scholarly journals Partial Cystectomy Could Be a Better Option of Bladder Preservation in T1 High-Grade Bladder Cancer Patients: A Propensity Score Matching Study

2021 ◽  
Author(s):  
Xiangpeng Zhan ◽  
Bin Fu
Keyword(s):  
Bladder Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cancer Patients ◽  
Bladder Tumor ◽  
Protective Factor ◽  
Tumor Resection ◽  
Partial Cystectomy ◽  
High Grade ◽  
Bladder Preservation

Abstract Purpose: Partial cystectomy was investigated as a method of bladder preservation with better disease outcomes than transurethral bladder tumor resection in T1 high-grade bladder cancer patients.Method and materials: The national Surveillance, Epidemiology, and End Results database（SEER） (2004-2015) was used to obtain patients diagnosed with T1 high-grade bladder cancer, and finally, 25263 patients were enrolled in our study. The Kaplan-Meier method with the log-rank test was performed to analyze the outcome of overall survival (OS) and cancer-specific survival (CSS) between patients undergoing PC, TURBT, or RC. Moreover, the propensity score matching (PSM) and multivariable Cox proportional hazard model were also utilized in the study.Results: Ultimately, 24635 patients were undergoing TURBT, while 190 and 438 patients were respectively assigned to PC and RC groups. Compared with patients with TURBT, a tendency of a higher proportion of higher older and male patients was observed in the PC group. When matching with RC patients, patients in the PC group were common older and had bigger tumor sizes and single tumor. (All P<0.05). After 1:1 PSM, 190 patients with TURBT and 160 patients receiving RC were selected. In survival analysis, the patients in the PC group had a higher survival probability of both OS and CSS before and after PSM compared with those in the TURBT group. Meanwhile, no significant differences were observed between the RC and PC groups in OS and CSS analysis. Moreover, multivariable cox regression showed that PC was a protective factor for overall mortality (OM) and cancer-specific mortality (CSM) compared with TURBT in T1 high-grade patients. (All P<0.05)Conclusion: Patients undergoing partial cystectomy were shown to have a better outcome compared to those with transurethral bladder tumor resection in T1 high-grade bladder cancer patients. Partial cystectomy was a worthwhile alternative for T1 high-grade bladder cancer.

Comparing Prognosis Associated with Partial Cystectomy and Trimodal Therapy for Muscle-Invasive Bladder Cancer Patients

2021 ◽  
pp. 1-12
Author(s):  
Quanxin Su ◽  
Shenglin Gao ◽  
Chao Lu ◽  
Xingyu Wu ◽  
Li Zuo ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Partial Cystectomy ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Cox Regression Analysis ◽  
Trimodal Therapy ◽  
Muscle Invasive ◽  
Cause Specific Survival

<b><i>Objective:</i></b> This study aimed to compare the survival outcomes between trimodal therapy (TT) and partial cystectomy (PC) in muscle-invasive bladder cancer (MIBC) patients. <b><i>Methods:</i></b> The data of 13,096 patients with MIBC diagnosed between 2004 and 2015 were retrieved from the Surveillance, Epidemiology, and End Results database. Among them, 4,041 patients underwent TT and 1,670 patients underwent PC. Propensity score matching was performed to balance the characteristics between the 2 treatment groups. A multivariate Cox regression analysis model and a competing risk model were used to evaluate overall survival (OS) and cancer-specific survival. Cumulative incidence survival curves were obtained using the Kaplan-Meier method. <b><i>Results:</i></b> Results of multivariate Cox analysis before propensity score matching showed that the TT group had a 31% reduction in cause-specific survival relative to the PC group (HR: 0.69, 95% CI: 0.61–0.78, <i>p</i> &#x3c; 0.001) and a 28% reduction in OS (HR: 0.72, 95% CI: 0.66–0.79, <i>p</i> &#x3c; 0.001). After propensity score matching, the 2 groups yielded 972 patients, with 3-year cause-specific survival rates of 54.1% and 68.5% in the TT group and the PC group, respectively. <b><i>Conclusions:</i></b> Patients who underwent PC had a better prognosis than those who received TT. In addition, for MIBC patients who required bladder-sparing therapy, advanced age (≥80 years), pathological type of squamous cell carcinoma, and tumor stage of T3–4, N2–3, and M1 were independent poor prognostic factors.

scholarly journals The Origin of Tumor DNA in Urine of Urogenital Cancer Patients: Local Shedding and Transrenal Excretion

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 535
Author(s):  
Anouk E. Hentschel ◽  
Rianne van den Helder ◽  
Nienke E. van Trommel ◽  
Annina P. van Splunter ◽  
Robert A. A. van Boerdonk ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Bladder Cancer ◽  
Cancer Patients ◽  
Liquid Biopsy ◽  
Bladder Tumor ◽  
Great Promise ◽  
Tumor Tissues ◽  
Catheter Urine ◽  
Tumor Dna ◽  
Urogenital Cancers

