External validation of European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment scoring models to predict recurrence and progression in Japanese patients with non-muscle invasive bladder cancer treat

2014 ◽  
Vol 21 (12) ◽  
pp. 1201-1207 ◽  
Author(s):  
Yasuo Kohjimoto ◽  
Hiroki Kusumoto ◽  
Satoshi Nishizawa ◽  
Kazuro Kikkawa ◽  
Yoshiki Kodama ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
External Validation ◽  
Japanese Patients ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
European Organization ◽  
Oncological Treatment ◽  
Muscle Invasive

Analysis of external validation for recurrence and progression of EORTC and CUETO risk scores for non-muscle invasive bladder cancer

2018 ◽  
pp. 1-5
Keyword(s):  
Bladder Cancer ◽  
External Validation ◽  
Daily Practice ◽  
Invasive Bladder Cancer ◽  
Risk Scores ◽  
Male Population ◽  
Muscle Invasive Bladder Cancer ◽  
European Organization ◽  
Risk Of Recurrence ◽  
Muscle Invasive

Bladder cancer (BCa) is the seventh most common tumor diagnosed in the male population and the eleventh when considered both genres. Of urologic tumors, the BCa is the second most incident. For a better follow-up of BCa, the prognostic factors were reason of several studies in the last few years. The risk factors stratification is important to classify and assists the treatment, based on the risk of recurrence and progression. There are two scores widely used in daily practice to stratify the risk of recurrence and progression, the European Organization for Research and Treatment Cancer (EORTC) and Club Urológico Español de Tratamento Oncológico (CUETO). The EORTC score for BCa has its limitations, it was based on studies previous to use of Bacille Calmette-Guerin (BCG), to overcome this limitation it was developed the CUETO score, which predicts recurrence and progression of BCa in patients who underwent BCG. We review the most recent studies about the use of risk scores for BCa, although they are widely used, there are still a lack of validation works and information about their safety and effectiveness. We compiled the data of this paper to analysis the external validation for recurrence and progression of EORTC and CUETO scores for non-muscle invasive bladder cancer and concluded that risk scores successfully stratified recurrence and progression, despite having a tendency to overestimate the rates.

scholarly journals Comparison of the EORTC and CUETO prognostic models in non-muscle-invasive bladder cancer

2018 ◽  
Vol 14 (2) ◽  
pp. 162-170
Author(s):  
A. D. Kaprin ◽  
O. I. Apolikhin ◽  
B. Ya. Alekseev ◽  
D. A. Roshchin ◽  
A. A. Kachmazov ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Treatment Strategy ◽  
Scoring Systems ◽  
Prognostic Models ◽  
Invasive Bladder Cancer ◽  
Molecular Characteristics ◽  
Muscle Invasive Bladder Cancer ◽  
European Organization ◽  
Genetic Characteristics ◽  
Muscle Invasive

Bladder cancer is one of the most common malignant diseases involving the urinary system. Accurate prediction of the disease course and outcome is crucial for choosing an appropriate treatment strategy in these patients. Currently, there are several prognostic models for predicting non-muscle invasive bladder cancer outcomes. The scoring systems developed by the European Organization for Research and Treatment of Cancer (EORTC) and the Spanish Urological Club for Oncological Treatment (CUETO) are the most widely used prognostic models for bladder cancer. Despite the undeniable merits of these scales, they need to be supplemented. Since the prognostic score has a direct impact on the treatment strategy, intensity and costs of postoperative follow-up, and outcome, its accuracy should be higher than it is now. Identifying the additional parameters that would increase the robustness of these models is one of the major challenges for researchers.The molecular and genetic characteristics of the tumor, that can be estimated after the first surgery, are probably the best candidates for this role. The main limitation of these prognostic models lies in the fact that they assess only morphological properties of the tumor, while the most important molecular characteristics are neglected. These scoring systems do not evaluate clinical factors, concomitant diseases, and iatrogenic complications occurring during the treatment of relapses. The assessment of molecular mechanisms and clinical characteristics underlying the development of non-muscle-invasive bladder cancer as well as identification of key molecular markers, that could complement the currently existing risk assessment models, are the most important goals for researchers dealing with bladder cancer. It will significantly improve predictive capabilities of these models, ensuring the choice of an optimal treatment strategy.

MCM5 urine expression (ADXBLADDER) is a reliable biomarker of high-risk non- muscle-invasive bladder cancer recurrence: A prospective matched case-control study

2020 ◽  
pp. 1-5
Author(s):  
Łukasz Białek ◽  
Katarzyna Czerwińska ◽  
Łukasz Fus ◽  
Wojciech Krajewski ◽  
Anna Sadowska ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Predictive Value ◽  
External Validation ◽  
Cancer Recurrence ◽  
Invasive Bladder Cancer ◽  
Control Group ◽  
High Grade ◽  
Urinary Biomarker ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

BACKGROUND: Mini Chromosome Maintenance 5 (MCM5) is considered as a urinary biomarker of bladder cancer. ADXBLADDER is a commercially available test to detect MCM5 antibodies. OBJECTIVE: External validation of ADXBLADDER test as a urinary biomarker of histopathologically confirmed non-muscle invasive bladder cancer (NMIBC) recurrence. METHODS: The study enrolled 119 consecutive patients with a history of NMIBC and 37 healthy volunteers matched as controls. Single, full-void urine samples were collected from patients before cystoscopy ± TUR. To measure MCM5 expression, Arquer Diagnostics ADXBLADDER test was used. The study protocol was registered within the clinical trials database (NCT03796299). RESULTS: Among patients with NMIBC history, recurrence was diagnosed in 83 patients (69.7%). ADXBLADDER demonstrated sensitivity of 73.5% (95% confidence interval (CI) 62.7%–82.6%), specificity of 33.3% (95% CI 18.6% to 51%), overall negative predictive value (NPV) of 35.3% (95% CI 23.3% to 49.5%) and overall positive predictive value of 71.8% (95% CI 66.1% to 76.8%) for detecting recurrence. In a control group, false positive ADXBLADDER results were noticed in 18 patients (48.6%). The sensitivity and NPV were the highest in invasive tumors (100% and 100%, respectively) and in high-grade recurrences (81.8% and 94.1%, respectively). CONCLUSIONS: ADXBLADDER has a moderate sensitivity and poor specificity in detecting NMIBC recurrence. However, it properly diagnoses patients with T1+ stage recurrence or high-grade tumors.

