Perioperative chemotherapy for muscle-invasive urothelial carcinoma of the bladder

2015 ◽  
pp. 142-156
Author(s):  
Guilherme Godoy ◽  
Guru Sonpavde
Keyword(s):  
Urothelial Carcinoma ◽  
Perioperative Chemotherapy ◽  
Carcinoma Of The Bladder ◽  
Muscle Invasive

Extensive lymph node dissection in the era of increasing perioperative chemotherapy for muscle-invasive urothelial carcinoma of the bladder.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15018-e15018
Author(s):  
Dara Denise Holder ◽  
James Lin ◽  
Micheal Whalen ◽  
James M. McKiernan ◽  
Guarionex DeCastro
Keyword(s):  
Lymph Node ◽  
Urothelial Carcinoma ◽  
Lymph Node Dissection ◽  
Perioperative Chemotherapy ◽  
Node Dissection ◽  
Risk Of Death ◽  
Kaplan Meier ◽  
Nodal Yield ◽  
Carcinoma Of The Bladder ◽  
Muscle Invasive

e15018 Background: The efficacy of perioperative chemotherapy (CHT) in the management of muscle invasive urothelial carcinoma of the bladder (UCB) has been attributed to its ability to eliminate occult disease, which when coupled with a cystectomy can reduce recurrence. The therapeutic role of lymphadenctomy (LND), with an appropriate template and nodal yield, during radical cystectomy (RC) is well established. To date, there have been no studies examining the integrative effect of an extended LND and the use of perioperative CHT for patients with muscle-invasive UCB. As such we examined the interaction between survival and extent of LND based on whether patients received perioperative CHT or RC only. Methods: Review of our urologic oncology database yielded 314 patients with cT2-4N0M0 UCB who underwent RC with and without perioperative CHT between 1990- 2011. Extended lymph node dissection was defined as the removal of ≥11 nodes. Clinical and pathological variables were analyzed using Cox Hazard and Kaplan Meier models. The primary endpoints examined were overall (OS) and disease-specific (DSS) survival. Results: Two hundred and four (65%) patients were identified who underwent RC only, while 110 (35%) patients received perioperative CHT and RC. There was no significant difference between the 2 groups in common demographic and pathologic variables. Fifty-one percent of patients who underwent CHT and RC and 42% who underwent a RC only had an extensive LND (p=0.16), with a mean nodal yield of 9. Extended LND was associated with a non-significant decreased risk of death in the RC-only group (HR=0.54, CI: 0.23-1.20, p=0.14), and a non-significant increase in patients who underwent perioperative CHT (HR=1.25, CI: 0.71-2.81, p=0.56). Kaplan Meier analysis showed an increase in the probability of DSS at 2 years in the RC-only group who underwent an extended LND vs. a standard LND (0.96 vs. 0.84, p= 0.12) while no such trend was observed in the perioperative CHT patients (0.75 vs. 0.75, p=0.35). Conclusions: Surgical management of occult micrometastatic disease through extended LND improves survival in patients undergoing RC only, but offers no additional benefit over perioperative CHT.

MP65-11 MUCIN 16 IS A MUTATIONAL HOTSPOT FOR NON-MUSCLE INVASIVE UROTHELIAL CARCINOMA OF THE BLADDER

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Sumeet Syan-Bhanvadia ◽  
Christopher Duymich ◽  
Yong June Kim ◽  
Jessica Charlet ◽  
Hung-Yoon Yoon ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Carcinoma Of The Bladder ◽  
Muscle Invasive

scholarly journals Comparative Cancer Cell Signaling in Muscle-Invasive Urothelial Carcinoma of the Bladder in Dogs and Humans

Biomedicines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1472
Author(s):  
Maria Malvina Tsamouri ◽  
Thomas M. Steele ◽  
Maria Mudryj ◽  
Michael S. Kent ◽  
Paramita M. Ghosh
Keyword(s):  
Urothelial Carcinoma ◽  
Human Cancer ◽  
Clinical Signs ◽  
Common Type ◽  
Diagnostic Biomarkers ◽  
Naturally Occurring ◽  
Carcinoma Of The Bladder ◽  
Muscle Invasive ◽  
Cancer Cell Signaling

Muscle-invasive urothelial carcinoma (MIUC) is the most common type of bladder malignancy in humans, but also in dogs that represent a naturally occurring model for this disease. Dogs are immunocompetent animals that share risk factors, pathophysiological features, clinical signs and response to chemotherapeutics with human cancer patients. This review summarizes the fundamental pathways for canine MIUC initiation, progression, and metastasis, emerging therapeutic targets and mechanisms of drug resistance, and proposes new opportunities for potential prognostic and diagnostic biomarkers and therapeutics. Identifying similarities and differences between cancer signaling in dogs and humans is of utmost importance for the efficient translation of in vitro research to successful clinical trials for both species.

scholarly journals Recurrence and upstaging rates of T1 high-grade urothelial carcinoma of the bladder on repeat resection in a Canadian, resource-limited, healthcare system

2018 ◽  
Vol 12 (8) ◽  
Author(s):  
Adam Kinnaird ◽  
Peter Dromparis ◽  
Howard Evans
Keyword(s):  
Urothelial Carcinoma ◽  
Healthcare System ◽  
Bladder Tumour ◽  
Muscularis Propria ◽  
High Grade ◽  
Recurrence Rates ◽  
Repeat Resection ◽  
Resource Limited ◽  
Carcinoma Of The Bladder ◽  
Muscle Invasive

Introduction: Non-muscle-invasive bladder cancer is the most expensive malignancy to treat. Current Canadian guidelines recommend repeat transurethral resection of bladder tumour (TURBT) within six weeks after initial resection of T1 high-grade (T1HG) urothelial carcinoma, prior to initiation of intravesical bacillus Calmette- Guerin treatment. This is a burden on operating room usage and adds further cost and risk of complications. Internationally, major cancer centres report significant rates of recurrence and upstaging on repeat resection, however, minimal Canadian data is available. We aimed to determine the rate of recurrence and upstaging in a resource-limited, Canadian healthcare system.Methods: A retrospective review of patients receiving TURBT between November 2009 and November 2014 was performed. Patients were included if they had all three of the following: a pathological diagnosis of T1HG, adequate muscularis propria present in the specimen, and a repeat resection.Results: We reviewed 3166 patients who underwent TURBT and found 173 to meet our inclusion criteria. The overall recurrence and upstaging rates were 57.2% and 9.2%, respectively. Tumour recurrence and upstaging occurred more often in patients who had repeat resection after 12‒24 weeks compared to those patients whose repeat resection occurred within 12 weeks.Conclusions: Although recurrence rates are similar, we have found upstaging rates to be three- to four-fold lower than those previously reported. Despite this, one in 10 patients will be upstaged, justifying use of this resource within our healthcare system. Finally, timely repeat resection, within 12 weeks appears to be associated with preventing disease progression.

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