scholarly journals Prognostic and predictive value of ALDH1, SOX2 and SSEA-4 in bladder cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Matias Blomqvist ◽  
Ilmari Koskinen ◽  
Eliisa Löyttyniemi ◽  
Tuomas Mirtti ◽  
Peter J. Boström ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Predictive Value ◽  
Treatment Options ◽  
Clinicopathological Characteristics ◽  
Stem Cell Markers ◽  
Cancer Specific Survival ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Resistance To Chemotherapy

AbstractTransurethral resection of bladder tumor (TUR-BT) and radical cystectomy (RC) are standard treatment options for bladder cancer (BC). Neoadjuvant chemotherapy (NAC) prior to RC improves outcome of some patients but currently there are no valid biomarkers to identify patients who benefit from NAC. Presence of cancer stem cells (CSC) has been associated with poor outcome and resistance to chemotherapy in various cancers. Here we studied the expression of stem cell markers ALDH1, SOX2 and SSEA-4 with immunohistochemistry in tissue microarray material consisting of 195 BC patients treated with RC and 74 patients treated with TUR-BT followed by NAC and RC. Post-operative follow-up data of up to 22 years was used. Negative to weak cytoplasmic SOX2 staining was associated with lymphovascular invasion and non-organ confined disease. It was also associated with shortened cancer-specific survival, but the finding was not statistically significant. Contrary to previous reports, none of the other tested biomarkers were associated with cancer-specific mortality or clinicopathological characteristics. Neither were they associated with response to NAC. Despite the promising results of previously published studies, our results suggest that CSC markers ALDH1, SOX2 and SSEA-4 have little if any prognostic or predictive value in BC treated with RC.

scholarly journals Sex Differences of ≥pT1 Bladder Cancer Survival in Austria: A Descriptive, Long-Term, Nation-Wide Analysis Based on 27,773 Patients

2015 ◽  
Vol 94 (4) ◽  
pp. 383-389 ◽  
Author(s):  
Thomas Waldhoer ◽  
Ingrid Berger ◽  
Gerald Haidinger ◽  
Nadine Zielonke ◽  
Stephan Madersbacher
Keyword(s):  
Bladder Cancer ◽  
Cancer Survival ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Population Based Study ◽  
Age Cohorts ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
The Relationship

Introduction: In recent days, the relationship between gender, tumour stage and survival of bladder cancer has attracted interest. Materials and Methods: The Austrian cancer registry was linked to the national death statistics. All patients with urothelial cancer of the urinary bladder with stages pT1, pT2, pT3 and pT4 diagnosed between 1983 until 2012 were followed for up to 15 years. Overall and cancer-specific mortality were estimated by cumulative incidence. Results: A total of 27,773 patients were analysed. The male:female ratio declined from 3:1 for stage pT1-tumours (n = 16,416) to 2.6:1 for pT2 (n = 6,548), 2.1:1 for pT3 (n = 3,111) and 1.9:1 for pT4 (n = 1,698). The 5 years cumulative overall death rate for pT1 tumours was slightly lower for women (0.31 vs. 0.32; p = 0.016). The opposite was observed for more advanced tumour stages: pT2: women 0.66, men: 0.60 (p = 0.0001); pT3: women 0.76, men 0.72 (p = 0.0004) and for pT4: women 0.90, men 0.85 (p = 0.0001). Cancer-specific survival was identical for pT1-tumours in both sexes, while women had a worse cancer-specific survival in both age cohorts (<70 years and ≥70 years) with higher tumour stages. Conclusions: This population-based study demonstrates that (1) a rise of advanced bladder cancer stages in women and (2) that women with tumour stages >pT1 have a shorter cancer-specific and overall survival.

