The bladder epicheck test and cytology in the follow-up of patients with non-muscle-invasive high grade bladder carcinoma.

Background&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 (> 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.

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The combination cytology/epichek test in non muscle invasive bladder carcinoma follow-up: Effective tool or useless expence?

Urologic Oncology Seminars and Original Investigations ◽

10.1016/j.urolonc.2020.06.018 ◽

2020 ◽

Author(s):

Francesco Pierconti ◽

Maurizio Martini ◽

Vincenzo Fiorentino ◽

Tonia Cenci ◽

Sara Capodimonti ◽

...

Keyword(s):

Bladder Carcinoma ◽

Muscle Invasive

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Treatment of High-grade Non–muscle-invasive Bladder Carcinoma by Standard Number and Dose of BCG Instillations Versus Reduced Number and Standard Dose of BCG Instillations: Results of the European Association of Urology Research Foundation Randomised Phase III Clinical Trial “NIMBUS”

European Urology ◽

10.1016/j.eururo.2020.04.066 ◽

2020 ◽

Vol 78 (5) ◽

pp. 690-698 ◽

Cited By ~ 5

Author(s):

Marc-Oliver Grimm ◽

Antoine G. van der Heijden ◽

Marc Colombel ◽

Tim Muilwijk ◽

Luis Martínez-Piñeiro ◽

...

Keyword(s):

Clinical Trial ◽

Bladder Carcinoma ◽

European Association ◽

Standard Dose ◽

Phase Iii ◽

High Grade ◽

Phase Iii Clinical Trial ◽

Muscle Invasive ◽

European Association Of Urology

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The relationship between ABO blood group type and tumor grade, stage, recurrence and progression in transitional cell carcinoma of the bladder: A preliminary report

Journal of Clinical Urology ◽

10.1177/2051415819869462 ◽

2019 ◽

Vol 13 (3) ◽

pp. 205-209

Author(s):

Deviprasad Tiwari ◽

Harshit Garg ◽

Brusabhanu Nayak ◽

Prabhjot Singh ◽

Amlesh Seth

Keyword(s):

Bladder Cancer ◽

Blood Group ◽

Bladder Carcinoma ◽

Statistical Significance ◽

Transitional Cell ◽

Abo Blood Group ◽

Level Of Evidence ◽

Muscle Invasive ◽

Blood Grouping

Objectives: ABO blood grouping is a well-proven prognostic factor in many malignancies. This study aims to study the association and impact of ABO blood group on disease recurrence and progression in bladder carcinoma. Material and methods: Patients with bladder carcinoma undergoing transurethral resection of bladder tumor (TURBT) were studied prospectively for at least 1-year follow-up for recurrence and progression of the disease. Demographic profile along with blood group was noted. Results: Two hundred patients were included in the study and 194 patients were included in the final analysis. Muscle-invasive bladder cancer was present in 39 (20.1%) patients and the high-grade tumor was present in 88 (45.3%) patients. There was no statistical significance between the association of blood grouping and grade ( p=0.29) and stage of the disease ( p=0.20). During the follow-up period, there were 100 (64.5%) recurrences and 15 (9.7%) patients with non-muscle-invasive bladder carcinoma had progression. The association of blood group with recurrence ( p=0.66) and progression ( p=0.11) of disease was not statistically significant. Conclusion: There is no association between bladder cancer and ABO blood group in terms of grade and stage of the disease. The recurrence and progression of the disease did not differ significantly in different blood groups. Level of Evidence: 2b

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Bladder Carcinoma Data with Clinical Risk Factors and Molecular Markers: A Cluster Analysis

BioMed Research International ◽

10.1155/2015/168682 ◽

2015 ◽

Vol 2015 ◽

pp. 1-14 ◽

Cited By ~ 27

Author(s):

Enrique Redondo-Gonzalez ◽

Leandro Nunes de Castro ◽

Jesús Moreno-Sierra ◽

María Luisa Maestro de las Casas ◽

Vicente Vera-Gonzalez ◽

...

