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Journal of B.U.ON. : Official Journal... 2015Urothelial carcinomas are malignant tumors that arise from the urothelial epithelium and may involve the lower and upper urinary tract. They are characterized by... (Review)
Review
Urothelial carcinomas are malignant tumors that arise from the urothelial epithelium and may involve the lower and upper urinary tract. They are characterized by multiple, multifocal recurrences throughout the genitourinary tract. Bladder tumors account for 90-95% of urothelial carcinomas and are the most common malignancies of the urinary tract. Upper urinary tract urothelial carcinomas (UTUC) are relatively rare, accounting for 5% of urothelial tumors. The incidence of subsequent bladder cancer after surgical treatment for UTUC is approximately 15-50%. In contrast, patients with a primary tumor of the bladder have a low risk (2-6%) the development of UTUC. Identification of prognostic factors and early detection of recurrent disease provide a better strategy for postoperative monitoring, surveillance, and potentially improve patient outcomes. In this review study we discuss the main risk factors for UTUC recurrence after radical cystectomy, and risk factors for intravesical recurrence after radical nephroureterectomy.
Topics: Cystectomy; Humans; Neoplasm Recurrence, Local; Nephrectomy; Prognosis; Risk Factors; Urinary Bladder Neoplasms
PubMed: 26011327
DOI: No ID Found -
TheScientificWorldJournal Jun 2011Bladder cancer is the fifth most common cancer in Western society, with the global burden predicted to increase significantly in the foreseeable future. Over 90% of... (Review)
Review
Bladder cancer is the fifth most common cancer in Western society, with the global burden predicted to increase significantly in the foreseeable future. Over 90% of these bladder cancers are transitional cell carcinomas of urothelial origin (urothelial carcinomas or UCs) and at presentation, over 70% will be non-muscle-invasive or stage Ta/T1 tumours, with the remainder being muscle-invasive or stages T2-4. Bladder UC is a highly heterogeneous disease: for the 50-55% of bladder cancer patients presenting with Ta tumours, recurrence is the main issue, but for the 20-25% of patients presenting with T1 tumours, progression is the main issue. Progression to, or presentation with, muscle-invasive disease represents the critical step for patients, necessitating more aggressive therapies and carrying significantly worse survival rates. We therefore urgently require detailed molecular insights into the pathogenesis of muscle-invasive bladder cancer so that the disease can be more adequately and appropriately treated at presentation, so that progression from stages Ta/T1 can be abrogated, and so that the risk of recurrence following treatment can be minimised. The recently identified bladder cancer stem cells are considered to be mediators of resistance to current therapies and therefore represent strong candidate biological targets. The aim of this review is to discuss the background and basic science of such cells, and the implications for current and future therapies.
Topics: Biomarkers; Humans; Neoplasm Invasiveness; Neoplastic Stem Cells; Signal Transduction; Urinary Bladder; Urinary Bladder Neoplasms
PubMed: 21666988
DOI: 10.1100/tsw.2011.117 -
Current Opinion in Urology Jul 2019The purpose of this review is to examine and evaluate similarities and differences in bladder cancer expression subtypes and to understand the clinical implications of... (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to examine and evaluate similarities and differences in bladder cancer expression subtypes and to understand the clinical implications of the molecular subtyping.
RECENT FINDINGS
Four independent classification systems have been described, and there are broad similarities among the subtyping callers. Two major subtypes have been identified, that is, luminal and basal, with underlying subcategories based on various distinct characteristics. Luminal tumors generally bear a better prognosis and increased survival than basal tumors, although there is subtle variation in prognosis among the different subtypes within the luminal and basal classifications. Clinical subtyping is now commercially available, although there are limitations to its generalizability and application.
SUMMARY
Expression subtyping is a new method to personalize bladder cancer management. However, there is probably not sufficient evidence to incorporate use into current standards-of-care. Validation cohorts with clinically meaningful outcomes may further establish the clinical relevance of molecular subtyping of bladder cancer. Additionally, genetic alterations in bladder cancer may 'color' the interpretation of individual tumors beyond the expression subtype to truly personalize care for bladder cancer.
