scholarly journals Do Standardised Prognostic Algorithms Reflect Local Practice? Application of EORTC Risk Tables for Non-Muscle Invasive (pTa/pT1) Bladder Cancer Recurrence and Progression in a Local Cohort

2011 ◽  
Vol 11 ◽  
pp. 751-759 ◽  
Author(s):  
Rajiv Pillai ◽  
Duolao Wang ◽  
Erik K. Mayer ◽  
Paul Abel
Keyword(s):  
Bladder Cancer ◽  
Cell Cancer ◽  
Transitional Cell ◽  
Cancer Recurrence ◽  
Risk Groups ◽  
Original Algorithm ◽  
Transitional Cell Cancer ◽  
Study Population ◽  
Muscle Invasive ◽  
Prognostic Data

A risk calculator algorithm to allow prediction of probabilities of 1- and 5-year recurrence and progression rates in individuals with pTa/pT1 bladder cancer has been proposed by the European Organisation for Research and Treatment of Cancer (EORTC) and was incorporated into the European Association of Urology guidelines in 2006. We attempted to validate this algorithm in a cohort of patients with known outcome. Prognostic data were collected from a consecutively presenting cohort of 109 patients with non-muscle invasive (pTa/pT1) transitional cell cancer (TCC) at a single institution between 1983 and 1985. Using the same statistical models as in the EORTC original paper, predicted probabilities of 1- and 5-year recurrence and progression were calculated. Patients were divided into four risk groups for recurrence (Ir-IVr) and progression (Ip-IVp), respectively, using six prognostic criteria. These were then compared to the probabilities predicted in the EORTC algorithm. The predicted 1- and 5-year probabilities of recurrence were significantly higher in the study population as compared to the original EORTC algorithm for all four risk groups. The predicted 1-year probabilities for progression in groups Ip/IIIp and at 5-years for groups Ip/IIp were in accordance with the original algorithm, but were higher for the other progression groups. The concordance for the model of prediction using the study group for recurrence at 1 and 5 years was 62 and 63%, respectively, and for progression was 65 and 67, respectively. We were unable to validate the proposed algorithm in our group of patients. Although our study has limitations that prevent firm conclusions on the validity of the algorithm, it does expose some of the drawbacks of standardised nomograms when applied to local clinical practice.

Indici di proliferazione (Ki 67, TLI) ed espressione della p53. Introduzione: Proliferation indices (Ki 67, TLI) and p53 expression. Introduction

1995 ◽  
Vol 62 (2) ◽  
pp. 229-233
Author(s):  
R. Minari ◽  
B. Monica
Keyword(s):  
Bladder Cancer ◽  
Prognostic Factors ◽  
Cell Cancer ◽  
Transitional Cell ◽  
Ki 67 ◽  
P53 Expression ◽  
Proliferation Indices ◽  
Cancer Of The Bladder ◽  
Pathologic Findings ◽  
Transitional Cell Cancer

Histologic and pathologic findings are the most common and useful prognostic factors in transitional cell cancer of the bladder. Thus, clinicians know their peculiar limits very well. The Authors report the results of a literature review about an oncogenic-derivative protein (p53) and about indices of proliferation Ki 67 and TLI, which are frequently studied in bladder cancer.

scholarly journals Tulium laser in urothelial carcinoma of the bladder with spread to the ostium of the ureter

2020 ◽  
Vol 16 (3) ◽  
pp. 198-204
Author(s):  
M. E. Novikov ◽  
N. A. Meleshko ◽  
I. G. Akopyan
Keyword(s):  
Bladder Cancer ◽  
Urinary Tract ◽  
Urothelial Cancer ◽  
Cell Cancer ◽  
Transitional Cell ◽  
Upper Urinary Tract ◽  
En Bloc ◽  
Non Invasive ◽  
Transitional Cell Cancer ◽  
Urothelial Bladder

Urothelial transitional cell cancer in developed countries is the 4th most common. In terms of frequency, it is outstripped only by prostate, breast, lung, and colorectal cancer. In the vast majority of cases, urothelial carcinoma develops in the bladder. It accounts for 90—95 % of all cases of transitional cell cancer of the urinary tract. Much less often, in 5—10 % have to deal with its localization in the upper urinary tract (in the calico-pelvic system or ureter). In 17 % of upper urinary tract cancers, bladder cancer is simultaneously diagnosed. The incidence of urothelial transitional cell cancer has increased over the past few decades as a result of improved diagnosis and improved survival of patients with this nosology. The use of modern, high-tech equipment for visualization and direct surgical intervention contributes to such results. The use of laser energy as the main tool for tissue dissection in endoscopic oncourology reveals the undeniable advantages of this method in comparison with the traditional electrosurgery.We present a clinical observation of the diagnosis and surgical treatment of urothelial bladder cancer with invasion of the ureter, performed by en-bloc tulium laser. An operation was performed-transurethral resection of a urothelial bladder tumor with invasion of the ureter, performed by en-bloc tulium laser. Intraoperatively, ureteropieloscopy was performed, and the tumor did not spread to the upper urinary tract beyond the intramural part of the ureter. Thanks to the precision of the action of the tulium laser on the tissue, not resection, but, in fact, dissection of the bladder wall, a high-quality macropreparation was obtained, which made it possible to establish a final diagnosis. Histological conclusion: from the bladder — non-invasive urothelial cancer G2-3; from the mouth of the left ureter — fragments of fibrous tissue lined with urothelium from atypia. 3 months after the operation — no recurrence of urothelial cancer was revealed, which indicates a high quality of the operation.This clinical observation demonstrates the superiority of laser en-bloc dissection compared to the treatment of bladder tumors. Obtaining a macro-product of urothelial transitional cell cancer of the highest quality can contribute to avoiding unjustified radical nephrureterectomies and conducting organ-preserving treatment, for absolute and elective indications. The 1.94 µm Tulium Erbium laser is an effective tool for performing minimally invasive transurethral interventions in non-invasive bladder cancer.