Role of adjuvant chemotherapy in advanced stage upper urinary tract urothelial carcinoma after radical nephroureterectomy: A competing risk analysis.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 367-367
Author(s):  
Minyong Kang ◽  
Hyung Suk Kim ◽  
Jae Young Joung ◽  
Yong Ho Shin ◽  
Byong Chang Jeong ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Risk Analysis ◽  
Causes Of Death ◽  
Locally Advanced ◽  
Competing Risk ◽  
Radical Nephroureterectomy ◽  
Competing Risk Analysis ◽  
Cancer Specific Survival ◽  
Specific Mortality ◽  
Cancer Specific Mortality

367 Background: To determine whether adjuvant chemotherapy (ACH) influences cancer-specific mortality, bladder cancer-specific mortality, and other-cause mortality in patients with locally advanced upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU) through the use of competing risk analysis. Methods: Among 785 patients with UTUC who underwent RNU from 1994 through 2015, we analyzed 338 individuals with locally advanced UTUC (pathologic T3–T4 and/or positive lymph nodes) without distant metastases. Patients were classified into two groups according to receipt of ACH. The study endpoints were UTUC-, bladder cancer- and other cause-specific survivals. The association of potential risk factors with outcome was tested with the Fine and Gray regression model. Results: Overall, 42.6% (n = 144) received ACH following RNU. During a median follow-up duration of 31.5 months, rates of UTUC-, bladder cancer-, and other cause-mortalities were 32.5% (n = 110), 5.0% (n = 17), and 4.1% (n = 14), respectively. Of note, there were no significant differences in overall survival between the observation and ACH groups according to the competing risks of death (UTUC, bladder cancer, and other causes of death). Multivariate analysis showed that only older age at surgery (≥ 65 years; hazard ratio [HR] = 1.71) and positive resection margin (HR = 7.25) remained as poor predictors of UTUC-specific and bladder cancer-specific survival, respectively. Additionally, no factors were identified as independent predictors of other causes of death. Conclusions: In summary, through competing risk analysis, we demonstrated that postoperative chemotherapy did not improve UTUC-specific and bladder-cancer specific survival, nor other cause-specific survival, in patients with locally advanced UTUC who underwent RNU. These results can offer practical information for clinicians regarding treatment decision making in these patients, who are at high risk of death due to competing causes.

scholarly journals Effect of Intravesical Chemotherapy on the Survival of Patients with Non-Muscle-Invasive Bladder Cancer Undergoing Transurethral Resection: A Retrospective Cohort Study Among Older Adults

2021 ◽  
Vol 14 (1) ◽  
pp. 20-25
Author(s):  
Ashis K. Das ◽  
Devi K. Mishra ◽  
Saji S. Gopalan
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Older Patients ◽  
P Value ◽  
Muscle Invasive Bladder Cancer ◽  
Cancer Specific Survival ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Muscle Invasive ◽  
Overall Mortality

Background: The average age of diagnosis for bladder cancer is 73 and about 75 percent of all bladder cancers are non-muscle invasive at initial diagnosis. It is recommended that non-muscle invasive bladder cancers (NMIBC) should be treated with transurethral resection of the bladder tumor (TURBT) followed by chemotherapy. However, there is no large-scale study from real-world databases to show the effectiveness of chemotherapy on the survival of older adults with NMIBC that have undergone TURBT. This study aimed to investigate the effects of chemotherapy on survival among older NMIBC patients with TURBT. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database (2010-2015), we performed analyses of cancer-specific mortality and overall mortality comparing chemotherapy versus no chemotherapy after TURBT. Coarsened exact matching was performed to balance the baseline patient characteristics. Cox proportional hazards and Kaplan-Meir analyses were used to evaluate survival outcomes. Results: A total of 3,222 matched patients with 1,611 in each arm (chemotherapy and no chemotherapy) were included in our study. After adjusting for covariates, multivariable Cox regression analyses show chemotherapy was associated with lower cancer-specific mortality (HR 0.63; 95% CI 0.42-0.94; p value 0.024). However, chemotherapy did not have any effect on overall mortality (HR 0.84; 95% CI 0.65-1.07; p value 0.159). The Kaplan-Meier curves show the protective effects of chemotherapy on cancer specific survival (p=0.032), but not on overall survival (p=0.34). Conclusion: Chemotherapy improved cancer specific survival among older patients with non-muscle invasive bladder cancer undergoing TURBT surgery, but it had no effect on overall survival. There is a need for more granular level real-world data on chemotherapy regimens and dosage to effectively investigate the effects of chemotherapy on the survival of older patients with NMIBC that have undergone TURBT.

