Seminal-sparing cystectomy and ileocapsuloplasty

The aim in managing stage pT1 bladder cancer is to anticipate tumour progression when cystectomy is still curative. The concern over major life-style alterations attributed to a radical operation has largely been eliminated by the development of a “nerve-sparing” technique and bladder replacement or continent diversion. Impotence after cystectomy derives from injury to the pelvic nerve plexus that provides autonomic innervation to the corpora cavernosa. The dangerous moments of “nerve-sparing” cystectomy can be avoided by leaving both the seminal vesicles and the prostatic capsule in place. We present our series of 24 “seminal-sparing” cystectomies performed between April 1990 and April 1996 in highly selected patients with recurrent T1 bladder cancer. All the patients could achieve erections that were adequate for sexual intercourse and neither local recurrences nor distant metastases have been observed at a mean follow-up of 38 months.

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S&T-05 LONG-TERM FOLLOW-UP AFTER NEOBLADDER WITH PROSTATIC CAPSULE AND SEMINAL-SPARING CYSTECTOMY (PCSSC) FOR BLADDER CANCER

The Journal of Urology ◽

10.1016/j.juro.2016.02.2834 ◽

2016 ◽

Vol 195 (4S) ◽

Author(s):

Salvatore Siracusano ◽

Renzo Colombo ◽

Stefano Ciciliato ◽

Laura Toffoli ◽

Tommaso Silvestri ◽

...

Keyword(s):

Bladder Cancer ◽

Prostatic Capsule ◽

Long Term Follow Up

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Serum Matrix Metalloproteinase-2, -7 and -9 (MMP-2, MMP-7, MMP-9) levels as Prognostic Markers in Patients with Colorectal Cancer

Journal of Health Sciences ◽

10.17532/jhsci.2012.35 ◽

2012 ◽

Vol 2 (3) ◽

pp. 169-175

Author(s):

Elena Kostova ◽

Maja Slaninka Miceska ◽

Nikola Labacevski ◽

Krume Jakjovski ◽

Jasmina Trojacanec ◽

...

Keyword(s):

Colorectal Cancer ◽

Prognostic Markers ◽

Tumour Progression ◽

Distant Metastases ◽

Serum Levels ◽

Postoperative Treatment ◽

Matrix Metalloproteinase 2 ◽

Poor Survival ◽

Disease Staging

Introduction: Matrix metalloproteinases are produced by tumour cells, hence, they may be associated with tumour progression including invasion, migration, angiogenesis and metastasis. Finding prognostic markers to better identify patients with higher risk for poor survival would be valuable in order to customize pre- and postoperative treatment as well as to enable closer follow-up of these patients. Aim of our study was to examineMMP-2, MMP-7 and MMP-9 serum levels and correlated them with pathological data such as stage of the colorectal cancer (CRC) and outcome.Methods: The investigation included 82 patients with operable CRC without distant metastases, who had underwent blood tests in order to determine the MMP-2, MMP-7 and MMP-9 serum levels in the following time periods: preoperatively, 3, 6, 9 and 12 months postoperatively.Results: The values of the investigated MMPs decrease postoperatively and start to increase 6 month later in patients of all stages of the disease, reaching the highest value 12 month postoperatively with statistically important differences of MMP-2, MMP-7 and MMP-7 serum levels in terms of disease staging and defined points of time. Analysis of the results showed that the MMP-2 serum levels obtained 3 and 12 months postoperatively,than MMP-7 serum levels 12 months postoperatively and the MMP-9 serum levels in all analyzed points in time were in significant association with the CRC patients’outcome.Conclusion: The MMP-2, MMP-7 and especially MMP-9 serum values could be important indicators for diagnosis of the patients with CRC and for monitoring of disease progression.

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Conservative Treatment for T2-T4 Bladder Cancer with Primary Chemotherapy and Radiotherapy: A Pilot Study

Tumori Journal ◽

10.1177/030089169307900112 ◽

1993 ◽

Vol 79 (1) ◽

pp. 53-57 ◽

Cited By ~ 4

Author(s):

Giorgio Cruciani ◽

Claudio Dazzi ◽

Francesco Montanari ◽

Salvatore Voce ◽

Vincenzo Salerno ◽

...

