Improving Rates of Immediate Postoperative Intravesical Chemotherapy with Gemcitabine for Low-Grade Bladder Cancer: An Implementation Analysis

2021 ◽  
Author(s):  
Alexis R. Steinmetz ◽  
Jacob Gantz ◽  
Kevin Fiscella ◽  
Edward M. Messing
Keyword(s):  
Bladder Cancer ◽  
Intravesical Chemotherapy ◽  
Low Grade ◽  
Implementation Analysis

Up-Front Intravesical Chemotherapy for Low Stage, Low Grade Recurrent Bladder Cancer

1996 ◽  
pp. 91-93 ◽  
Author(s):  
Massimo Maffezzini ◽  
Alchiede Simonato ◽  
Marco Zanon ◽  
Marco Raber ◽  
Giorgio Carmignani
Keyword(s):  
Bladder Cancer ◽  
Intravesical Chemotherapy ◽  
Low Grade ◽  
Recurrent Bladder Cancer

scholarly journals Analysis of Japanese Patients Treated with or without Long-Term Epirubicin Plus Ara-C Intravesical Instillation Therapy for Low-Grade Superficial Bladder Cancer

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Tomonori Kato ◽  
Kazushi Nomura ◽  
Fukuo Kondo ◽  
Masami Wakisaka ◽  
Akira Komiya
Keyword(s):  
Bladder Cancer ◽  
Tumor Recurrence ◽  
Superficial Bladder Cancer ◽  
Transitional Cell ◽  
Japanese Patients ◽  
Intravesical Instillation ◽  
Intravesical Chemotherapy ◽  
Low Grade ◽  
Free Rate

The high incidence of tumor recurrence following transurethral resection (TUR) represents a major problem encountered in the management of bladder cancer. This study examined the efficacy of intravesical chemotherapy in superficial bladder cancer. We retrospectively analyzed 90 Japanese cases with low-grade superficial transitional cell carcinoma (stage T1, grades 1 and 2) who were rendered tumor-free by TURBT (TUR of bladder tumor) and who thereafter were treated with or without intravesical chemotherapy. Among them, instillation was terminated in 2 patients due to adverse effects (severe but reversible chemical cystitis). Remaining 88 patients were divided into 2 groups according to therapy: the TURBT-only group(n=46), defined as patients treated with TURBT alone, and the Instillation group(n=42), defined as patients treated with weekly intravesical instillation therapies using epirubicin plus Ara-C. Recurrence-free rate was significantly higher in the Instillation group than in the TURBT-only group (p=0.02, HR = 0.457). The 5-year recurrence-free rate was 58.5% for the Instillation group and 38.6% for the TURBT-only group. Our instillation schedule represents the most intensive regimen among previously reported therapies and resulted in a 54.3% decrease in incidence of tumor recurrence. We believe that the results of this study could provide useful information on management of bladder cancer.

PD12-05 IMPROVING RATES OF INTRAVESICAL CHEMOTHERAPY FOR LOW GRADE BLADDER CANCER

2020 ◽  
Vol 203 ◽  
pp. e260-e261
Author(s):  
Jacob Gantz* ◽  
Alexis Steinmetz ◽  
Thomas Osinski ◽  
Edward Messing
Keyword(s):  
Bladder Cancer ◽  
Intravesical Chemotherapy ◽  
Low Grade

scholarly journals MP73-07 INTRAVESICAL CHEMOTHERAPY FOR LOW GRADE BLADDER CANCER

2020 ◽  
Vol 203 ◽  
pp. e1123-e1124
Author(s):  
Niranjan Sathianathen ◽  
Jacob Gantz* ◽  
Fernando Alarid-Escudero ◽  
Karen Kuntz ◽  
Nathan Lawrentschuk ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Intravesical Chemotherapy ◽  
Low Grade

Up-Front Intravesical Chemotherapy for Low Stage, Low Grade Recurrent Bladder Cancer

1996 ◽  
Vol 155 (1) ◽  
pp. 91-93 ◽  
Author(s):  
Massimo Maffezzini ◽  
Alchiede Simonato ◽  
Marco Zanon ◽  
Marco Raber ◽  
Giorgio Carmignani
Keyword(s):  
Bladder Cancer ◽  
Intravesical Chemotherapy ◽  
Low Grade ◽  
Recurrent Bladder Cancer

scholarly journals A urine-based DNA methylation assay to facilitate early detection and risk stratification of bladder cancer

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Weimei Ruan ◽  
Xu Chen ◽  
Ming Huang ◽  
Hong Wang ◽  
Jiaxin Chen ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Bladder Cancer ◽  
Risk Stratification ◽  
Early Stage ◽  
Operative Risk ◽  
Low Grade ◽  
Single Center ◽  
Detection Model ◽  
Methylation Assay ◽  
Muscle Invasive