scholarly journals Effect of intravesical chemotherapy on the survival of patients with non-muscle-invasive bladder cancer undergoing transurethral resection: a retrospective cohort study among older adults

2021 ◽  
Author(s):  
Ashis Kumar Das ◽  
Devi Kalyan Mishra ◽  
Saji Saraswathy Gopalan
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Older Patients ◽  
P Value ◽  
Muscle Invasive Bladder Cancer ◽  
Cancer Specific Survival ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Muscle Invasive ◽  
Overall Mortality

AbstractBackgroundThe average age of diagnosis for bladder cancer is 73 and about 75 percent of all bladder cancers are non-muscle invasive at initial diagnosis. It is recommended that non-muscle invasive bladder cancers (NMIBC) should be treated with transurethral resection of the bladder tumor (TURBT) followed by chemotherapy. However, there is no large-scale study from real-world databases to show the effectiveness of chemotherapy on the survival of older adults with NMIBC that have undergone TURBT. This study aimed to investigate the effects of chemotherapy on survival among older NMIBC patients with TURBT.MethodsUsing the Surveillance, Epidemiology, and End Results (SEER) database (2010-2015), we performed analyses of cancer-specific mortality and overall mortality comparing chemotherapy versus no chemotherapy after TURBT. Coarsened exact matching was performed to balance the baseline patient characteristics. Cox proportional hazards and Kaplan-Meir analyses were used to evaluate survival outcomes.ResultsA total of 3,222 matched patients with 1,611 in each arm (chemotherapy and no chemotherapy) were included in our study. After adjusting for covariates, multivariable Cox regression analyses show chemotherapy was associated with lower cancer-specific mortality (HR 0.63; 95% CI 0.42-0.94; p value 0.024). However, chemotherapy did not have any effect on overall mortality (HR 0.84; 95% CI 0.65-1.07; p value 0.159). The Kaplan-Meier curves show the protective effects of chemotherapy on cancer specific survival (p=0.032), but not on overall survival (p=0.34).ConclusionChemotherapy improved cancer specific survival among older patients with non-muscle invasive bladder cancer undergoing TURBT surgery, but it had no effect on overall survival. There is a need for more granular level real-world data on chemotherapy regimens and dosage to effectively investigate the effects of chemotherapy on survival of older patients with NMIBC that have undergone TURBT.

scholarly journals Preoperative Serum Gamma-Glutamyltransferase as a Prognostic Biomarker in Patients Undergoing Radical Cystectomy for Bladder Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Shiqiang Su ◽  
Lizhe Liu ◽  
Chao Sun ◽  
Yanhua Nie ◽  
Hong Guo ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Elevated Serum ◽  
Disease Free Survival ◽  
Prognostic Models ◽  
Lymph Node Status ◽  
Cancer Specific Survival ◽  
Gamma Glutamyltransferase ◽  
Preoperative Serum