Keyword(s):

Bladder Cancer ◽

Conservative Treatment ◽

Transitional Cell ◽

Distant Metastases ◽

Phase Iii ◽

Severe Toxicity ◽

Pelvic Radiotherapy ◽

Actuarial Survival ◽

Actuarial Survival Rate

Aims and Background After radical cystectomy, with or without pelvic radiotherapy, more than 50 % of patients affected by infiltrating bladder cancer died of distant metastases. Polychemotherapy yields 25 % complete remissions (CR) in patients with invasive transitional cell bladder carcinoma; although many concerns exist about the duration of such CR. This study was undertaken with the aim of evaluating the efficacy and safety of an integrated chemo-radio-therapeutic treatment, in order to broaden indications to a conservative surgical therapy. Methods Thirty-three consecutive patients with bladder urothelial cancer T2-T4, N0, M0, have been treated. Patients received neoadjuvant chemotherapy (rescue-M-VEC) consisted of methotrexate 30 mg/sqm plus folinic acid 15 mg after 24 h on days 1, 15, 22; vinblastine 3 mg/sqm on days 1, 15 and 22; epidoxorubicin 30 mg/sqm on day 1; cisplatin 70 mg/sqm on day 1. This cycle was repeated on day 29. After 2 cycles of rescue-M-VEC, patients underwent pelvic cobalt teletherapy 40 Gy combined with low dose cisplatin 25 mg/sqm/week. After restaging, responding patients underwent further radiation therapy (24 Gy) as booster consolidation. Results After 2 cycles of chemotherapy and pelvic radiotherapy 14/31 evaluable patients (45.2 %) achieved CR and 11/31 (35.4 %) partial remission, with an overall response rate of 80.6 % (25/31). With a median follow up of 21 months the actuarial survival rate at 24 months was equal to 79.8 %. Eleven radical cystectomies were performed, 6 of which at restaging in non responding patients and 5 during the follow up due to relapse. Of the 25 patients selected for bladder conservation, 12 (48 %) have not yet shown relapses. Three out of 31 (9.7 %) patients died of distant metastases. No severe toxicity has been observed: moreover no patient developed stomatitis after chemotherapy. Conclusions Our results seem encouraging but longer follow-up and further phase III studies need to be carried out to demonstrate the feasibility of conservative treatment in muscle infiltrating bladder cancer.

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Prostatic Capsule- and Nerve-sparing Cystectomy in Organ-confined Bladder Cancer: Preliminary Results

World Journal of Surgery ◽

10.1007/s00268-005-7852-7 ◽

2005 ◽

Vol 29 (10) ◽

pp. 1277-1281 ◽

Cited By ~ 27

Author(s):

Gianni Martis ◽

Gianluca D’Elia ◽

Massimo Diana ◽

Maurizio Ombres ◽

Bruno Mastrangeli

Keyword(s):

Bladder Cancer ◽

Nerve Sparing ◽

Preliminary Results ◽

Prostatic Capsule

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Recovery challenges faced by bladder cancer survivors after recent cystectomy and urinary diversion.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.90 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 90-90

Author(s):

Carmit K. McMullen ◽

Kim N. Danforth ◽

Marilyn L Kwan ◽

Joanna E Bulkley ◽

Maureen Cecelia O'Keeffe-Rosetti ◽

...

Keyword(s):

