scholarly journals Overall survival, disease-specific survival and local recurrence outcomes in patients with muscle-invasive bladder cancer treated with external beam radiotherapy and brachytherapy: a systematic review

2020 ◽  
Vol 125 (6) ◽  
pp. 780-791 ◽  
Author(s):  
Liam Mannion ◽  
Cecilia Bosco ◽  
Rajesh Nair ◽  
Vinod Mullassery ◽  
Deborah Enting ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Bladder Cancer ◽  
Local Recurrence ◽  
External Beam Radiotherapy ◽  
External Beam ◽  
Disease Specific Survival ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive ◽  
Disease Specific

External beam radiotherapy and concurrent gemcitabine for muscle-invasive bladder cancer: Toxicities and early outcomes.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 443-443 ◽  
Author(s):  
Elana Nack ◽  
Jonathan E. Rosenberg ◽  
Bernard H. Bochner ◽  
Guido Dalbagni ◽  
Michael J. Zelefsky ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Distant Metastasis ◽  
External Beam Radiotherapy ◽  
Survival Outcomes ◽  
External Beam ◽  
Muscle Invasive Bladder Cancer ◽  
Grade 3 ◽  
Muscle Invasive ◽  
Disease Specific

443 Background: To report toxicities and early outcomes of external beam radiotherapy (EBRT) with concurrent gemcitabine for muscle-invasive bladder cancer (MIBC) Methods: Between 9/04 - 4/15, 85 patients (median age 77) with MIBC (cT2-T4, Nx-3) underwent transurethral resection (TUR) (39 complete, 43 incomplete, 2 unknown) followed by EBRT (median dose 64.8Gy) with concurrent gemcitabine (20-27 mg/m2) twice weekly. 25 patients (29%) received neoadjuvant chemotherapy. Patients were followed q3 months with imaging, cystoscopy and/or cytology. Early ( < 90 days) and late ( > 90 days) toxicities were graded according to the Common Terminology Criteria for Adverse Events (v4.0). Median followup was 19.5 months; 74 (87%) had > 3 month followup. Kaplan-Meier and Cox regression were used for survival and multivariate analyses. Results: Acute grade ≥ 3 hematologic, gastrointestinal or genitourinary toxicity occurred in 18%, 1.5% and 1.3% of patients, respectively. 73/85 (86%) patients received full EBRT course without interruption. 78/85 (92%) received > 50% of the prescribed gemcitabine. The most common reason for a gemcitabine interruption/dose reduction was hematologic (80%). Late grade 3 toxicity included hematuria (n = 5), urinary obstruction (n = 4) and cystitis (n = 1). The 2-year freedom from in-bladder recurrence and bladder-intact survival was 53% and 60%, respectively. The 2-year distant metastasis-free, disease-specific and overall survivals were 66%, 69% and 62%, respectively. A complete TUR was associated with improvements in 2 year bladder-intact (73% vs 51%, p = 0.01), disease-specific (87% vs 54%, p = 0.001), distant metastasis-free (83% vs 52%, p < 0.0001) and overall survival (78% vs 50%, p = 0.003) compared with incomplete TUR. Neoadjuvant chemotherapy and nodal status had no significant impact on survival outcomes. Conclusions: EBRT with concurrent gemcitabine is well-tolerated for MIBC, even in an elderly population. Hematologic (acute) and genitourinary (late) toxicities are most common. Survival outcomes in this unselected population are comparable to prior trials, although longer followup is needed. A complete TUR prior to chemoradiation is strongly recommended.

Genomic profiling of muscle invasive bladder cancer to predict response to bladder-sparing trimodality therapy.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 513-513 ◽  
Author(s):  
David Tomoaki Miyamoto ◽  
Ewan Gibb ◽  
Kent William Mouw ◽  
Yang Liu ◽  
Chin-Lee Wu ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Genomic Profiling ◽  
Disease Specific Survival ◽  
Clinical Factors ◽  
Gene Set Enrichment ◽  
Muscle Invasive Bladder Cancer ◽  
Trimodality Therapy ◽  
Muscle Invasive ◽  
Bladder Sparing ◽  
Disease Specific