BackgroundSerum gamma-glutamyltransferase (GGT) has been reported to be correlated with survival in a variety of malignancies. However, its effect on patients with bladder cancer (BC) treated by radical cystectomy has never been evaluated.Patients and MethodsWe retrospectively evaluated 263 patients who underwent radical surgery in our center. Baseline features, hematologic variables, and follow-up data were obtained. The endpoints included overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). The relationship between GGT and survival were evaluated.ResultsThe median follow-up period for all patients was 34.7 (22.9-45.9) months. At the last follow-up, 67 patients died, 51 patients died of cancer, 92 patients experienced disease recurrence. Patients with an elevated serum GGT had a higher rate of pT3-T4 tumors. Patients with a higher preoperative serum GGT had a lower rate of OS, CSS and DFS (P &lt; 0.001 for all). Multivariate analysis identified that preoperative serum GGT was independent predictor of OS (HR: 3.027, 95% CI: 1.716-5.338; P &lt; 0.001), CSS (HR: 2.115, 95% CI: 1.093-4.090; P = 0.026), DFS (HR: 2.584, 95% CI: 1.569-4.255; P &lt; 0.001). Age, diabetes history, pathologic T stage, and lymph node status also were independent predictors of prognosis for BC patients.ConclusionsOur results indicated that preoperative serum GGT was an independent prognosis predictor for survival of BC patients after radical cystectomy, and can be included in the prognostic models.

scholarly journals Diet Quality and All-Cause and Cancer-Specific Mortality in Older Adults with Invasive Cancer: The Multiethnic Cohort Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 555-555
Author(s):  
Song-Yi Park ◽  
Yurii Shvetsov ◽  
Minji Kang ◽  
V Wendy Setiawan ◽  
Carol Boushey ◽  
...  
Keyword(s):  
Older Adults ◽  
Diet Quality ◽  
Cancer Mortality ◽  
Healthy Eating Index ◽  
Invasive Cancer ◽  
Japanese American ◽  
Multiethnic Cohort ◽  
Specific Mortality ◽  
Cancer Specific Mortality

Abstract Objectives We examined the association of postdiagnostic diet quality with all-cause and cancer-specific mortality in older adults diagnosed with invasive cancer, in comparison with those without invasive cancer, in the Multiethnic Cohort. Methods Data were from 66,374 African American, Native Hawaiian, Japanese American, Latino, and White men and women, who had no prevalent cancer, heart disease, or stroke at baseline (1993–1996, 45–75 years) and completed a quantitative food frequency questionnaire at both baseline and 10-year follow-up (2003–2007). Overall diet quality was measured by the Healthy Eating Index (HEI)-2015, the Alternative HEI-2010 (AHEI-2010), the alternate Mediterranean Diet (aMED), and the Dietary Approaches to Stop Hypertension (DASH) scores. Invasive cancer cases between the baseline and 10-year surveys and deaths after the 10 year survey were identified through linkage to cancer registries and to state death files and the National Death Index. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated in multivariate Cox models for the dietary indexes at 10-year follow-up with subsequent mortality. Results Age-adjusted mean scores of the 4 dietary indexes at baseline (prediagnosis) and 10-year follow-up (postdiagnosis) were similar or slightly lower in participants with cancer (n = 5998), compared to those without cancer (n = 60,376). Among participants with cancer (71.5 ± 8.0 years), 2006 all-cause and 1005 cancer-specific deaths were identified during a mean follow-up of 8 years after the 10-year survey. Postdiagnostic scores from all 4 indexes were associated with lower risk of all-cause and cancer mortality: for the highest vs. lowest quartiles, HR (95% CI) for all-cause mortality was 0.72 (0.62–0.82) for HEI-2015, 0.84 (0.73–0.96) for AHEI-2010, 0.74 (0.63–0.86) for aMED, and 0.76 (0.66–0.87) for DASH. The corresponding HRs (95% CIs) for cancer mortality were 0.81 (0.66–0.99), 0.81 (0.66–0.99), 0.72 (0.58–0.89), and 0.79 (0.65–0.97). These HRs were similar to those for participants without cancer. Conclusions Postdiagnostic high-quality diet was related to lower all-cause and cancer mortality in older adults with invasive cancer, with risk reduction comparable to that among participants without cancer. Funding Sources National Cancer Institute.

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