Keyword(s):

Molecular Markers ◽

Bladder Carcinoma ◽

Clinical History ◽

Prostatic Hyperplasia ◽

Biological Behavior ◽

Preoperative Imaging ◽

Muscle Invasive ◽

New Diagnosis

Bladder cancer occurs in the epithelial lining of the urinary bladder and is amongst the most common types of cancer in humans, killing thousands of people a year. This paper is based on the hypothesis that the use of clinical and histopathological data together with information about the concentration of various molecular markers in patients is useful for the prediction of outcomes and the design of treatments ofnonmuscle invasive bladder carcinoma(NMIBC). A population of 45 patients with a new diagnosis of NMIBC was selected. Patients withbenign prostatic hyperplasia(BPH),muscle invasive bladder carcinoma(MIBC),carcinoma in situ(CIS), and NMIBC recurrent tumors were not included due to their different clinical behavior. Clinical history was obtained by means of anamnesis and physical examination, and preoperative imaging and urine cytology were carried out for all patients. Then, patients underwent conventionaltransurethral resection(TURBT) and some proteomic analyses quantified the biomarkers (p53, neu, and EGFR). A postoperative follow-up was performed to detect relapse and progression. Clusterings were performed to find groups with clinical, molecular markers, histopathological prognostic factors, and statistics about recurrence, progression, and overall survival of patients with NMIBC. Four groups were found according to tumor sizes, risk of relapse or progression, and biological behavior. Outlier patients were also detected and categorized according to their clinical characters and biological behavior.

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Ability of urovysion FISH analysis to select patients with low- or intermediate-risk non-muscle-invasive bladder cancer (LI-NMIBC) for decreased surveillance.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.7_suppl.283 ◽

2011 ◽

Vol 29 (7_suppl) ◽

pp. 283-283

Author(s):

H. M. Rosevear ◽

A. J. Lightfoot ◽

M. A. O'Donnell

Keyword(s):

First Year ◽

Fish Analysis ◽

Low Grade ◽

High Grade ◽

Genetic Changes ◽

Screening Intervals ◽

Muscle Invasive ◽

Initial Resection

283 Background: Recurrent LI-NMIBC is difficult to detect cytologically, requiring frequent cystoscopies. Urovysion's (Abbot Laboratories, Downers Grove, IL) fluorescent in situ hybridization assay (FISH) detects genetic changes associated with LI-NMIBC and may be useful in identifying patients for extended screening intervals. Methods: Charts of 54 consecutive patients with LI-NMIBC who underwent cystoscopy, cytology, and FISH analysis every 3 months for the first year after resection since 2004 were retrospectively identified and reviewed. We analyzed the number of tumors or high-grade cytologies that would have been missed if surveillance cystoscopy, cytology, and FISH analysis had not been done between 3 and 12 months post-resection for patients with a normal cystoscopy, cytology, and FISH analysis at 3 months after initial resection and compared those results to patients with normal cystoscopy, cytology, and abnormal FISH analysis. Results: Mean age of the 54 patients was 67 (range 25–89) and 41 were males. Thirty-nine patients had normal cystoscopy, cytology, and FISH analysis at 3-months follow-up. If no further surveillance was done until 1 year post-resection, 2 low-grade tumors (3 and 7 mm at 7 months post-resection) and 2 incidents of high-grade cytology would have been missed (4 of 39, 10%). Fifteen patients had normal cystoscopy and cytology but abnormal FISH analysis results at 3 months. If no further surveillance had been done until 1 year after resection, 6 tumors (6 of 15, 40%) (5, 8, 3, 3, 9, 2 mm at 5, 6, 6, 7, 9, 10 months post-resection) and no high-grade cytology would have been missed. Overall, statistically fewer patients with normal compared to abnormal FISH analysis at first follow-up developed tumors before 1 year (4 of 39 vs. 6 of 15, p=0.033). Conclusions: FISH analysis can be used to significantly increase our ability to select patients suitable for extended screening intervals. It may be prudent to include FISH analysis at the first post-resection follow-up before selecting patients with LI-NMIBC for an extended screening interval. [Table: see text]

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