10.1097/JU.0000000000002649 -
Urologic Oncology Jan 2014Micro ribonucleic acid (miR) expression is altered in urologic malignancies, including bladder cancer (BC). Individual miRs have been shown to modulate multiple... (Review)
Review
PURPOSE
Micro ribonucleic acid (miR) expression is altered in urologic malignancies, including bladder cancer (BC). Individual miRs have been shown to modulate multiple signaling pathways that contribute to BC. We reviewed the primary literature on the role of miRs in BC; we provide a general introduction to the processing, regulation, and function of miRs as tumor suppressors and oncogenes and critically evaluate the literature on the implications of altered miR expression in BC.
MATERIALS AND METHODS
We searched the English language literature for original and review articles in PubMed from 1993 to March 2013, using the terms "microRNA" and "bladder cancer," "transitional cell carcinoma," or "urothelial carcinoma." This search yielded 133 unique articles with more than 85% of them published within the last 3 years.
RESULTS
To date, the majority of miR studies in BC use profiling to describe dynamic changes in miR expression across stage and grade. Generalized down-regulation of miRs, including those that target the fibroblast growth factor 3 pathway, such as miR-145, miR-101, miR-100, and miR-99a, has been observed in low-grade, non-muscle invasive BC. In contrast, generalized increased expression of miRs is observed in high-grade, muscle-invasive BC compared with adjacent normal bladder urothelium, including miRs predicted to target p53, such as miR-21 and miR-373. Furthermore, p53 suppresses transcriptional factors that promote mesenchymal differentiation, ZEB-1 and ZEB-2, through regulation of the miR200 family.
CONCLUSIONS
Aberrations in miR expression identified between non-muscle invasive BC and muscle-invasive BC provide insight into the molecular alterations known to distinguish the two parallel pathways of bladder carcinogenesis. The heterogeneity of tumor specimens and research methods limits the reproducibility of changes in miR expression profiles between studies and underscores the importance of in vivo validation in a field that utilizes in silico miR target-prediction models.
Topics: Carcinoma, Transitional Cell; Gene Expression Profiling; Gene Expression Regulation, Neoplastic; Humans; MicroRNAs; Models, Genetic; Signal Transduction; Urinary Bladder Neoplasms
PubMed: 23911686
DOI: 10.1016/j.urolonc.2013.04.014