Abstract Background Current non-invasive tests have limited sensitivities and lack capabilities of pre-operative risk stratification for bladder cancer (BC) diagnosis. We aimed to develop and validate a urine-based DNA methylation assay as a clinically feasible test for improving BC detection and enabling pre-operative risk stratifications. Methods A urine-based DNA methylation assay was developed and validated by retrospective single-center studies in patients of suspected BC in Cohort 1 (n = 192) and Cohort 2 (n = 98), respectively. In addition, a prospective single-center study in hematuria patient group (Cohort 3, n = 174) was used as a second validation of the model. Results The assay with a dual-marker detection model showed 88.1% and 91.2% sensitivities, 89.7% and 85.7% specificities in validation Cohort 2 (patients of suspected BC) and Cohort 3 (patients of hematuria), respectively. Furthermore, this assay showed improved sensitivities over cytology and FISH on detecting low-grade tumor (66.7–77.8% vs. 0.0–22.2%, 0.0–22.2%), Ta tumor (83.3% vs. 22.2–41.2%, 44.4–52.9%) and non-muscle invasive BC (NMIBC) (80.0–89.7% vs. 51.5–52.0%, 59.4–72.0%) in both cohorts. The assay also had higher accuracies (88.9–95.8%) in diagnosing cases with concurrent genitourinary disorders as compared to cytology (55.6–70.8%) and FISH (72.2–77.8%). Meanwhile, the assay with a five-marker stratification model identified high-risk NMIBC and muscle invasive BC with 90.5% sensitivity and 86.8% specificity in Cohort 2. Conclusions The urine-based DNA methylation assay represents a highly sensitive and specific approach for BC early-stage detection and risk stratification. It has a potential to be used as a routine test to improve diagnosis and prognosis of BC in clinic.

scholarly journals Diagnostic Value of Telomerase Activity in Patients With Bladder Cancer: A Meta-Analysis of Diagnostic Test

2020 ◽  
Vol 10 ◽  
Author(s):  
Lei Peng ◽  
Jinze Li ◽  
Chunyang Meng ◽  
Jinming Li ◽  
Dandan Tang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Negative Likelihood Ratio ◽  
High Specificity ◽  
Diagnostic Value ◽  
Telomerase Activity ◽  
Low Grade ◽  
Potential Biomarker ◽  
Significant Difference

BackgroundThis study aimed to evaluate the diagnostic value of telomerase activity (TA) for bladder cancer (BC) by meta-analysis.MethodsWe conducted a systematic search of studies published on PubMed, Embase, and Web of Science up to June 1, 2019. We used Stata 15 and Review Manager 5.3 for calculations and statistical analysis.ResultsTo evaluate the diagnostic value of TA for BC, we performed a meta-analysis on 22 studies, with a total of 2,867 individuals, including sensitivity, specificity, positive and negative likelihood ratio (PLR, NLR), diagnostic odds ratio (DOR), and 95% confidence intervals (CIs). The pooled parameters were calculated from all studies, and we found a sensitivity of 0.79 (95% CI: 0.72–0.84), a specificity of 0.91 (95% CI: 0.87–0.94), a PLR of 8.91 (95% CI: 5.91–13.43), an NLR of 0.24 (95% CI: 0.15–0.37), a DOR of 37.90 (95% CI: 23.32–61.59), and an AUC of 0.92 (95% CI: 0.90–0.94). We also conducted a subgroup analysis based on the different stages and grades of BC. Results from the subgroup analysis showed that there was no significant difference in TA in either high and low stages of BC, but that low-grade tumors had a lower TA than high-grade tumours.ConclusionsTA can be used as a potential biomarker for the diagnosis of bladder cancer with its high specificity. Rigorous and high-quality prospective studies are required to verify our conclusion.

scholarly journals Alternating Cystoscopy with Bladder EpiCheck ® in the Surveillance of Low-Grade Intermediate-Risk NMIBC: A Cost Comparison Model

2021 ◽  
pp. 1-9
Author(s):  
Yair Lotan ◽  
Georgios Gakis ◽  
Matteo Manfredi ◽  
Juan Morote ◽  
Hugh Mostafid ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Specificity ◽  
Cancer Surveillance ◽  
European Countries ◽  
Cost Comparison ◽  
Sensitivity Analyses ◽  
Low Grade ◽  
Intermediate Risk ◽  
Tree Model ◽  
Urine Marker

BACKGROUND: Bladder cancer surveillance is invasive, intensive and costly. Patients with low grade intermediate risk non-muscle invasive bladder cancer (NMIBC) are at high risk of recurrence. OBJECTIVE: The objective of this model is to compare the cost of a strategy to alternate surveillance with cystoscopy and a urine marker, Bladder EpiCheck, to standard surveillance. METHODS: A decision tree model was built using TreeAge Pro Healthcare to compare standard surveillance (Standard) with a modified surveillance incorporating Bladder EpiCheck. The model was based on 2 years of surveillance. Outcomes were obtained from literature. Costs were obtained from US and 9 European countries. Sensitivity analyses were performed. RESULTS: The efficacy of the model was equivalent in terms of recurrence for each arm with median recurrence rate of 22%. When setting marker price at 200 local currency, the marker arm was less expensive in the USA, Netherlands, Switzerland, Belgium, Italy, Austria and UK by 154€ to 329€ per patient, for a 2-year period. Cost was higher in France, Spain, and Germany by 33–103€. Cost parity was achieved with marker price between 148€ and $421. Marker cost and specificity have the greatest impact on the overall model cost. CONCLUSIONS: A strategy alternating the urine marker Bladder EpiCheck with cystoscopy in the surveillance of patients with low grade intermediate risk bladder cancer is cost equivalent in the US and European countries when the marker is priced 148€ –$421, as a result of the marker’s high specificity (86%). Prospective studies will be necessary to validate these findings.

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