scholarly journals Histopathology of urinary bladder carcinoma: Less common variants

2011 ◽  
Vol 139 (9-10) ◽  
pp. 693-699 ◽  
Author(s):  
Ivan Damjanov ◽  
Mileta Golubovic
Keyword(s):  
Bladder Cancer ◽  
Poor Prognosis ◽  
Clinical Course ◽  
Transitional Cell ◽  
Urinary Bladder Carcinoma ◽  
High Grade ◽  
Common Variants ◽  
Muscle Invasive ◽  
Microscopic Morphology ◽  
Urothelial Tumours

Bladder cancer is a common form of neoplasia which most often presents histologically as urothelial (transitional cell) carcinoma. In this article we review recent publications dealing with the less common variants of urothelial carcinoma such as tumours that show unusual forms of differentiation or the well know squamous, glandular, or sarcomatoid differentiation. Urothelial tumours may also show several distinct growth variants characterized by a nested, micropapillary, lymphoepithelioma-like, or plasmacytoid and giant cell growth pattern. The clinical course of bladder cancer varies depending on the histological type of neoplasia, grade and stage of the tumour. High-grade muscle-invasive urothelial cancers and tumours showing variant microscopic morphology have in general high mortality and poor prognosis.

scholarly journals A Single-Institutional Study of Human Immunodeficiency Virus-Related Bladder Cancer

2021 ◽  
Author(s):  
Mengmeng Zhang ◽  
Yanyan Zhang ◽  
Zhiqiang Zhu ◽  
Yu Zhang
Keyword(s):  
Bladder Cancer ◽  
Cancer Patients ◽  
Clinical Characteristics ◽  
Transitional Cell ◽  
Invasive Bladder Cancer ◽  
Low Grade ◽  
High Grade ◽  
Muscle Invasive Bladder Cancer ◽  
Tumor Pathology ◽  
Muscle Invasive

Abstract Purpose: We wished to investigate the clinical characteristics, treatments for tumor, pathology and outcomes of bladder cancer patients with HIV-infected.Patients and methods: We identified 10 cases of bladder cancer with HIV-infected from 2015 to 2020.We retrospectively investigated the clinical characteristics of the cases including demographic information, clinical presentation, TNM stage and so on. We investigated treatments for tumor, pathology, outcomes and HIV-relevant parameters during patients’ hospitalization course as well. Results: In our study, it was astonished to find that bladder cancer patients with HIV-infected were males at the median age of 51 years old, and no females were diagnosed on the contrary. Nine (90%)patients presented with painless gross hematuria, while one patient with incidental findings on ultrasonic examination. Six(60%) patients co-infected with another kind of infectious disease, four with syphilis, and two with HBV respectively. The median CD4+ T-lymphocyte cell count was 493/ul withthin 2 weeks prior to the diagnosis bladder cancer. Cystoscope examination manifested that the lesions were located in the trigonum of the bladder in four(40%)patients. All patients underwent surgeries successfully, six underwent transurethral resection of bladder tumor(TURBT),two of whom relapsed once, and one underwent TURBT twice due to recurrence and then RC and urethrectomy because of urethral invasion. All non muscle-invasive bladder cancer(NMIBC)patients received intravesical chemotherapy with pirarubicin 30mg for at least half year conventionally, and only one patient occurred mild adverse reaction of irritative symptoms of bladder. Pathologic analysis documented that all patients(100%) had transitional cell carcinoma(TCC). Tumor grade classification showed that three cases were identified with low grade TCC, and six cases with high grade or invasive TCC, two of whom occurred recurrence for once or twice respectively. One patient was identified with low grade TCC of primary tumor and high grade TCC of recurrent focal(Figure 2).Five cases(50%) were ascertained as (NMIBC) with pT1N0M0, while the rest five patients(50%) were muscle-invasive bladder cancer(MIBC) with at least pT2N0M0. During the median follow-up of 56 months (range from 5 months to 68 months) six cases(five were MIBC patients )died due to distant metastases. No patients acceptted adjuvent immunotherapy mainly due to the role of PD-1+ T cells in HIV transcription in treated aviremic individuals, concerns of unknown adverse effects and economic factors.Conclusions: It seemed like that bladder caner patients had higher tumor stage and more aggressive pathology. we did not find any evidence on the relationship between immunodeficiency and cancer progression because of relatively stable HIV status of this crew in our study. MIBC patients with HIV-infected really have worse outcomes, and more attention is warranted to pay to this special population in this situation when they present with hematuria extraordinarily.