Topics: Biomarkers, Tumor; Gene Expression Profiling; Humans; Immunophenotyping; Metadata; Mutation; Neoplasm Invasiveness; Prognosis; Urinary Bladder Neoplasms
PubMed: 31158107
DOI: 10.1097/MOU.0000000000000641 -
Modern Pathology : An Official Journal... Jun 2009Significant progress has been made in the standardization of bladder neoplasm classification and reporting. Accurate staging using the American Joint Committee on... (Review)
Review
Significant progress has been made in the standardization of bladder neoplasm classification and reporting. Accurate staging using the American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) TNM system is essential for patient management, and has been reinforced by clinical evidence in recent years. It is now recognized that 'superficial' bladder carcinomas are a heterogenous group of tumors with diverse biological and clinical manifestations. The term 'superficial,' therefore, is no longer used for bladder tumor nomenclature. Recognition of diagnostic pitfalls associated with lamina propria invasion is critical for the evaluation of bladder tumor specimens. Neither the 1973 nor the 2004 WHO grading system appears to be useful for predicting the clinical outcome of invasive urothelial carcinoma. This review will discuss recent progress and controversial issues on the staging and substaging of bladder carcinomas. Essential elements for handling and reporting of bladder tumor specimens will also be discussed.
Topics: Carcinoma, Transitional Cell; Humans; Neoplasm Staging; Pathology, Surgical; Specimen Handling; Urinary Bladder Neoplasms
PubMed: 19494855
DOI: 10.1038/modpathol.2009.1 -
American Society of Clinical Oncology... May 2018The treatment of muscle-invasive bladder cancer (MIBC) is complex and requires a multidisciplinary collaboration among surgery, radiation, and medical oncology. Although... (Review)
Review
The treatment of muscle-invasive bladder cancer (MIBC) is complex and requires a multidisciplinary collaboration among surgery, radiation, and medical oncology. Although neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) and lymph node dissection has been considered the standard treatment for MIBC, many patients are unfit for surgery or cisplatin-ineligible, and considerations for bladder-preservation strategies not only are increasingly recognized as optimal treatment alternatives, but also should feature in the range of management options presented to patients at the time of diagnosis. Apart from chemotherapy, immunotherapy has also been used with success in locally advanced and metastatic bladder cancer and is moving into the MIBC space. Prospective studies addressing trends in management that span systemic, surgical, and radiation options for patients are discussed in this article.
Topics: Biomarkers, Tumor; Combined Modality Therapy; Disease Management; Humans; Molecular Targeted Therapy; Neoadjuvant Therapy; Neoplasm Invasiveness; Neoplasm Staging; Perioperative Period; Treatment Outcome; Urinary Bladder Neoplasms
PubMed: 30231340
DOI: 10.1200/EDBK_201227 -
CA: a Cancer Journal For Clinicians 1998The challenge in bladder cancer is to control superficial disease and prevent its recurrence or progression. Patients with invasive disease need to be identified... (Review)
Review
The challenge in bladder cancer is to control superficial disease and prevent its recurrence or progression. Patients with invasive disease need to be identified earlier, when disease may be less advanced and more amenable to cure. An important area for further investigation is the biology of the various forms of bladder cancer and the various pathways of development they may follow.
Topics: Biomarkers, Tumor; Diagnostic Imaging; Female; Humans; Male; Neoplasm Invasiveness; Neoplasm Staging; Prognosis; Urinary Bladder; Urinary Bladder Neoplasms
PubMed: 9742894
DOI: 10.3322/canjclin.48.5.269 -
Investigative and Clinical Urology Jun 2016Nonmuscle invasive bladder cancer (NMIBC) is known to be a heterogeneous malignancy that requires varying treatment modalities and follow-up schedules. Low-grade Ta... (Review)
Review
Nonmuscle invasive bladder cancer (NMIBC) is known to be a heterogeneous malignancy that requires varying treatment modalities and follow-up schedules. Low-grade Ta papillary tumors are categorized as low-risk NMIBC because of their favorable prognosis. There is an expanding movement that overdiagnosis and overtreatment should be avoided considering the economic impact and the patients' quality of life. It has been over 10 years since the initial assessment of active surveillance for low-risk NMIBC suggested its feasibility and safety. However, urologists are still unfamiliar with this treatment option, which can be ideal in appropriately selected patients. In this review article, we focus on active surveillance for low-risk NMIBC and discuss the evidence and rationale for this treatment option. There are several issues to resolve in order to advocate active surveillance as a standard option in selected patients. A specific follow-up protocol including intervals of cystoscopy, urine cytology, urine markers, and other radiographic examinations need to be optimized and validated. Finally, we integrate the available data into the follow-up strategy and propose a new surveillance protocol for active surveillance of recurrent low-risk bladder cancer.
