The Treatment of High Grade Superficial Bladder Cancer and Carcinoma In Situ with BCG -- A Questionnaire Survey of Consultant Practice in England and Wales

UBC® Rapid Test is a test that detects fragments of cytokeratins 8 and 18 in urine. We present results of a multicentre study measuring UBC® Rapid Test in bladder cancer patients and healthy controls with focus on carcinoma in situ (CIS) and high-grade bladder cancer. From our study with N = 452 patients, we made a stratified sub-analysis for carcinoma in situ of the urinary bladder. Clinical urine samples were used from 87 patients with tumours of the urinary bladder (23 carcinoma in situ, 23 non-muscle-invasive low-grade tumours, 21 non-muscle-invasive high-grade tumours and 20 muscle-invasive high-grade tumours) and from 22 healthy controls. The cut-off value was defined at 10.0 µg/L. Urine samples were analysed by the UBC® Rapid Test point-of-care system (concile Omega 100 POC reader). Pathological levels of UBC Rapid Test in urine are higher in patients with bladder cancer in comparison to the control group (p < 0.001). Sensitivity was calculated at 86.9% for carcinoma in situ, 30.4% for non-muscle-invasive low-grade bladder cancer, 71.4% for nonmuscle-invasive high grade bladder cancer and 60% for muscle-invasive high-grade bladder cancer, and specificity was 90.9%. The area under the curve of the quantitative UBC® Rapid Test using the optimal threshold obtained by receiveroperated curve analysis was 0.75. Pathological values of UBC® Rapid Test in urine are higher in patients with high-grade bladder cancer in comparison to low-grade tumours and the healthy control group. UBC® Rapid Test has potential to be more sensitive and specific urinary protein biomarker for accurate detection of high-grade patients and could be added especially in the diagnostics for carcinoma in situ and non-muscle-invasive high-grade tumours of urinary bladder cancer.

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Pathology of Superficial Bladder Cancer With Emphasis on Carcinoma In Situ

The Journal of Urology ◽

10.1016/s0022-5347(17)44942-1 ◽

1986 ◽

Vol 136 (2) ◽

pp. 540-542

Author(s):

R.S. Weinstein ◽

A.W. Miller ◽

J.S. Coon ◽

B.U. Pauli ◽

D. Schwartz

Keyword(s):

Bladder Cancer ◽

Carcinoma In Situ ◽

Superficial Bladder Cancer

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Pathological Characteristics of Primary Bladder Carcinoma Treated at a Tertiary Care Hospital and Changing Demographics of Bladder Cancer in Sri Lanka

Advances in Urology ◽

10.1155/2016/5751647 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6

Author(s):

S. Sasikumar ◽

K. S. N. Wijayarathna ◽

K. A. M. S. Karunaratne ◽

U. Gobi ◽

A. Pathmeswaran ◽

...

Keyword(s):

Bladder Cancer ◽

Sri Lanka ◽

Bladder Carcinoma ◽

Carcinoma In Situ ◽

De Novo ◽

Tertiary Care ◽

Care Hospital ◽

High Grade ◽

Female Ratio

Objectives. The aim was to compare demographics and pathological features of bladder carcinoma treated in a urology unit with findings of previous studies done in Sri Lanka.Materials and Methods. Data of newly diagnosed patients with bladder cancer in a tertiary referral centre from 2011 to 2014 were analysed. Data on bladder cancers diagnosed from 1993 to 2014 were obtained from previous publications and Sri Lanka Cancer Registry.Results. There were 148 patients and mean age was 65 years. Male to female ratio was 4.1 : 1. Urothelial carcinoma (UC) was found in 89.2% of patients. Muscle invasion was noted in 35% of patients compared to 48.4% two decades ago. In patients with UC, 16.5% were found to have pT1high grade tumour. It was 5.3% from 1993 to 2000. Pure squamous cell carcinoma was found in 8.1% of patients while primary or de novo carcinoma in situ (not associated with high grade pT1tumours) was seen in one patient only.Conclusions. The percentage of squamous carcinoma is higher among Sri Lankan patients while primary carcinoma in situ is a rarity. The percentage of muscle invasive disease has decreased while the percentage of pT1high grade tumours has increased during the last two decades in Sri Lanka.

