Pre-treatment Lymphocytopaenia is a Valid Adverse Prognostic Factor in Muscle-invasive and Advanced Bladder Cancer

Anemia is a common symptom in cancer patients and usually associated with poor prognosis. Urinary bladder cancer (BC) is the most common cancer in the urological tract with anemia being one the most common presenting symptom. Radical radiotherapy is the treatment of choice for advancer disease with many factors could influence the prognosis. Aim: To identify pre-treatment hemoglobin level as prognostic factor for advanced bladder cancer treated with radiotherapy. Materials and Methods: A retrospective study reviewed the data of 88 patients with advanced bladder cancer, treated with radical radiotherapy from 2013 to 2018. Results: Median follow-up was 45 months. The median PFS was 26.87 months but when comparing anemic to non–anemic patient there was significant difference (17.25 and 40.02 months) respectively. Also as regards overall survival the median was 28.98 months but 20.24 and 40.47 months in anemic and non-anemic patients respectively with significant difference. Local or distant progression detected in 36 out of 50 anemic patients compared to only 4 out of 38 non-anemic patients. In multivariate analysis anemia was proved to be the strongest predictor of mortality. Conclusion: Pre-treatment Hb level is an important factor affecting the prognosis of advanced bladder cancer patients treated with radical radiotherapy. Low HB level could be considered as a good biological marker for aggressive disease.

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Validation of preoperative thrombocytosis as adverse prognostic factor in advanced bladder cancer (BCA) after radical cystectomy (RC)

European Urology Supplements ◽

10.1016/s1569-9056(17)30452-9 ◽

2017 ◽

Vol 16 (3) ◽

pp. e682

Author(s):

B. Foerster ◽

M. Moschini ◽

M. Abufaraj ◽

F. Soria ◽

Y. Lotan ◽

...

Keyword(s):

Bladder Cancer ◽

Prognostic Factor ◽

Radical Cystectomy ◽

Adverse Prognostic Factor ◽

Advanced Bladder Cancer

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Combination of GP88 Expression in Tumor Cells and Tumor-Infiltrating Immune Cells Is an Independent Prognostic Factor for Bladder Cancer Patients

Cells ◽

10.3390/cells10071796 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1796

Author(s):

Markus Eckstein ◽

Verena Lieb ◽

Rudolf Jung ◽

Danijel Sikic ◽

Katrin Weigelt ◽

...

Keyword(s):

Bladder Cancer ◽

Prognostic Factor ◽

Tumor Cells ◽

Immune Cells ◽

Potential Candidate ◽

Poor Prognostic Factor ◽

Risk Of Death ◽

Increased Risk ◽

Muscle Invasive ◽

Disease Specific

Urothelial bladder cancer (BCa) is the ninth most commonly diagnosed cancer worldwide and accounts for approximately 3% of global cancer diagnoses. We are interested in prognostic markers that may characterize tumor cells (TCs) and immune cells (ICs) and their relationship in BCa. A potential candidate marker that meets these criteria is progranulin (GP88), which is expressed separately in TCs and ICs. We analyzed GP88 expression by immunohistochemistry (IHC) in 196 muscle-invasive BCa samples using a tissue microarray. The immunoreactive score for GP88 staining in TCs and the percentage of GP88-positive ICs was determined. An easy cutoff for the staining status of TCs (positive vs. negative) and ICs (0% vs. >0%) and, more generally, negative vs. positive GP88 staining could be applied. We detected 93 patients (47.4%) and 92 patients (46.9%) with GP88-positive TCs or ICs, respectively. The IHC results were correlated with clinicopathological and survival data. Positive GP88 staining in TCs appeared to be an independent poor prognostic factor for disease-specific survival (DSS) (RR (relative risk) = 1.74; p = 0.009) and recurrence-free survival (RFS) (RR = 1.92; p = 0.002). In contrast, negative GP88 staining in ICs was an independent negative predictor for overall survival (OS) (RR = 2.18; p < 0.001), DSS (RR = 2.84; p < 0.001) and RFS (RR = 2.91; p < 0.001) in multivariate Cox’s regression analysis. When combining GP88 staining in TCs and ICs, a specific combination of GP88-positive TCs and GP88-negative ICs was associated with a 2.54-fold increased risk of death, a 4.21-fold increased risk of disease-specific death and a 4.81-fold increased risk of recurrence compared to GP88-negative TCs and GP88-positive ICs. In summary, GP88 positivity in TCs is a negative prognostic factor for DSS and RFS. In addition, GP88 positivity can mark ICs that are associated with a good prognosis (OS, DSS and RFS). The combination of GP88 staining in TCs and ICs appears to be a significant independent prognostic biomarker in muscle-invasive BCa.

