scholarly journals Utility and Safety of Repeat Transurethral Resection of Bladder Tumor Performed at a Tertiary Center

2020 ◽  
Vol 9 (02) ◽  
pp. 086-089
Author(s):  
Anand Raja ◽  
Kanuj Malik ◽  
Arulmolichelvan Arunandhichelvan ◽  
N. Kathiresan ◽  
L. S. Ravishankar
Keyword(s):  
Transurethral Resection ◽  
Bladder Tumor ◽  
Residual Disease ◽  
Residual Tumor ◽  
Disease Recurrence ◽  
Resected Specimen ◽  
Safe Procedure ◽  
Recurrence Rates ◽  
Tertiary Center ◽  
The Impact

Abstract Introduction Repeat transurethral resection of bladder tumor (ReTURBT) has become an integral part of the management of superficial bladder cancers at various urological centers around the world. Early detection of residual disease, leading to upstaging in some cases, leads to decrease in recurrence rates. Our study aimed to analyze the impact of ReTURBT in detecting residual tumor and tumor recurrences, hence validating the benefits of procedure as a routine. Materials and Methods A total of 152 patients with superficial bladder cancer who were treated at Cancer Institute (WIA) between January 2005 and December 2013 were analyzed and followed up for 3 years. Results Of the 152 cases who underwent ReTURBT, 47 patients had residue in the final histopathology of the resected specimen (31%). The overall rate of upstaging to muscle-invasive disease following ReTURBT was 3.3%. The mean follow-up period was 47.13 months, during which 25 (17%) out of 147 patients who underwent ReTURBT had disease recurrence. There was no additional morbidity due to ReTURBT as compared with the primary procedure. Conclusion ReTURBT is an effective procedure in treating recurrent tumors also as long as they remain superficial. The procedure when performed with utmost care in experienced hands remains a very safe procedure to be followed as a routine and standard.

scholarly journals Usefulness of narrow-band imaging in transurethral resection of bladder tumor: Early experience from a tertiary center in India

2019 ◽  
Vol 08 (04) ◽  
pp. 226-228
Author(s):  
Kanuj Malik ◽  
Anand Raja ◽  
Sivakumar Mahalingam ◽  
L.S Ravishankar
Keyword(s):  
White Light ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Urinary Bladder Cancer ◽  
Early Experience ◽  
Current Standard ◽  
Tertiary Center ◽  
Long Term Follow Up

Abstract Background: The current standard for diagnosis and treatment of urinary bladder cancer is transurethral resection of bladder tumor (TURBT) using white light guidance. Narrow band imaging (NBI) has emerged as a promising method for identifying additional bladder lesions. Various studies have been published to evaluate its sensitivity in identifying new lesions and its impact on decreasing recurrences. In this study, we evaluated our early experience using NBI in TURBTs. Aims and Objective: The aim of the study is to determine the accuracy of NBI in identifying additional malignant lesions during TURBT. Materials and Methods: We retrospectively collected data for all patients who underwent either TURBT or repeat TURBT with white light and NBI from November 2016 to July 2017 at Cancer Institute (WIA). The number of additional lesions identified using NBI was evaluated along with its correlation with the final histopathology. Results: Forty patients were analysed of which 20 underwent TURBT and 20 underwent repeat TURBT. Of these, 36 patients had complete resection of tumour. Additional lesions were detected in 6 patients (14%) by NBI of which 2 (33%) were malignant histology. The additional lesions detected were carcinoma in situ and no patient was upstaged. Conclusion: The inclusion of NBI to conventional white light TURBT increases the sensitivity for identifying additional lesions. The limitation of NBI is high false positivity and its availability. Long term follow up studies with larger subset of patients are required to evaluate its role in decreasing recurrences and justification in routine clinical practice.

Impact on survival of surgically defined favorable responses to salvage intraperitoneal chemotherapy in small-volume residual ovarian cancer.