In urogenital cancers, urine as a liquid biopsy for non-invasive cancer detection holds great promise for future clinical application. Their anatomical position allows for the local shedding of tumor DNA, but recent data indicate that tumor DNA in urine might also result from transrenal excretion. This study aims to assess the origin of tumor-associated DNA in the urine of 5 bladder and 25 cervical cancer patients. Besides natural voided urine, paired urine samples were collected in which contact with the local tumor was circumvented to bypass local shedding. The latter concerned nephrostomy urine in bladder cancer patients, and catheter urine in cervical cancer patients. Methylation levels of GHSR, SST, and ZIC1 were determined using paired bladder tumor tissues and cervical scrapes as a reference. Urinary methylation levels were compared to natural voided urine of matched controls. To support methylation results, mutation analysis was performed in urine and tissue samples of bladder cancer patients. Increased methylation levels were not only found in natural voided urine from bladder and cervical cancer patients, but also in the corresponding nephrostomy and catheter urine. DNA mutations detected in bladder tumor tissues were also detectable in all paired natural voided urine as well as in a subset of nephrostomy urine. These results provide the first evidence that the suitability of urine as a liquid biopsy for urogenital cancers relies both on the local shedding of tumor cells and cell fragments, as well as the transrenal excretion of tumor DNA into the urine.

Impact of chemotherapy on prognosis of resectable pathological T3N0M0 esophageal cancer patients: a population-based study

2021 ◽  
Author(s):  
Xiang Gu ◽  
Yizhi Ge ◽  
Jia Liu ◽  
Qian Ding ◽  
Junfeng Chu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Propensity Score ◽  
Cell Carcinoma ◽  
Propensity Score Matching ◽  
Squamous Cell ◽  
Protective Factor ◽  
Histological Type ◽  
Propensity Score Matching Analysis ◽  
The Impact

Aims: This study aimed to retrospectively determine the influence factors and survival effects of chemotherapy in pathological T3N0M0 esophageal cancer (EC) patients based on histological type. Methods: A total of 1136 pathological T3N0M0 EC patients who had surgery were chosen from the Surveillance, Epidemiology and End Results database. The patients were divided into subgroups based on histological type and chemotherapy status. Multivariate logistic regression, log-rank test and Cox regression were used to identify prognostic risk factors and survival differences. A propensity score matching analysis was applied to adjust the covariates. The impact of additional chemotherapy was also assessed in patients who had postoperative radiotherapy. Results: The 5-year overall survival was 36.4% for all patients. Chemotherapy was an independent protective factor of survival in both adenocarcinoma and squamous cell carcinoma patients. In the survival analysis, chemotherapy significantly improved the prognosis of EC patients, both for adenocarcinoma and squamous cell carcinoma. Propensity score matching analysis validated these results. Conclusion: Chemotherapy is recommended for pathological T3N0M0 EC patients regardless of histological type.

scholarly journals Usefulness of tumor traction with a snare and endoclips in gastric submucosal tumor resection: a propensity-score-matching analysis

2020 ◽  
Author(s):  
Qiang Zhang ◽  
Jian-Qun Cai ◽  
Zhen Wang
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Operative Time ◽  
Perioperative Complications ◽  
Tumor Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Resection Rate ◽  
En Bloc ◽  
Gastric Submucosal Tumors

Abstract Background Endoscopic resection, including endoscopic submucosal dissection (ESD) and endoscopic full-thickness resection (EFR), was used to resect small gastric submucosal tumors (SMTs). Our team explored a method of tumor traction using a snare combined with endoclips to assist in the resection of SMTs. This study aims to explore the safety and effectiveness of the method. Methods This research performed a propensity-score-matching (PSM) analysis to compare ESD/EFR assisted by a snare combined with endoclips (ESD/EFR with snare traction) with conventional ESD/EFR for the resection of gastric SMTs. Comparisons were made between the two groups, including operative time, en bloc resection rate, perioperative complications, and operation-related costs. Results A total of 253 patients with gastric SMTs resected between January 2012 and March 2019 were included in this study. PSM yielded 51 matched pairs. No significant differences were identified between the two groups in perioperative complications or the costs of disposable endoscopic surgical accessories. However, the ESD/EFR-with-snare-traction group had a shorter median operative time (39 vs 60 min, P = 0.005) and lower rate of en bloc resection (88.2% vs 100%, P = 0.027). Conclusions ESD/EFR with snare traction demonstrated a higher efficiency and en bloc resection rate for gastric SMTs, with no increases in perioperative complications and the costs of endoscopic surgical accessories. Therefore, the method seems an appropriate choice for the resection of gastric SMTs.

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