scholarly journals Perioperative outcomes after open radical cystectomy for muscle invasive bladder cancer

2019 ◽  
Vol 6 (2) ◽  
pp. 23-30
Author(s):  
Samir Shrestha ◽  
Pukar Maskey ◽  
Anjit Phuyal ◽  
Jay N. Shah
Keyword(s):  
Bladder Cancer ◽  
Blood Transfusion ◽  
Radical Cystectomy ◽  
Perioperative Complications ◽  
Transitional Cell ◽  
Perioperative Outcomes ◽  
High Grade ◽  
Presenting Symptoms ◽  
Catheter Dislodgement ◽  
Muscle Invasive

Introductions: Radical cystectomy with bilateral pelvic lymphadenectomy is a primary intervention for muscle invasive or refractory, high grade Ta, T1, Tis bladder cancer. Owing to its major undertaking, patient succumbs to infection and various morbidities. This study was to assess the perioperative outcomes and complications of radical cystectomy. Methods: This retrospective study analyzed the perioperative outcome (early mortality within 30 days, length of stay, requirement of blood transfusion) of radical cystectomy in patients with bladder cancer during four years at Patan Hospital, Patan Academy of Health Sciences, Lalitpur, Nepal. Ethical approval was obtained. Study variables included patient’s demographics, presenting symptoms, tumor types and configuration, need for blood transfusion, length of surgery, pathological stages, types of urinary diversions, hospital stay, early (<30 days) and late (31-90 days) morbidity and mortality. Results: Total 32 patients underwent radical cystectomy. Data analysed on 18 patients, mean age was 66.7 years and painless hematuria 17 (94.4%). All were transitional cell carcinoma, high grade lesion in 17 (94.4%). Overall 6 (33.3%) patients developed early postoperative complications, paralytic ileus and prolong lymph drainage in 5 (27.8%), wound dehiscence in 4 (22.2%) and ureteric catheter dislodgement in two. There were 2 (11.1% of 18) mortalities (the mortality audit showed total 5 (15.6%) out of 32 radical cystectomy during the study period. Conclusions: Perioperative complications occurred in 1/3rd following radical cystectomy for muscle invasive bladder, more complications in those with preoperative associated co-morbidities.

scholarly journals Peri-Operative Morbidity and Outcomes of Radical Cystectomy- Institutional Experience of Single Center

2020 ◽  
Vol 4 (1) ◽  
pp. 107-113
Author(s):  
Amit Mani Upadhyay ◽  
Ashok Kumar Kunwar ◽  
Manik Lama ◽  
Kabir Tiwari ◽  
Sanjesh Bhakta Shrestha ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Ileal Conduit ◽  
Invasive Bladder Cancer ◽  
Urinary Bladder Carcinoma ◽  
High Grade ◽  
Muscle Invasive Bladder Cancer ◽  
Operative Morbidity ◽  
Free Survival ◽  
Muscle Invasive

Introduction: The incidence of urinary bladder carcinoma increases distinctly with increasing age. Radicalcystectomy has been the gold standard for the treatment of patients with muscle-invasive bladder cancer or recurrent high-grade non-muscle invasive bladder cancer. Our study aimed to see the peri-operative morbidity and surgical outcomes of the patient who had undergone radical cystectomy in our low volume center. Methods: We retrospectively reviewed the inpatient charts as well as the outpatient records of 10 patients who had undergone radical cystectomy performed in our center for 9 years. A review of the literature on perioperativemorbidity of radical cystectomy was also done using the combination of keywords like mortality, complications, and outcomes of surgery. Results: Age of the patients ranged from 40-80 years. Eight of them were male and two were female. Painlesshematuria (70%) was the commonest presenting symptom, 80% of them were smokers. Three patients received neoadjuvant chemotherapy. Nine patients had radical cystectomy with an ileal conduit, whereas one patient hadradical cystectomy with orthotropic neo-bladder. In postoperative complications, five patients had Clavien-Dindograde I, three patients had grade II, one patient had grade IIIB and one patient had grade V complications. Two years of cancer-free survival was 90% and five years of cancer-free survival was 50%. Conclusions: Radical cystectomy with ileal conduit was still the choice of surgery in muscle-invasive and recurrent high-grade non-muscle invasive bladder cancer.

scholarly journals Effectivity of intravescical thermo-chemotherapy prophylaxis for patients with high recurrence and progression risk for non-muscle invasive bladder cancer