1992 ◽  
Vol 10 (9) ◽  
pp. 1479-1484 ◽  
Author(s):  
M Markman ◽  
B Reichman ◽  
T Hakes ◽  
J L Lewis ◽  
W Jones ◽  
...  
Keyword(s):  
Median Survival ◽  
Small Volume ◽  
Residual Disease ◽  
Controlled Trial ◽  
Residual Tumor ◽  
Maximum Diameter ◽  
Cancer Center ◽  
Impact On Survival ◽  
Microscopic Residual Disease ◽  
The Impact

PURPOSE To evaluate the impact on survival of the attainment of surgically defined favorable responses (S-R) to salvage intraperitoneal (IP) chemotherapy after initial systemic cytotoxic drug delivery. PATIENTS AND METHODS We examined the survival of patients who were treated on one of three phase II IP trials that were conducted at the Memorial Sloan-Kettering Cancer Center. A total of 58 patients whose largest residual tumor masses measured less than or equal to 0.5 cm in maximum diameter at the initiation of this salvage therapy were assessable for response, 28 of whom (48%) demonstrated a S-R, which included 19 (33%) who achieved a surgically defined complete response (S-CR). RESULTS With a median follow-up of 43+ months (range, 33+ to 58+ months) from the initiation of IP therapy, 12 of 19 (63%) have recurred. The median duration of S-CR for the 10 patients with microscopic residual disease was 32 months compared with 15 months for the nine patients with macroscopic residual disease (largest tumor mass less than or equal to 0.5 cm; P greater than .1). For patients with microscopic residual disease who experienced a S-CR (n = 10) after salvage IP therapy, the median overall survival from the initiation of therapy has not been reached, but will exceed 4 years compared with a 25-month median survival for the nonresponding patients (n = 13; P = .004). The median survival for the 18 patients with small-volume macroscopic disease who responded to therapy was 40 months compared with 19 months for the nonresponders (P = .009). CONCLUSION Although the results of this evaluation are encouraging and suggest that the attainment of a S-R, particularly a S-CR, after IP chemotherapy may result in a clinically meaningful favorable impact on survival, a randomized controlled trial will be required to address definitively this important issue.

Adoptive Cell Immunotherapy for Epithelial Ovarian Cancer

2018 ◽  
Author(s):  
Samir A. Farghaly
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Residual Disease ◽  
Adoptive Cell Therapy ◽  
Human Leukocyte ◽  
Progression Free Survival ◽  
Tumor Infiltrating Lymphocytes ◽  
Residual Tumor ◽  
Disease Recurrence ◽  
Platinum Based Chemotherapy

The standard management for epithelial ovarian cancer (EOC) is a combination of aggressive debulking surgery with residual tumor of less than 1 cm and platinum-based chemotherapy. However, a high percentage of patients experience disease recurrence. Extensive efforts to find new therapeutic options have been made, albeit cancer cells develop drug resistance and malignant progression occurs. Novel therapeutic strategies are needed to enhance progression-free survival and overall survival of patients with advanced EOC. Several preclinical and clinical studies investigated feasibility and efficacy of adoptive cell therapy (ACT) in EOC. The aim of this chapter is to present an overview of ACT in EOC, focusing on Human Leukocyte Antigen (HLA)-restricted tumor infiltrating lymphocytes and MHC-independent immune effectors such as natural killer and cytokine-induced killer. The available data suggest that ACT may provide the best outcome in patients with low tumor burden, minimal residual disease, or maintenance therapy. Further preclinical studies and clinical trials are needed.

scholarly journals Safety and efficacy of en bloc transurethral resection versus conventional transurethral resection for primary nonmuscle-invasive bladder cancer: a meta-analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Dong Zhang ◽  
Lifeng Yao ◽  
Sui Yu ◽  
Yue Cheng ◽  
Junhui Jiang ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Meta Analysis ◽  
Residual Tumor ◽  
Detrusor Muscle ◽  
En Bloc ◽  
Safety And Efficacy ◽  
Significant Difference ◽  
Bladder Detrusor