Topics: Animals; Disease Models, Animal; Evidence-Based Medicine; Humans; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Population Surveillance; Prognosis; Urinary Bladder Neoplasms; Watchful Waiting
PubMed: 27326406
DOI: 10.4111/icu.2016.57.S1.S4 -
Current Opinion in Urology May 2019This review examines both trimodality therapy (TMT) in the definitive management of bladder cancer as well as the use of adjuvant radiotherapy for bladder cancer with a... (Review)
Review
PURPOSE OF REVIEW
This review examines both trimodality therapy (TMT) in the definitive management of bladder cancer as well as the use of adjuvant radiotherapy for bladder cancer with a specific focus on publications from the last 2 years.
RECENT FINDINGS
TMT is an effective management strategy for muscle invasive bladder cancer with outcomes similar to radical cystectomy. Effectiveness of this strategy exists in variant histologies and can be personalized with use of biomarkers. There is a role for adjuvant radiotherapy in locally advanced bladder cancer, especially in the age of improved imaging and modern radiotherapy techniques.
SUMMARY
This review should provide the reader data necessary to support use of TMT and adjuvant radiation therapy in their clinic.
Topics: Combined Modality Therapy; Cystectomy; Humans; Immunotherapy; Neoplasm Invasiveness; Organ Sparing Treatments; Radiotherapy, Adjuvant; Treatment Outcome; Urinary Bladder Neoplasms
PubMed: 30855374
DOI: 10.1097/MOU.0000000000000601 -
BMJ Case Reports Jul 2023A man in his 70s previously diagnosed with an adenocarcinoma of the prostate, received external beam radiation therapy (EBRT) and brachytherapy 11 years ago. Ten years...
A man in his 70s previously diagnosed with an adenocarcinoma of the prostate, received external beam radiation therapy (EBRT) and brachytherapy 11 years ago. Ten years later, he developed urinary symptoms and a cystoscopy identified a bladder neck tumour. A transurethral resection of a bladder tumour was performed, and pathology revealed a high-grade adenocarcinoma consistent with a colorectal primary. A colonoscopy was unremarkable, and imaging studies showed tumour involving the bladder and prostate. Tumour markers and a CARIS genomic prevalence score also favoured a colorectal cancer primary.The patient refused surgery and underwent chemoradiation with a combination of EBRT and brachytherapy with concurrent capecitabine. Imaging studies obtained 6 months after reirradiation revealed an enlarged left-sided mesorectal lymph node concerning for disease recurrence. The lymph node was treated with Stereotactic Body Radiation Therapy and his post-treatment imaging revealed a response to treatment with no other evidence of disease.
Topics: Male; Humans; Urinary Bladder; Prostatic Neoplasms; Neoplasm Recurrence, Local; Brachytherapy; Urinary Bladder Neoplasms; Adenocarcinoma
PubMed: 37463778
DOI: 10.1136/bcr-2022-252747 -
Current Opinion in Urology Sep 2011Patients with locally 'advanced' or muscle invasive bladder cancer have higher mortality rates than patients with nonmuscle invasive ('superficial') bladder cancer.... (Review)
Review
PURPOSE OF REVIEW
Patients with locally 'advanced' or muscle invasive bladder cancer have higher mortality rates than patients with nonmuscle invasive ('superficial') bladder cancer. Biomarkers can stratify clinical outcomes and thus promise to more accurately prognosticate and thus help assign patients to the appropriate treatments. The aim of this review is to summarize biomarker developments in the past year and to discuss their implications in prognosis and treatment selection in locally advanced bladder cancer.
RECENT FINDINGS
Prognostic biomarkers for bladder cancer are identified at the DNA, RNA and/or protein levels. Some are new markers, whereas others are established markers with new roles in bladder cancer. Markers can report on the risk of disease recurrence or metastasis, or treatment responsiveness and thus are useful in determining 'who to treat' and 'what to treat with'.
SUMMARY
The list of biomarkers for prognosis and treatment selection for advanced bladder cancer is growing. For most, their clinical relevance is unclear due to their lack of validation in external datasets. MicroRNAs and new techniques including next-generation sequencing offer additional opportunities for biomarker discovery, validation, and clinical applications.
Topics: Biomarkers, Tumor; Epigenomics; Humans; Neoplasm Invasiveness; Pharmacogenetics; Prognosis; Severity of Illness Index; Treatment Outcome; Urinary Bladder Neoplasms
PubMed: 21814055
DOI: 10.1097/MOU.0b013e32834956d6