The impact of the presence of Squamous Cell Carcinoma (SCC) variant at Trans-Urethral Resection of the Bladder (TURB) on pathological and follow-up outcomes in patients affected by Non Muscle-Invasive Bladder Cancer (NMIBC)

2021 ◽  
Vol 79 ◽  
pp. S1039
Author(s):  
F. Chierigo ◽  
G. Mantica ◽  
F. Ambrosini ◽  
R. Malinaric ◽  
S. Smelzo ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Bladder Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive ◽  
The Impact

scholarly journals Intravesical Therapy for Non-Muscle-Invasive Bladder Cancer: What Is the Real Impact of Squamous Cell Carcinoma Variant on Oncological Outcomes?

Medicina ◽  
2022 ◽  
Vol 58 (1) ◽  
pp. 90
Author(s):  
Guglielmo Mantica ◽  
Francesco Chierigo ◽  
Rafaela Malinaric ◽  
Salvatore Smelzo ◽  
Francesca Ambrosini ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Bladder Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Regression ◽  
Disease Recurrence ◽  
Intravesical Therapy ◽  
Regression Analyses ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

Background and Objectives: To evaluate the oncological impact of squamous cell carcinoma (SCC) variant in patients submitted to intravesical therapy for non-muscle-invasive bladder cancer (NMIBC). Materials and Methods: Between January 2015 and January 2020, patients with conventional urothelial NMIBC (TCC) or urothelial NMIBC with SCC variant (TCC + SCC) and submitted to adjuvant intravesical therapies were collected. Kaplan–Meier analyses targeted disease recurrence and progression. Uni- and multivariable Cox regression analyses were used to test the role of SCC on disease recurrence and/or progression. Results: A total of 32 patients out of 353 had SCC at diagnosis. Recurrence was observed in 42% of TCC and 44% of TCC + SCC patients (p = 0.88), while progression was observed in 12% of both TCC and TCC + SCC patients (p = 0.78). At multivariable Cox regression analyses, the presence of SCC variant was not associated with higher rates of neither recurrence (p = 0.663) nor progression (p = 0.582). Conclusions: We presented data from the largest series on patients with TCC and concomitant SCC histological variant managed with intravesical therapy (BCG or MMC). No significant differences were found in term of recurrence and progression between TCC and TCC + SCC. Despite the limited sample size, this study paves the way for a possible implementation of the use of intravesical BCG and MMC in NMIBC with histological variants.

scholarly journals The Impact of Non-compliance to Standardized Risk-adjusted Protocol in Non-Muscle Invasive Bladder Cancer on Recurrence, Progression and Mortality: Lessons to Learn in the Era of COVID-19

2020 ◽  
Author(s):  
Faris Abushamma ◽  
Zain Khayyat ◽  
Aya Soroghle ◽  
Sa’ed H. Zyoud ◽  
Ahmad Jaradat ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Mortality Rate ◽  
Invasive Bladder Cancer ◽  
Progression Rate ◽  
Muscle Invasive Bladder Cancer ◽  
Strict Adherence ◽  
Surveillance Protocol ◽  
Muscle Invasive ◽  
The Impact

Abstract BackgroundNon-Muscle Invasive Bladder Cancer (NMIBC) is potentially curable or a controllable disease if strict adherence to surveillance protocol is followed. Management and surveillance of NMIBC begin at the time of diagnosis up to few years thereafter based on the risk group category. There is scanty data in the literature evaluating the impact of non-compliance to surveillance protocol on progression, recurrence, and mortality rate. We do believe that this data will add to the literature especially during the COVID-19 pandemic which affects and delays daily elective surgeries. MethodsA retrospective study of two hundred bladder biopsy and resection between 2012-2017. Eighty-eight patients with minimal 3 years follow up data were included. Patients were divided into 2 groups based on their compliance with the cystoscopy follow up as recommended by the European guidelines. We compared the cystoscopy compliant group to the non-compliant group in view of recurrence, progression, and mortality. In addition, missing variable items during surveillance are calculated in a new scoring model to predict the adverse outcome. ResultsRecurrence rate (RR), progression rate (PR), metastasis rate (MsR) and mortality rate (MR) are significantly higher in non-compliant group, RR: (92.6%) (P<0.001), PR: (54.1%) (P<0.001), MsR: (37.7%) (P<0.001), MR: (23.5%) (P= 0.002) respectively. In subgroup analysis, intermediate and high-risk groups have a PR rate of zero in the compliant group while it is 100% (P<0.001) and 56.4% (P=0.001) in the non-compliant group respectively. Kaplan Meier (KM) graph shows that compliant patients were more likely to be better than non-compliant. ConclusionsNoncompliance to a standardized surveillance protocol in NMIBC is associated statistically and clinically with adverse outcomes in comparison to a compliant group which mandates strict adherence to surveillance guidelines to improve outcomes in NMIBC.