Abstract Background The purpose of this meta-analysis is to compare the safety and efficacy of en bloc transurethral resection of bladder tumor (EBRT) versus conventional transurethral resection of bladder tumor (CTURBT). Methods We performed a meta-analysis of relevant articles through November 2019 using PubMed, Embase, and Cochrane Central Register to compare the safety and efficacy of EBRT versus CTURBT. The main endpoint included the operation time (OT), hospitalization time (HT), catheterization time (AT), perioperative period complications, bladder detrusor muscle found in the specimen, the residual tumor on the base, the ratio of the same site recurrence, and 12/24/36-month recurrence rate. Cochrane Collaboration’s Revman software, version 5.3, was used for statistical analysis. Results A total of 19 studies with 2651 patients were included, 1369 underwent EBRT and 1282 underwent CTURBT. Patients treated with EBRT had a significantly lower AT, HT, obturator nerve reflex, bladder perforation, bladder irritation, postoperative complications, and 24-month recurrence rate than those who underwent CTURBT. While no significant difference was found in terms of OT, the ratio of bladder detrusor muscle found in the specimen, the residual tumor on the base, 12-month recurrence rate, 36-month recurrence rate, and the ratio of the same site recurrence. In mitomycin subgroup, EBRT was superior to CTURBT in terms of 12/24-month recurrence rate. Similarly, in the prospective subgroup and retrospective subgroup, EBRT had a lower 24-month recurrence rate than CTURBT. However, no significant difference was found in the low, intermediate, and high-risk group in the light of 12–36-month recurrence rate. Conclusions Based on the included 19 articles, EBRT had a significantly lower AT, HT, intraoperative and postoperative complications, and 24-month recurrence rate than those treated with CTURBT. Well-designed randomized controlled trials were needed to reevaluate these outcomes. Trial registration This meta-analysis was reported in agreement with the PRISMA statement and was registered on PROSPERO 2019 CRD42019121673.

The Result of Re-Transurethral Resection of Bladder Tumor in Eight Years

2021 ◽  
Vol 104 (9) ◽  
pp. 1411-1414
Keyword(s):  
Transurethral Resection ◽  
Bladder Tumor ◽  
Residual Tumor ◽  
Pathology Report ◽  
Detrusor Muscle ◽  
Incomplete Resection ◽  
High Grade ◽  
Recurrence Free Survival ◽  
Minor Complication ◽  
Free Survival

Objective: To analyses the residual tumor and staging after transurethral resection of bladder tumor (TURBT). Moreover, to analyze the recurrence and free survival patients who received treatment by re-transurethral resection of bladder tumor (RE-TURBT) and their complications. Materials and Methods: A retrospective study from 35 patients operated by RE-TURBT between January 2010 and December 2018 was done. The patients in the present study were qualified by 1) incomplete resection from the first TURBT, 2) the detrusor muscle did not appear in specimen for high grade transition cell carcinoma, 3) any T1 lesion, or 4) large or multifocal lesion. The analysis of the residual tumor included staging, recurrence-free survival, and complication after RE-TURBT from the pathology report and follow up method. Results: Thirty-five patients were included in this study. The average age of the patients operated by RE-TURBT was 69 years old, with a range of 44 to 87 years old. The presenting symptom was hematuria with gross hematuria in 28 patients (80%) and microhematuria in seven patients (20%). Twenty-five patients (71.4%) were male. The relative factor was smoking in 23 patients (65%) and coexisting with irritative voiding symptom in 11 patients (31.4%). The present study found that there was incomplete resection in 11 patients (31.4%), with under-staging in five patients and incomplete resection in six patients. There were 14 months recurrence-free survival and minor complication in RE-TURBT patients. Conclusion: One third of the patients operated by RE-TURBT had unreasonable staging, especially in Ta high grade staging. This could change the treatment in two patients (5.7%), which found minor complication from RE-TURBT, and improve recurrence-free survival. Keywords: Transurethral resection of bladder tumor (TURBT); Re Transurethral resection of bladder tumor (Re-TURBT)