513 Background: Trimodality therapy with TURBT followed by chemoradiation is an acceptable alternative to cystectomy for muscle invasive bladder cancer (MIBC). Genomic profiling has demonstrated MIBC can be divided into molecular subtypes with differing responses to chemotherapy. We explored the utility of genomic data to select patients for bladder-sparing trimodality therapy. Methods: Transcriptome wide gene expression profiles were generated for 189 MIBC TURBT samples from patients treated with trimodality therapy at a single institution. Of these, 103 passed microarray QC. Molecular subtype and expression of bladder cancer genes were assessed for association with overall and disease-specific survival. Transcriptome wide differential expression analysis was used to explore gene set enrichment in trimodality therapy response groups. Results: The chemoradiation cohort (n = 103) had a median followup of 6.9 years for alive patients, and was classified into four subtypes: basal (n = 44), basal claudin-low (n = 12), infiltrated luminal (n = 17) and luminal tumors (n = 30). There was no significant difference in overall or disease-specific survival by subtype. However, higher expression of the luminal-associated PPARG was correlated with increased survival after adjusting for subtype and clinical factors (HR = 0.52, p = 0.002). In contrast, a p53 signature predicted worse survival after adjusting for clinical factors (HR = 1.92, p = 0.022). Elevated mRNA expression of the DNA damage repair gene MRE11 was associated with improved survival in the trimodality cohort (HR = 0.69, P = 0.031), consistent with its potential role as a predictive biomarker for radiation response. Gene set enrichment revealed differential regulation of immune pathways in trimodality therapy responders relative to non-responders, including enrichment of interferon gamma signaling (p = 0.01) and CXCL9 (p = 0.031), suggestive of an interplay between tumor immunologic microenvironment and response to chemoradiation. Conclusions: Transcriptional profiling of MIBC revealed gene signatures correlated with response to chemoradiation, suggesting the potential of genomics to guide use of trimodality therapy.

scholarly journals Increased utilization of external beam radiotherapy relative to cystectomy for localized, muscle-invasive bladder cancer: a SEER analysis

Bladder ◽  
2018 ◽  
Vol 5 (3) ◽  
pp. 34
Author(s):  
Tyler J. Wilhite ◽  
David Routman ◽  
Andrea L. Arnett ◽  
Amy E. Glasgow ◽  
Elizabeth B. Habermann ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
External Beam Radiotherapy ◽  
Invasive Bladder Cancer ◽  
External Beam ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

scholarly journals Subtype specific expression and survival prediction of pivotal lncRNAs in muscle invasive bladder cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sebastien Rinaldetti ◽  
Thomas Stefan Worst ◽  
Eugen Rempel ◽  
Maximilian C. Kriegmair ◽  
Arndt Hartmann ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Molecular Subtype ◽  
Invasive Bladder Cancer ◽  
Survival Prediction ◽  
Disease Specific Survival ◽  
Muscle Invasive Bladder Cancer ◽  
Specific Expression ◽  
Cancer Subtypes ◽  
Muscle Invasive ◽  
Disease Specific

AbstractComprehensive transcriptome expression analyses of bladder cancer revealed distinct lncRNA clusters with differential molecular and clinical characteristics. In this study, pivotal lncRNAs were assessed for their impact on survival and their differential expression between the molecular bladder cancer subtypes. FFPE samples from chemotherapy-naïve patients with muscle invasive bladder cancer (MIBC) were analyzed on the Nanostring nCounter platform for absolute quantification. An established 36-gene panel was used for molecular subtype classification into basal, luminal and infiltrated MIBC. In a second step, 14 pivotal lncRNAs were assessed for their molecular subtype attribution, and their predictive value in disease-specific survival. In silico validation was performed on a total of 487 MIBC patients (MDA, TGCA and Chungbuk cohort). Several pivotal lncRNAs showed a distinct molecular subtype attribution: e.g. MALAT1 showed a downregulation in the basal subtype (p = 0.009), TUG1 and CBR3AS1 showed an upregulation in the luminal subtype (p ≤ 0.001). High transcript levels of SNHG16, CBR3AS1 and H19 appeared to be predictive for a shorter disease-specific survival. Patients overexpressing putative oncogenes MALAT1 and TUG1 in MIBC tissue presented prolonged survival, suggesting tumor suppressive effects of both lncRNAs. The Nanostring nCounter proved to be a valid platform for the quantification of low-abundance transcripts including lncRNAs.

