Prognostic Factors in Stage T1 Bladder Cancer: Tumor Pattern (Solid or Papillary) and Vascular Invasion More Important than Depth of Invasion

14560 Background: Transitional cell carcinomas (TCC) of the renal pelvis and ureter are relatively uncommon. An important characteristic of TCC is multifocality throughout the all urinary tract simultaneously and/or subsequently. To clarify the association between UTTCC and bladder tumors, we retrospectively analysed 86 patients with UTTCC in order to evaluate prognostic factors for recurrence and to identify risk factors for development of bladder cancers. Methods: All 86 upper tract transitional cell carcinoma patients (pts) were treated surgically between January 1988 and July 2005. Median age was 69 years (range: 34–91). We observed a male predominance (71%) and 78% of patients were heavy smokers. Forty-five (52.3%) patients had a diagnosis of bladder transitional carcinoma. The median age of this group of patients was 70 range 40–87). In fifteen cases (17%), bladder tumour occurred first than upper tract neoplasia; in 14 patients bladder and upper tract tumours were synchronous. Results: Median survival was 97 months; 49 (57%) patients are alive and 43 are disease-free. Grading, stage T, lympho-vascular invasion and squamous differentiation were significant prognostic factors for systemic relapse (p < 0.05). Twenty-eight pts (32.5%) developed subsequent transitional bladder cancer after a median time of 12 months; multifocality of primitive tumours was significant predictive factor. Invasive UTTCC were less likely associated with bladder cancer. We observed that superficial bladder cancer developed more frequently in pts with well differentiated (G1–2) primitive cancer (90% of cases), without lympho-vascular invasion and with history of heavy smoke exposition. Conclusions: In our study, T, N and G confirmed to be the most important prognostic factors for systemic relapse. Lympho-vascular invasion highly predicts metastasis. Our analysis highlights that upper urinary tract cancers seem to have different history and different pattern of association with bladder tumours, according to specific prognostic factors. The development of recurrent superficial bladder cancer is more frequently associated with small well differentiated multifocal upper tract tumours.Therefore follow-up should be oriented according to these characteristics. No significant financial relationships to disclose.

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The prognostic significance of vascular invasion in stage T1 bladder cancer

Histopathology ◽

10.1111/j.1365-2559.1995.tb00287.x ◽

1995 ◽

Vol 27 (1) ◽

pp. 27-33 ◽

Cited By ~ 43

Author(s):

J.I. LOPEZ ◽

J.C. ANGULO

Keyword(s):

Bladder Cancer ◽

Vascular Invasion ◽

Prognostic Significance ◽

Stage T1

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Analysis of prognostic factors related to primary superficial bladder cancer tumor recurrence in prophylactic intravesical epirubicin therapy

International Journal of Urology ◽

10.1046/j.1442-2042.1999.06441.x ◽

1999 ◽

Vol 6 (4) ◽

pp. 178-183 ◽

Cited By ~ 9

Author(s):

Tsunenori Kondo ◽

Shiro Onitsuka ◽

Osamu Ryoji ◽

Takeshi Kihara ◽

Yukiko Goto ◽

...

Keyword(s):

Bladder Cancer ◽

Prognostic Factors ◽

Tumor Recurrence ◽

Superficial Bladder Cancer ◽

Cancer Tumor

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Improving Selection Criteria for Early Cystectomy in High-Grade T1 Bladder Cancer: A Meta-Analysis of 15,215 Patients

Journal of Clinical Oncology ◽

10.1200/jco.2014.57.6967 ◽

2015 ◽

Vol 33 (6) ◽

pp. 643-650 ◽

Cited By ~ 102

Author(s):

William Martin-Doyle ◽

Jeffrey J. Leow ◽

Anna Orsola ◽

Steven L. Chang ◽

Joaquim Bellmunt

Keyword(s):