901 The impact of frozen biopsy of bladder tumor bed during transurethral resection: A randomized prospective trial

2014 ◽  
Vol 13 (1) ◽  
pp. e901-e901a
Author(s):  
Juveniz J.A.Q.J. Queiroz ◽  
Sant Anna A.C.S. Crippa ◽  
Dalloglio M.F.D. Francisco ◽  
Nesrallah A.J.N. João ◽  
Chade D.C.C. Cezar ◽  
...  
Keyword(s):  
Transurethral Resection ◽  
Bladder Tumor ◽  
Prospective Trial ◽  
Tumor Bed ◽  
Randomized Prospective Trial ◽  
The Impact

1881 IMPACT OF FROZEN BIOPSY OF BLADDER TUMOR BED DURING TRANSURETHRAL RESECTION ON RESIDUAL TUMOR AND UPSTAGING AT RETUR

2013 ◽  
Vol 189 (4S) ◽  
Author(s):  
JOÃO ALEXANDRE QUEIROZ JUVENIZ ◽  
ADRIANO JOÃO NESRALLAH ◽  
ALEXANDRE CRIPPA SANT'ANNA ◽  
CARLOS HIROKATSU WATANABE SILVA ◽  
CLAUDIO BOVOLENTA MURTA ◽  
...  
Keyword(s):  
Transurethral Resection ◽  
Bladder Tumor ◽  
Residual Tumor ◽  
Tumor Bed

scholarly journals Use of Cetuximab in Combination with Cisplatin and Adjuvant Pelvic Radiation for Stage IIIB Vulvar Carcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Jennifer Bergstrom ◽  
Michael Bidus ◽  
Edward Miles ◽  
Jay Allard
Keyword(s):  
Vulvar Cancer ◽  
Residual Disease ◽  
Growth Factor Receptor ◽  
Disease Recurrence ◽  
Adjuvant Radiation ◽  
Recurrence Rates ◽  
Inguinal Lymph Node Dissection ◽  
Pelvic Radiation ◽  
Advanced Stages ◽  
Epidermal Growth

Vulvar cancer is a rare carcinoma constituting only 4% of gynecologic malignancies and 0.6% of female cancers. Most chemotherapy regimens have been created from extrapolation from anal and cervical cancer research. Advanced stages have the worst prognosis and oftentimes invasive surgical procedures are needed to cure disease with high recurrence rates.Case.A 50 yo G2P2 presented for a 2 cm mass in her right labia. The patient underwent a partial radical vulvectomy and bilateral superficial and deep inguinal lymph node dissection. Bilateral inguinal lymph nodes were positive for residual disease. The patient underwent whole pelvic radiation with cisplatin as a radiosensitizer. The primary tumor was epidermal growth factor receptor (EGFR) positive and cetuximab, a monoclonal antibody to EGFR, was added. The patient underwent seven cycles of chemotherapy including cisplatin and cetuximab with adjuvant radiation therapy to the pelvis. She currently is without evidence of disease recurrence since completing treatment 4 years ago.Conclusion.One previous case report showed short-term palliative success of five months for recurrent, metastatic vulvar cancer. This case suggests that cetuximab could possibly be used in initial management of patients with advanced stages of vulvar cancer to improve prognosis.

Evaluation of the role of second TUR for transurethral resection of bladder tumor in one piece (TURBO).

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 298-298
Author(s):  
H. Ikeda ◽  
M. Nomura ◽  
T. Shou ◽  
K. Ishikawa ◽  
E. Kashiwagi ◽  
...  
Keyword(s):  
Transurethral Resection ◽  
Bladder Tumor ◽  
Operation Time ◽  
Safe Procedure ◽  
Pathological Findings ◽  
Holding Period ◽  
Specimen Retrieval ◽  
Hospitalization Period ◽  
Second Tur ◽  
Muscle Invasive