2017 ◽  
Vol 89 (2) ◽  
pp. 102 ◽  
Author(s):  
Ali Serdar Gözen ◽  
Paolo Umari ◽  
Walter Scheitlin ◽  
Fuat Ernis Su ◽  
Yigit Akin ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Recurrent Disease ◽  
Bladder Wall ◽  
Invasive Bladder Cancer ◽  
Outpatient Basis ◽  
High Grade ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

Background&amp;Aim: High grade non-muscle invasive bladder cancer (NMIBC) is common in urological practice. Most of these cancers are or become refractory to intravesical immunotherapy and chemotherapy. Here we evaluated the efficacy of combined local bladder hyperthermia and intravesical mitomycin-C (MMC) instillation in patients with high-risk recurrent NMIBC. Materials and methods: Between February 2014 and December 2015, 18 patients with high risk NMIBC were enrolled. Patients were treated in an outpatient basis with 6 weekly induction sessions followed by monthly maintenance sessions with intravesical MMC in local hyperthermia with bladder wall thermo-chemotherapy (BWT) system (PelvixTT system, Elmedical Ltd., Hod Hasharon, Israel). The follow-up regimen included cystoscopy after the induction cycle and thereafter with regular intervals. Time to disease recurrence was defined as time from the first intravesical treatment to endoscopic or histological documentation of a new bladder tumour. Adverse events were recorded according to CTC 4.0 (Common Toxicity Criteria) score system. Results: Mean age was 72 (32-87) years. 10 patients had multifocal disease, 9 had CIS, 6 had recurrent disease and 2 had highly recurrent disease (&gt; 3 recurrences in a 24 months period). 6 patients underwent previous intravesical chemotherapy with MMC. The average number of maintenance sessions per patient was 7.6. After a mean follow-up of 433 days, 15 patients (83.3%) were recurrence-free. 3 patients had tumour recurrence after a mean period of 248 days without progression. Side effects were limited to grade 1 in 2 patients and grade 2 in 1 patient. Conclusions: BWT seems to be feasible and safe in high grade NMIBC. More studies are needed to identify the subgroup of patients who may benefit more from this treatment.

scholarly journals Does the Urinary Mast Cell Mediators Predict the Immune Response to BCG in Patients with Primary High-Grade Non-Muscle Invasive Bladder Cancer?

2020 ◽  
Author(s):  
Muhammed Fatih Simsekoglu ◽  
İslim Kaleler ◽  
Bulent Onal ◽  
Cetin Demirdag ◽  
Sinharib Citgez ◽  
...  
Keyword(s):  
Immune Response ◽  
Bladder Cancer ◽  
Mast Cell ◽  
Critical Role ◽  
Invasive Bladder Cancer ◽  
High Grade ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive ◽  
Healthy Participants ◽  
Bcg Instillation

Background: Mast cells play a critical role in tumor-associated immune pathways. We aimed to determine whether the urinary mast cell mediators predict the immune response in patients with non-muscle invasive bladder cancer (NMIBC) treated with Bacillus Calmette-Guérin (BCG) immunotherapy. Methods: Nineteen patients who have received immunotherapy due to NMIBC and 19 healthy participants were enrolled. Urine samples were collected to assay N-methylhistamine, histamine, and tryptase levels immediately before the first BCG instillation, immediately after the third and sixth instillations, and four weeks after the sixth instillation in patients with NMIBC and at a single visit in healthy participants. Cystoscopic examinations were performed on the patient with NMIBC at three-month intervals for two years. The changes in urinary markers due to BCC response, BCG instillation, and the presence of NMIBC were assessed. Results: The average age was 56.1 ± 10.5 years in patients with NMIBC. Fourteen patients had high-grade Ta tumors, and 5 had high-grade T1 tumors. While 12 patients responded, 6 presented with recurrence and 1 with progression. There was no correlation between the levels of mast cell mediators and BCG response. The N-methylhistamine and histamine levels were increased significantly with the onset of immunotherapy, and N-methylhistamine levels were significantly decreased when immunotherapy was terminated. Pre-BCG estimated marginal means of N-methylhistamine were significantly higher in patients with NMIBC than healthy participants. Conclusions: Our study is the first study to identify the changes in mast cell mediators with the onset of immunotherapy and with the presence of bladder cancer. However, these mediators were not found to predict the patients’ response to immunotherapy.

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