Micropapillary bladder cancer: Stage at presentation and treatment outcome—Analysis of 121 patients from a cancer database.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 289-289 ◽  
Author(s):  
Joshua D. Holyoak ◽  
Zachary Panfili ◽  
Ravi P. Kiran ◽  
Naveen Pokala
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Radical Surgery ◽  
Statistical Tests ◽  
Cell Cancer ◽  
Transitional Cell ◽  
Invasive Disease ◽  
Treatment Type ◽  
The Mean ◽  
Muscle Invasive

289 Background: The micropapillary variant of transitional cell cancer(MPTCC) is an aggressive pathological subtype of bladder cancer and radical cystectomy is recommended for patients with non−muscle invasive disease. This study compares the treatment patterns and survival outcome in 121 patients. Methods: Patients with MPTCC (code 8131) were identified from the Surveillance Epidemiology and End Results (SEER 17) database. Data was analyzed for demographics, stage, treatment, overall (OS) and cancer specific survival (CSS). Appropriate statistical tests were used. Results: 121 patients were identified (2001−08). Mean age was 73.3 years, 76.9% were male (76.9%, n=93), 82.7% were Caucasian. 40.5% (n=49) had non−muscle invasive (NMI) disease and 59.5% had muscle−invasive disease (MI) at diagnosis. The T stage was Ta or Tis (n=17), T1 (n=32), T2 (n=38) T3 (n=20) and T4 (n=14). 23 patients had node positive disease, the nodal status was not known in 4 patients. 10 patients had distant metastasis. Surgical procedures performed include, TURBT (n=83), Radical cystectomy (n=34), pelvic exenteration (n=1) and partial cystectomy (n=3). 8 patients received post−operative radiotherapy. The mean OS was 64.9, 42.9, 16.1 and 50.2 months and the mean CSS was 81.2, 56.3, 15.7 and 64.4 months for NMI, MI, distant and the whole group respectively. The 5−year OS was 40%, 54% and 34% and the 5 year CSS was 62%, 53% and 82% for the whole group, MI and NMI respectively. All patients with distant disease were dead by 28 months. On analysis of CSS by treatment type the 5−yr CSS for NMI was 81% (n=36) after TURBT and 100% (n=3) after Radical surgery. For MI disease the 3−yr CSS was 66% after TURBT (n=18) and the 5−yr CSS was 54% after radical surgery (n=29). On multivariate analysis, higher stage and age were associated with worse survival. TURBT was associated with better survival. Conclusions: MPTCC is a rare variant of TCC. 81% survival can be achieved with TURBT for non-muscle invasive MPTCC.

scholarly journals Expression of beta1-integrins and N-cadherin in bladder cancer and melanoma cell lines.

2000 ◽  
Vol 47 (4) ◽  
pp. 1159-1170 ◽  
Author(s):  
P Laidler ◽  
D Gil ◽  
A Pituch-Noworolska ◽  
D Ciołczyk ◽  
D Ksiazek ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cell Line ◽  
Cell Lines ◽  
Melanoma Cell ◽  
Cell Cancer ◽  
Transitional Cell ◽  
Melanoma Cells ◽  
Integrin Subunit ◽  
Bladder Cell ◽  
Transitional Cell Cancer

Changes in the expression of integrins and cadherins might contribute to the progression, invasion and metastasis of transitional cell cancer of the bladder and of melanomas. The expression of alpha5 (P < 0.001), alpha2 and beta1 (P < 0.05 - P < 0.001) integrin subunits in melanoma cells from noncutaneous metastatic sites (WM9, A375) were significantly increased as compared to cutaneous primary tumor (WM35) and metastatic (WM239) cell lines. These differences might be ascribed to the invasive character of melanoma cells and their metastasis to the noncutaneous locations. The significantly heterogeneous expression of beta1 integrin subunit in two malignant bladder cancer cell lines (T24 and Hu456) and nonsignificant differences in the expression of alpha2, alpha3, and alpha5 subunits between malignant and non-malignant human bladder cell lines do not allow an unanimous conclusion on the role of these intergrin subunits in the progression of transitional cancer of bladder. The adhesion molecule, expressed in all studied melanoma and bladder cell lines, that reacted with anti-Pan cadherin monoclonal antibodies was identified as N-cadherin except in the HCV29 non-malignant ureter cell line. However, neither this nor any other bladder or melanoma cell line expressed E-cadherin. The obtained results imply that the replacement of E-cadherin by N-cadherin accompanied by a simultaneous increase in expression of alpha2, alpha3 and alpha5 integrin subunits clearly indicates an increase of invasiveness of melanoma and, to a lesser extent, of transitional cell cancer of bladder. High expression of N-cadherin and alpha5 integrin subunit seems to be associated with the most invasive melanoma phenotype.

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