298 Background: Since transurethral resection of bladder tumor in one piece (TURBO) was reported in the Journal of Urology in 2000 by Ukai, some urologists carried out TURBO. We analyzed treatment results of TURBO in our hospital and examined the value of this procedure, especially for the pathological findings, recurrence and necessity of second TUR for TURBO. Methods: A total of 14 patients with bladder tumors carried out TURBO under spinal anesthesia, in some cases blocking the obtulater nerve, from April 2006 to June 2009 in our hospital. All cases were followed for over 1 year. The procedure is 1. point marking; 2. circular incision; 3. level incision; and 4. specimen retrieval using a needle electrode in accordance with the Ukai's method. We investigated pathological findings (margin situation), operation time, complications and recurrence. Results: It is possible to diagnose the precise pathlogical findings by TURBO. We judged the width and depth ew in sequential section. There were no complications during and after the operation. Operation time of TURBO (35–170 min) was longer than TUR-BT. Urethral catheter holding period and hospitalization period after TURBO was the same as TUR-BT. TURBO is a relatively safe procedure even for beginners. 5 cases had a recurrence in 13 cases. 2 cases had a recurrence in under 1 year, but the locations were other places. One case had a same place recurrence after 13 months. There were no cases of same place recurrence in under 1 year among margin-negative cases. Therfore we judged that ew-negative cases had no residual cancers. Conclusions: TURBO is a safe and useful procedure that provides precise pathological findings with minimal complications. Second TUR is not necessary for TURBO. TURBO has a possibility to be gold standard of the treatment for non-muscle invasive bladder cancer. No significant financial relationships to disclose.

Results of a phase II trial of neoadjuvant abiraterone + prednisone+ enzalutamide + leuprolide (APEL) versus enzalutamide + leuprolide (EL) for patients with high-risk localized prostate cancer (PC) undergoing radical prostatectomy (RP).

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 79-79 ◽  
Author(s):  
Rana R. McKay ◽  
Wanling Xie ◽  
Rosina Lis ◽  
Huihui Ye ◽  
Zhenwei Zhang ◽  
...  
Keyword(s):  
High Risk ◽  
Hormone Therapy ◽  
Phase Ii ◽  
Phase Ii Trial ◽  
Residual Disease ◽  
Pathologic Complete Response ◽  
Recurrence Rates ◽  
Increased Risk ◽  
Grade 3 ◽  
The Impact

79 Background: Patients with high-risk PC have an increased risk of recurrence and mortality despite therapy. Abiraterone, a CYP17 inhibitor, and enzalutamide, a next generation anti-androgen, have demonstrated improved overall survival in metastatic PC. In this multicenter randomized phase II trial, we evaluate the impact of second generation hormone therapy on RP pathologic outcomes. Methods: Eligible patients had biopsy Gleason score ≥4+3=7, PSA >20 ng/mL or cT3 disease (by prostate MRI). Lymph node were require to be <20 mm. Patients were randomized 2:1 to APE:EL for 6 cycles (24 weeks) followed by RP. All RPs underwent central pathology review. The primary endpoint was the rate of pathologic complete response (pCR) or minimum residual disease (MRD, tumor ≤5 mm). Secondary endpoints include PSA response, surgical staging at RP, positive margin rate, and safety. Results: 75 patients were enrolled at four sites: DFCI/BWH (n=55), BIDMC (n=11), UW (n=5), JHU (n=4). Median age was 62 years. Most patients had NCCN high-risk disease [n=66, 88%; cT3 n=21 (28%), Gleason 8-10 n=59 (79%), PSA >20 ng/mL n=17 (23%)]. All patients completed 6 cycles followed by RP. Median PSA nadir was 0.03 and 0.02 ng/mL and time to nadir was 3.7 and 4.6 months in the APEL and EL arms, respectively. The combined pCR or MRD rate was 30% (n=15/50) in the APEL arm and 16% (n=4/25) in the EL arm. The response difference was 14% (80% CI -3%-30%, p=0.263). 15 patients (14 in APEL; 1 in EL) had grade 3 adverse events (AEs). The most common grade 3 AEs were hypertension (n=7) and ALT increase (n=5). No grade 4-5 AEs occurred. Conclusions: Neoadjuvant hormone therapy plus RP in men with high-risk PC resulted in favorable pathologic responses (≤5 mm residual tumor) in 16-30% with a trend towards improved pathologic outcomes with APEL and acceptable safety profile. Follow-up is necessary to evaluate the impact of therapy on recurrence rates. Clinical trial information: NCT02268175. [Table: see text]

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