Risk Factors ◽

Bladder Cancer ◽

Prognostic Factors ◽

Lamina Propria ◽

Selection Criteria ◽

Meta Analysis ◽

Depth Of Invasion ◽

Cochrane Central Register ◽

High Grade ◽

Cancer Specific Survival

Purpose High-grade T1 (HGT1) bladder cancer is the highest risk subtype of non–muscle-invasive bladder cancer, with highly variable prognosis, poorly understood risk factors, and considerable debate about the role of early cystectomy. We aimed to address these questions through a meta-analysis of outcomes and prognostic factors. Methods PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and American Society of Clinical Oncology abstracts were searched for cohort studies in HGT1. We pooled data on recurrence, progression, and cancer-specific survival from 73 studies. Results Five-year rates of recurrence, progression, and cancer-specific survival were 42% (95% CI, 39% to 45%), 21% (95% CI, 18% to 23%), and 87% (95% CI, 85% to 89%), respectively (56 studies, n = 15,215). In the prognostic factor meta-analysis (33 studies, n = 8,880), the highest impact risk factor was depth of invasion (T1b/c) into lamina propria (progression: hazard ratio [HR], 3.34; P < .001; cancer-specific survival: HR, 2.02; P = .001). Several other previously proposed factors also predicted progression and cancer-specific survival (lymphovascular invasion, associated carcinoma in situ, nonuse of bacillus Calmette-Guérin, tumor size > 3 cm, and older age; HRs for progression between 1.32 and 2.88, P ≤ .002; HRs for cancer-specific survival between 1.28 and 2.08, P ≤ .02). Conclusion In this large analysis of outcomes and prognostic factors in HGT1 bladder cancer, deep lamina propria invasion had the largest negative impact, and other previously proposed prognostic factors were also confirmed. These factors should be used for prognostication and patient stratification in future clinical trials, and depth of invasion should be considered for inclusion in TNM staging criteria. This meta-analysis can also help define selection criteria for early cystectomy in HGT1 bladder cancer, particularly for patients with deep lamina propria invasion combined with other risk factors.

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Prognostic Factors in Stage T1 Grade 3 Bladder Cancer Survival: The Role of G1–S Modulators (p53, p21Waf1, p27kip1, Cyclin D1, and Cyclin D3) and Proliferation Index (ki67-MIB1)

European Urology ◽

10.1016/j.eururo.2003.11.011 ◽

2004 ◽

Vol 45 (5) ◽

pp. 606-612 ◽

Cited By ~ 75

Author(s):

A. Lopez-Beltran ◽

R.J. Luque ◽

J. Alvarez-Kindelan ◽

A. Quintero ◽

F. Merlo ◽

...

Keyword(s):

Bladder Cancer ◽

Prognostic Factors ◽

Cyclin D1 ◽

Cancer Survival ◽

Cyclin D3 ◽

Proliferation Index ◽

Grade 3 ◽

Stage T1

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High Apelin Level Indicates a Poor Prognostic Factor in Muscle-Invasive Bladder Cancer

Disease Markers ◽

10.1155/2019/4586405 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Long Yang ◽

Yan-Lei Li ◽

Xiao-Qing Li ◽

Zheng Zhang

Keyword(s):

Bladder Cancer ◽

Cancer Patients ◽

Vascular Invasion ◽

Tumor Stage ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

Kaplan Meier ◽

Tumor Tissues ◽

High Tumor Stage ◽

Muscle Invasive

Purpose. To compare the expression level of apelin in muscle-invasive bladder cancer and matched paracarcinoma tissues and investigate the relationship between apelin and clinical prognosis in the patients. Methods. To assess apelin expression by using immunohistochemical method compared with bladder tumors and matched paracarcinoma tissues. Subsequently, the correlation of apelin expression with the clinicopathological features of bladder cancer patients was analyzed. Kaplan-Meier survival curves method was used to analyze apelin prognostic significance for muscle-invasive bladder cancer patients (including 404 muscle-invasive bladder cancer patients and 28 normal bladder tissues, in TCGA dataset). Results. Apelin protein level was overexpressed in bladder tumor tissues compared with paracarcinoma tissues. Furthermore, high apelin expression was associated with high tumor stage (P<0.05), distant metastasis (P<0.05), and vascular invasion (P<0.05). Kaplan-Meier curve analyses showed that the overexpression of apelin was a potential predictor of overall survival and disease-free survival. Conclusion. Apelin was upregulated in bladder tumor tissues compared with matched adjacent noncancer tissues, especially in the high tumor stage, distant metastasis, and vascular invasion. What is more, high expression of apelin in muscle-invasive bladder cancer indicates the poor prognosis. These data suggested that apelin might be a therapeutic potential biomarker in muscle-invasive bladder cancer patients.

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