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Neoadjuvant Chemotherapy Plus Cystectomy Compared With Cystectomy Alone for Locally Advanced Bladder Cancer

50 Studies Every Urologist Should Know ◽

10.1093/med/9780190655341.003.0025 ◽

2021 ◽

pp. 141-146

Author(s):

Vikram M. Narayan

Keyword(s):

Adverse Effect ◽

Overall Survival ◽

Bladder Cancer ◽

Neoadjuvant Chemotherapy ◽

Randomized Study ◽

Locally Advanced ◽

Common Adverse Effect ◽

Advanced Bladder Cancer ◽

Muscle Invasive

This study summarizes a landmark study on the role of neoadjuvant chemotherapy with methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) in patients with muscle-invasive bladder cancer. This randomized study of M-VAC plus cystectomy versus cystectomy alone suggested improved overall survival in patients receiving neoadjuvant therapy. Severe granulocytopenia was a common adverse effect in the chemotherapy group, but no deaths were attributed to chemotherapy.

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Analysis of CXCL9, PD1 and PD-L1 mRNA in Stage T1 Non-Muscle Invasive Bladder Cancer and Their Association with Prognosis

Cancers ◽

10.3390/cancers12102794 ◽

2020 ◽

Vol 12 (10) ◽

pp. 2794 ◽

Cited By ~ 1

Author(s):

Jennifer Kubon ◽

Danijel Sikic ◽

Markus Eckstein ◽

Veronika Weyerer ◽

Robert Stöhr ◽

...

Keyword(s):

Bladder Cancer ◽

Regression Analysis ◽

Prognostic Factor ◽

Patient Group ◽

Independent Prognostic Factor ◽

Invasive Bladder Cancer ◽

Immune Markers ◽

Muscle Invasive Bladder Cancer ◽

Cox's Regression ◽

Muscle Invasive

Non-muscle invasive bladder cancer (NMIBC), which is characterized by a recurrence rate of approximately 30% and very long treatment times, remains a major unresolved problem for patients and the health care system. The immunological interplay between tumor cells and the immune environment is important for tumor development. Therefore, we analyzed the mRNA of three immune markers, CXCL9, PD1 and PD-L1, in NMIBC by qRT-PCR. The results were subsequently correlated with clinicopathological parameters and prognostic data. Altogether, as expected, higher age was an independent prognostic factor for overall survival (OS) and disease-specific survival (DSS), but not for recurrence-free survival (RFS). Lower CXCL9 mRNA was observed in multivariate Cox’s regression analysis to be an independent prognostic parameter for reduced OS (relative risk; RR = 2.08; p = 0.049), DSS (RR = 4.49; p = 0.006) and RFS (RR = 2.69; p = 0.005). In addition, PD-L1 mRNA was an independent prognostic factor for DSS (RR = 5.02; p = 0.042) and RFS (RR = 2.07; p = 0.044). Moreover, in univariate Cox’s regression analysis, the stratification of patients revealed that low CXCL9 or low PD1 mRNA was associated with reduced RFS in the younger patient group (≤71 years), but not in the older patient group (>71 years). In addition, low CXCL9 or low PD-L1 was associated with shorter RFS in patients with higher tumor cell proliferation and in patients without instillation therapy. In conclusion, the characterization of mRNA levels of immune markers differentiates NIMBC patients with respect to prognosis.

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