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Polymorphism within the cyclin D1 gene is associated with an increased risk of carcinoma in situ in patients with superficial bladder cancer

Urology ◽

10.1016/j.urology.2004.03.001 ◽

2004 ◽

Vol 64 (1) ◽

pp. 74-78 ◽

Cited By ~ 12

Author(s):

Masaaki Ito ◽

Tomonori Habuchi ◽

Jun Watanabe ◽

Shin Higashi ◽

Hiroyuki Nishiyama ◽

...

Keyword(s):

Bladder Cancer ◽

Cyclin D1 ◽

Carcinoma In Situ ◽

Superficial Bladder Cancer ◽

Increased Risk

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ROLE OF RESTAGING TRANSURETHRAL RESECTION OF BLADDER TUMOR IN PATHOLOGICAL UPSTAGING OF NON-MUSCLE INVASIVE HIGH-GRADE UROTHELIAL BLADDER TUMORS. OUR INSTITUTE EXPERIENCE

10.36106/6901373 ◽

2021 ◽

pp. 34-35

Author(s):

Jaheer Abbas Shaik ◽

Raghuveer Pedamallu ◽

Ram Reddy. Ch ◽

Rahul Devraj ◽

Vidyasagar. S ◽

...

Keyword(s):

Bladder Cancer ◽

Transurethral Resection ◽

Carcinoma In Situ ◽

Residual Disease ◽

Residual Tumour ◽

High Grade ◽

Bladder Tumors ◽

Muscle Invasive

Background: Transurethral resection of supercial bladder tumours is well known to be gold standard management. It is evident from the literature that initial TURBT is not enough for accurate pathological staging in non-muscle invasive bladder cancer. Aim: Our study is aimed at role of restaging TURBT in detection of residual disease for pathological upstaging in these high-risk patients to plan appropriate treatment. Methods: This is a prospective study of 32 patients with initially diagnosed Ta/T1 high-grade bladder cancer who had restaging TURBT in a study by Department of urology, NIMS, Hyderabad between January 2016 and December 2018 were included. Low-grade tumors, carcinoma in situ and muscle invasive bladder tumors were excluded. Data elements collected on patient demographics, presence of residual disease, disease progression and recurrence in the follow-up period. The data was statistically analyzed using descriptive statistics by SPSS version 17. P value <=0.05 is considered as statistically signicant. Results: The mean age for patients included in the study was 60.5 years. In our study, we found that 15 out of 32 cases (47%) has been detected with residual disease ensuring that single TURBT may not been efcient with complete removal of tumor. Six out of 32 cases (19%) had upstaging and 5 out of 32 cases had concurrent carcinoma in situ leading to change in treatment. Therefore, 11 out of 32 cases (34%) has been under staged by initial TURBT were adequately staged by restaging TURBT and subjected to radical cystoprostatectomy or chemo radiotherapy, This mandates the need for restaging TURBT at 6-8 weeks interval for adequate staging and management. Upstaging on restaging TURBT was seen in 19%. The progression-free survival rate at 16 months was 25 % in patients with residual tumour and 94% in cases without residual disease. Conclusion: We conclude that restaging TURBT effectively detects residual disease, helping pathological upstaging and planning denitive treatment in non-muscle invasive high-grade bladder tumour.

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Anal condylomas: predictors of recurrence and progression to high-grade dysplasia / carcinoma in situ

10.26226/morressier.57c5383ed462b80296c9b6f6 ◽

2016 ◽

Author(s):

Armando Peixoto

Keyword(s):

Carcinoma In Situ ◽

High Grade Dysplasia ◽

High Grade ◽

Predictors Of Recurrence

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Expression of Semaphorin 3A in Malignant and Normal Bladder Tissue: Immunohistochemistry Staining and Morphometric Evaluation

Biology ◽

10.3390/biology10020109 ◽

2021 ◽

Vol 10 (2) ◽

pp. 109

Author(s):

Ilan Bejar ◽

Jacob Rubinstein ◽

Jacob Bejar ◽

Edmond Sabo ◽

Hilla K Sheffer ◽

...