The impact of pathologic downstaging with neoadjuvant chemotherapy on survival of patients with muscle-invasive bladder cancer.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 491-491
Author(s):  
Alberto Martini ◽  
John R Heard ◽  
Nikhil Waingankar ◽  
Rachel Jia ◽  
John P. Sfakianos ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cox Model ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Invasive Bladder Cancer ◽  
Inclusion Criteria ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive ◽  
The Impact

491 Background: Achieving a pathologic complete response (pCR) with neoadjuvat chemotherapy (NAC) in patients with muscle-invasive bladder cancer (MIBC) has been correlated with improved survival. Such findings have served as justification for using pCR as an intermediate endpoint for clinical trials and perpetuated the notion that NAC only benefits patients achieving a pCR. The impact of downstaging (pDS) on outcomes of patients with MIBC treated with NAC has been underexplored. Methods: The National Cancer Database (NCDB) was queried to identify patients with MIBC (cT2-4N0M) treated with platinum-based NAC. A multivariable Cox model including either pDS or pCR and adjusted for potential confounders was generated and c-indices were computed to evaluate whether the inclusion of pDS or pCR was more informative in predicting overall survival (OS). Results: Overall 2,010 patients from NCDB met inclusion criteria. The median follow-up for survivors was 36 months with a 5-year OS of 47% (95% CI 44, 50%). Overall, 694 (43.5%) patients achieved pDS; 139, 201, 291, 49 and 14 downstaged of 1, 2, 3, 4 and 5 categories, respectively. The 5-year OS rate for patients who achieved pDS was 70%. A pCR was achieved by 306 (15%) of the patients, the 5-year OS rate in this group was 84%. In the NCDB, pDS and pCR emerged as predictors of OS: HR:0.36 (95% CI: 0.30,0.44, p<0.001) and 0.25 (95% CI: 0.18,0.25, p<0.001), respectively. The cindex of the model including pDS was 72 vs. 70 of the model with pCR. Conclusions: pDS represents a more informative endpoint in predicting OS with respect to pCR in patients receiving NAC for MIBC.

A prospective observational study on oral administration of Ellagic Acid and Annona Muricata in patients affected by non-muscle invasive bladder cancer not undergoing maintenance after 6-week intravesical prophylaxis

2021 ◽  
pp. 039156032110222
Author(s):  
Vincenzo Serretta ◽  
Ettore De Berardinis ◽  
Alchiede Simonato ◽  
Alessio Guarneri ◽  
Nino Dispensa ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Oral Administration ◽  
Ellagic Acid ◽  
Invasive Bladder Cancer ◽  
Prophylactic Effect ◽  
Annona Muricata ◽  
Muscle Invasive Bladder Cancer ◽  
Number Of Patients ◽  
Muscle Invasive

Introduction: BCG and MMC shortage and Covid-19 pandemic, more recently, limit accessibility to maintenance regimen in intravesical prophylaxis against recurrence of non-muscle invasive bladder cancer (NMIBC). Ellagic acid (EA) and Annona muricata (AM) exert antitumor activity against different human tumours. An observational prospective study on the prophylactic effect of oral administration of EA+AM in patients avoiding maintenance regimen is presented. Materials and methods: Patients affected by NMIBC and not undergoing maintenance after a 6-week course of intravesical prophylaxis with MMC or BCG were entered. Tis and very high-risk tumours were excluded. After informed consent, the patients were subdivided in relation to the oral assumption or not of EA (100 mg) plus AM (100 mg), daily for 6 months. All patients were submitted to 3-month cytology and cystoscopy. Results: 162 (90%) of 180 entered patients are evaluable, 90 and 72 receiving or not EA+AM. No difference emerged in patients’ characteristics between the two groups. BCG was given in 86 (54%) and chemotherapy in 74 (46%) patients. The recurrence free rate at 3, 6 and 12 months in patients assuming or not EA was 96.5% versus 84.6% ( p = 0.003), 85.4% versus 64.8% ( p = 0.005) and 74.2% versus 60.6% ( p = 0.246), respectively. The recurrence free survival at 12 months in patients assuming or not EA was 63.0% versus 34.5% ( p < 0.0001). Discussion and conclusions: Our study suffers several limits: not randomized trial although prospective, limited number of patients and short follow-up, nevertheless it shows the prophylactic effect of oral EA+AM in absence of maintenance after intravesical chemotherapy or immunotherapy induction.

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.

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