Transurethral Resection of Muscle-Invasive Bladder Cancer: 10-Year Outcome

2001 ◽  
Vol 19 (1) ◽  
pp. 89-93 ◽  
Author(s):  
Harry W. Herr
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Residual Tumor ◽  
Invasive Bladder Cancer ◽  
Tumor Site ◽  
Disease Specific Survival ◽  
Muscle Invasive Bladder Cancer ◽  
Primary Tumor Site ◽  
Muscle Invasive ◽  
Disease Specific

PURPOSE: To determine the 10-year outcome of patients with muscle-invasive bladder cancer treated by transurethral resection (TUR) alone. PATIENTS AND METHODS: Of 432 newly evaluated patients with muscle-invasive bladder cancer, 151 were treated by standard radical cystectomy or by definitive TUR, if restaging TUR of the primary tumor site showed no (T0) or only non–muscle-invasive (T1) residual tumor. Patients were followed-up every 3 to 6 months thereafter for a minimum of 10 years and up to 20 years. Primary end points of the study were disease-specific survival, survival with a bladder, frequency of recurrent invasive tumors in the bladder, and survival after salvage cystectomy. RESULTS: The 10-year disease-specific survival was 76% of 99 patients who received TUR as definitive therapy (57% with bladder preserved) compared with 71% of 52 patients who had immediate cystectomy (P = .3). Of the 99 patients treated with TUR, 82% of 73 who had T0 on restaging TUR survived versus 57% of the 26 patients who had residual T1 tumor on restaging TUR (P = .003). Thirty-four patients (34%) relapsed in the bladder with a new muscle-invasive tumor, 18 (53%) were successfully treated with salvage therapy via cystectomy, and 16 patients (16%) died of disease. CONCLUSION: Radical TUR for muscle-invasive bladder cancer is a successful bladder-sparing therapeutic strategy in selected patients who have no residual tumor on a repeat vigorous resection of the primary tumor site.

External Beam Radiotherapy for Medullary Thyroid Cancer Following Total or Near-Total Thyroidectomy

2020 ◽  
pp. 019459982094769
Author(s):  
Michael Jin ◽  
Uchechukwu C. Megwalu ◽  
Julia E. Noel
Keyword(s):  
Overall Survival ◽  
Advanced Disease ◽  
External Beam Radiotherapy ◽  
National Database ◽  
External Beam ◽  
Disease Specific Survival ◽  
Lymph Node Yield ◽  
Medullary Thyroid ◽  
The Impact ◽  
Disease Specific

Objectives Medullary thyroid carcinoma (MTC) often presents with advanced disease and takes an aggressive course as compared with more well-differentiated thyroid cancers. The role of adjuvant therapy, specifically external beam radiotherapy (EBRT), remains disputed. This study investigated the impact of EBRT on survival in MTC. Study Design Cross-sectional analysis of a national database. Setting Patients with MTC were identified from the SEER program (Surveillance, Epidemiology, and End Results). Methods Collected variables included age, sex, race, T and N stages, lymph node yield, and use of EBRT. Propensity score matching was performed to determine the association of EBRT with overall and disease-specific survival. Results A total of 2046 patients with locoregional MTC were identified. Of these, 152 received EBRT. Patients receiving EBRT were older and had more advanced disease. EBRT was not associated with differences in overall survival (hazard ratio, 1.12; 95% CI, 0.76-1.65) or disease-specific survival (1.66; 0.93-2.95), as well as in subset analysis of age and disease extent. Long-term overall survival was similar, with 77.3% (95% CI, 70.1%-85.3%) and 58.3% (48.2%-70.5%) of patients without EBRT alive at 5 and 10 years, respectively (vs 70.7% [63.2%-79.1%] and 52.3% [43.3%-63.2%] of patients with EBRT). There were no differences in 5- and 10-year disease-specific survival. Conclusion EBRT was not associated with improved overall or disease-specific survival in patients with MTC. Decisions regarding EBRT must be made with consideration of morbidity relative to benefit for individual patients.

Sign in / Sign up

Export Citation Format

Share Document