Development of a genomic-clinical classifier for predicting progression after radical cystectomy in patients with muscle invasive bladder cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4542-4542
Author(s):  
Anirban Pradip Mitra ◽  
Nicholas Erho ◽  
Lucia L.C. Lam ◽  
Ismael A. Vergara ◽  
Thomas Sierocinski ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Cancer Progression ◽  
External Validation ◽  
Multivariable Analysis ◽  
Invasive Bladder Cancer ◽  
K Nearest Neighbor ◽  
Muscle Invasive Bladder Cancer ◽  
Validation Set ◽  
Muscle Invasive

4542 Background: The mainstay of muscle-invasive bladder cancer treatment is surgical resection with/without multi-agent chemotherapy. Management decisions are based on a small number of clinical and pathologic parameters with poor prognostic and predictive power. There is an urgent need for enhanced biomarkers to guide therapy of this lethal disease. Here we have developed a genomic signature of bladder cancer progression using whole transcriptome profiling technology. Methods: 251 FFPE bladder cancer specimens were obtained from patients undergoing radical cystectomy at the University of Southern California (1998-2004). All patients had pT2-T4a,N0 urothelial carcinoma in the absence of pre-operative chemotherapy. Median follow-up was 5 years. RNA expression levels were measured with 1.4 million feature oligonucleotide microarrays. Patients were divided into a training set (2/3 of cohort) to develop a genomic classifier for risk of progression (defined as any type of bladder cancer recurrence), and a validation set (1/3 of cohort). In parallel, multivariable analysis was used to develop a clinical classifier using typical clinical and pathologic variables. Finally, a genomic-clinical classifier was built combining the genomic classifier with clinical variables using logistic regression. The receiver-operator characteristic (ROC) area under the curve (AUC) metric was used to evaluate each classifier in the validation set. Results: The genomic classifier consisted of 89 features corresponding to 80 genes that were combined in a k-nearest neighbor model (KNN89). KNN89 showed an AUC of 0.77 in ROC analysis on the validation set. The best clinical classifier showed an AUC of 0.72. The genomic-clinical classifier demonstrated an AUC of 0.81. Multivariable analysis incorporating all clinical parameters and KNN89 further revealed that KNN89 was the only significant predictor of bladder cancer progression (p=0.0077). Conclusions: We have developed a combined genomic-clinical classifier that shows improved performance over clinical models alone for prediction of progression after radical cystectomy. External validation of this classifier is ongoing.

Germline DNA copy number polymorphism to predict the efficacy of BCG therapy for non-muscle invasive bladder cancer.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 431-431
Author(s):  
Yoshiaki Yamamoto ◽  
Sho Ozawa ◽  
Masahiro Samoto ◽  
Junichi Mori ◽  
Ryo Inoue ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Copy Number ◽  
Progression Free Survival ◽  
Japanese Patients ◽  
Intravesical Instillation ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Free Survival ◽  
Bcg Therapy ◽  
Muscle Invasive

431 Background: Bacillus Calmette-Guerin (BCG) intravesical instillation is the most effective immunotherapy for non-muscle-invasive bladder cancer (NMIBC), however there are few reliable markers to elucidate the efficacy of BCG therapy. Germline copy number polymorphisms (CNPs) are expected to affect various diseases including human malignancies, but the significance of CNPs in NMIBC treated with BCG therapy remains unclear. FAM81A located on 15q22.2 was reported as one of tumor-associated ETS shared target genes in prostate cancer. PCSK6 located on 15q26.3 was reported to regulate proliferation and tumor progression in several cancers. The purpose of this study is to determine the prognostic value of CNPs for NMIBC treated with BCG therapy. To our knowledge, this is the first report to confirm CNPs as a potential biomarker for assessing the efficacy of immunotherapy. Methods: Array comparative genomic hybridization (CGH) was performed to search for candidate whole genome-wide CNPs related to NMIBC susceptibility. Next, quantitative real-time polymerase chain reaction was carried out to evaluate the effect of BCG therapy for 57 Japanese patients with NMIBC treated with BCG intravesical instillation. Results: Eleven CNPs were associated with NMIBC risk in array CGH. FAM81A and PCSK6 copy number according to those CNPs examined showed significant relationship with disease progression in NMIBC treated with BCG. The means of the relative copy numbers of patients with CNP and those without it were 1.58 and 2.10 for FAM81A ( P < 0.0001), and 1.06 and 1.80 for PCSK6 ( P < 0.0001), respectively. Univariate Cox proportional hazards regression analysis showed that FAM81A ( P = 0.0022), and PCSK6 ( P = 0.0147) copy number had a significant effect on progression-free survival. In multivariate analyses, FAM81A copy number was an independent prognostic factor for progression-free survival ( P = 0.0419, RR = 7.59, 95% CI, 1.07–153.42). The combination of FAM81A or PCSK6 CNP was the most significant prognostic biomarker to predict the efficacy of BCG therapy for NMIBC ( P = 0.0002). Conclusions: Germline DNA CNPs may be a potential new biomarker for estimating the efficacy of BCG therapy in Japanese patients with NMIBC.

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