Bladder Cancer ◽

Cancer Survivors ◽

Medical Care ◽

Urinary Diversion ◽

Well Being ◽

Home Health ◽

Survivorship Care ◽

Bladder Replacement ◽

Patient Reported

90 Background: Bladder cancer patients who are treated with cystectomy (bladder removal) and urinary diversion (bladder replacement) experience high rates of complications and hospital readmissions, and have substantial supportive care needs. Patient-reported priorities for improving early-phase survivorship care are lacking. Methods: On the basis of focus groups and in-depth interviews with 32 bladder cancer survivors about post-operative challenges, we developed a structured question listing 16 early survivorship challenges. We asked respondents to indicate which challenges had been difficult to manage at home. The item was part of a survey mailed to members of three Kaiser Permanente regions who had undergone cystectomy and urinary diversion for bladder cancer approximately 6 months previously (N = 197). Eligible patients were identified through health plan databases and chart review. Results: The response rate to the survey was 65%. Respondents reported an average of 3 challenges. The most commonly reported challenges pertained to coordination of medical care (69%), such as confusion about follow-up care, problems obtaining medical and ostomy supplies, knowing what complications to look for and who to notify if they occur, receiving home health care, or obtaining prompt medical advice. Other problems were caring for the urinary diversion (53%); dealing with urine leaks and incontinence (49%); problems with balance, vision, and dexterity (32%); difficulty managing emotions (23%); and management of lymphedema (11%) or incisional or parastomal hernias (7%). Conclusions: More than two thirds of bladder cancer survivors who had recently undergone cystectomy and urinary diversion struggled with medical care coordination. Managing self-care, complications, and emotional well-being after this major surgery can be difficult for patients, who must also navigate a variety of supportive services, such as medical follow-up with multiple departments and providers, home health services, and wound or ostomy care. A more formal approach to discharge and better communication among patients and providers will help improve early survivorship care for this group.

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Modified M-VAC regimen in advanced bladder cancer

Urologia Journal ◽

10.1177/039156039205901s40 ◽

1992 ◽

Vol 59 (1_suppl) ◽

pp. 121-123

Author(s):

M. Ruoppolo ◽

P. Tombolini ◽

C. Bellorofonte ◽

C. Zaatar ◽

F. Beleggia ◽

...

Keyword(s):

Bladder Cancer ◽

Locally Advanced ◽

Distant Metastases ◽

External Beam Radiation ◽

External Beam ◽

Beam Radiation ◽

Advanced Bladder Cancer ◽

Neo Adjuvant Chemotherapy ◽

Antiemetic Regime

Between June 1989 and May 1991, 11 patients with locally advanced and metastatic bladder cancer were treated by modified M-VAC regimen. After four or more courses of neo-adjuvant chemotherapy, the responders underwent to enlarged cystectomy. Patient's age ranged from 37 to 63 years (average 54 years). Four patients had T3NOMO disease, four had T3-4N1–2MO stage and three distant metastases. M-VAC regimen was modified according to the following schedule: MTX 30 mg/M2 on days 1 and 15, Vinblastin 3 mg/M2 on days 2 and 15, Doxorubicin 30 mg/M2 and Cisplatin 80 mg/M2 on day 2. Cisplatin infusion was preceded and followed by 2 liters of hydration fluid. Antiemetic regime with Ondansetron and Dexamethasone was instituted. All patients were evaluated for toxicity and response and six underwent 6–18 months of follow-up. 1 patient had significant increase of serum creatinine and, another had acute anemia. We observed 7 PR (65%) and 4 stable disease. In 2 cases of lung and liver localization metastases regressed completely. In 6 cases radical cystectomy was performed only and in 4 cases external beam radiation and cystectomy were performed after the chemotherapy. At 6, 7, 12, 16 months of follow-up 4 patients had no evidence of disease.

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Transurethral Resection Of En-Bloс Muscularis Non - Invasive Bladder Cancer

The American Journal of Medical Sciences and Pharmaceutical Research ◽

10.37547/tajmspr/volume03issue06-13 ◽

2021 ◽

Vol 03 (06) ◽

pp. 82-86

Author(s):

Mirzagaleb Nigmatovich Tillashayhov ◽

◽

Elena Vladimirovna Boyko ◽

Ravshan Abdurasulovich Khashimov ◽

Nodir Mahammatkulovich Rakhimov ◽

...

Keyword(s):

Bladder Cancer ◽

Recurrence Rate ◽

Tumour Progression ◽

High Recurrence Rate ◽

High Morbidity ◽

Non Invasive ◽

Long Term Follow Up ◽

Progression Risk

The high recurrence rate of muscle noninvasive bladder cancer (BC) dictates the search for new methods of surgical treatment. The problem of bladder cancer (BC) treatment is very urgent in urology, because of high morbidity, difficulties in determining the optimal treatment tactics, necessity of long-term follow-up examinations, high recurrence rate and progression. Risk and progression criteria have been developed to identify groups of patients in need of closer follow-up, which can be quantified using risk calculators for recurrence and tumour progression. Although there are clear guidelines for the treatment of patients with bladder cancer, it is also believed that the rate of recurrence depends on the quality of the primary surgical procedure performed [1,2].

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