Keyword(s):

Urothelial Carcinoma ◽

Carcinoma In Situ ◽

Urothelial Cancer ◽

Basal Layer ◽

Low Grade ◽

High Grade ◽

Bladder Tissue ◽

Normal Bladder ◽

Normal Bladder Tissue

Introduction: Our previous studies showed elevated levels of Semaphorin3a (Sema3A) in the urine of patients with urothelial cancer compared to healthy patients. The aim of this study was to analyze the extent of Sema3A expression in normal and malignant urothelial tissue using immune-staining microscopic and morphometric analysis. Materials and Methods: Fifty-seven paraffin-embedded bladder samples were retrieved from our pathology archive and analyzed: 14 samples of normal urothelium, 21 samples containing low-grade urothelial carcinoma, 13 samples of patients with high-grade urothelial carcinoma, 7 samples containing muscle invasive urothelial carcinoma, and 2 samples with pure urothelial carcinoma in situ. All samples were immunostained with anti Sema3A antibodies. The area of tissue stained with Sema3A and its intensity were analyzed using computerized morphometry and compared between the samples’ groups. Results: In normal bladder tissue, very light Sema3A staining was demonstrated on the mucosal basal layer and completely disappeared on the apical layer. In low-grade tumor samples, cells in the basal layer of the mucosa were also lightly stained with Sema3A, but Seama3A expression intensified upon moving apically, reaching its highest level on apical cells exfoliating to the urine. In high grade urothelial tumors, Seama3A staining was intense in the entire thickness of the mucosa. In samples containing carcinoma in situ, staining intensity was high and homogenous in all the neoplastic cells. Conclusions: Sema3A may be serve as a potential non-invasive marker of urothelial cancer.

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Intratumoral heterogeneity of surrogate molecular subtypes in urothelial carcinoma in situ of the urinary bladder: implications for prognostic stratification of high-risk non-muscle-invasive bladder cancer

Virchows Archiv ◽

10.1007/s00428-021-03054-0 ◽

2021 ◽

Author(s):

Stefan Garczyk ◽

Felix Bischoff ◽

Ursula Schneider ◽

Reinhard Golz ◽

Friedrich-Carl von Rundstedt ◽

...

Keyword(s):

Bladder Cancer ◽

High Risk ◽

Carcinoma In Situ ◽

Molecular Subtypes ◽

Smoking Status ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

Prognostic Stratification ◽

Muscle Invasive

AbstractReliable factors predicting the disease course of non-muscle-invasive bladder cancer (NMIBC) with carcinoma in situ (CIS) are unavailable. Molecular subtypes have potential for prognostic stratification of muscle-invasive bladder cancer, while their value for CIS patients is unknown. Here, the prognostic impact of both clinico-pathological parameters, including CIS focality, and immunohistochemistry-based surrogate subtypes was analyzed in a cohort of high-risk NMIBC patients with CIS. In 128 high-risk NMIBC patients with CIS, luminal (KRT20, GATA3, ERBB2) and basal (KRT5/6, KRT14) surrogate markers as well as p53 were analyzed in 213–231 biopsies. To study inter-lesional heterogeneity of CIS, marker expression in independent CIS biopsies from different bladder localizations was analyzed. Clinico-pathological parameters and surrogate subtypes were correlated with recurrence-free (RFS), progression-free (PFS), cancer-specific (CSS), and overall survival (OS). Forty-six and 30% of CIS patients exhibited a luminal-like (KRT20-positive, KRT5/6-negative) and a null phenotype (KRT20-negative, KRT5/6-negative), respectively. A basal-like subtype (KRT20-negative, KRT5/6-positive) was not observed. A significant degree of inter-lesional CIS heterogeneity was noted, reflected by 23% of patients showing a mixed subtype. Neither CIS surrogate subtype nor CIS focality was associated with patient outcome. Patient age and smoking status were the only potentially independent prognostic factors predicting RFS, PFS, OS, and PFS, respectively. In conclusion, further clarification of heterogeneity of surrogate subtypes in HR NMIBC and their prognostic value is of importance with regard to potential implementation of molecular subtyping into clinical routine. The potential prognostic usefulness of patient age and smoking status for high-risk NMIBC patients with CIS needs further validation.

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