scholarly journals Current and innovative approaches in the treatment of non-muscle invasive bladder cancer: the role of transurethral resection of bladder tumor and organoids

2020 ◽  
Vol 54 (2) ◽  
pp. 135-143
Author(s):  
Milena Taskovska ◽  
Mateja Erdani Kreft ◽  
Tomaz Smrkolj
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Cell Biology ◽  
New Technologies ◽  
Personalised Medicine ◽  
Bladder Tumour ◽  
Golden Standard ◽  
Oncological Results ◽  
Muscle Invasive ◽  
Urologic Cancers

AbstractBackgroundBladder cancer is the 7th most common cancer in men. About 75% of all bladder cancer are non-muscle invasive (NMIBC). The golden standard for definite diagnosis and first-line treatment of NMIBC is transurethral resection of bladder tumour (TURB). Historically, the monopolar current was used first, today bipolar current is preferred by most urologists. Following TURB, depending on the tumour grade, additional intravesical chemo- or/and immunotherapy is indicated, in order to prevent recurrence and need for surgical resection. Development of new technologies, molecular and cell biology, enabled scientists to develop organoids – systems of human cells that are cultivated in the laboratory and have characteristics of the tissue from which they were harvested. In the field of urologic cancers, the organoids are used mainly for studying the course of different diseases, however, in the field of bladder cancer the data are scarce.ConclusionsDifferent currents - monopolar and bipolar, have different effect on urothelium, that is important for oncological results and pathohistological interpretation. Specimens of bladder cancer can be used for preparation of organoids that are further used for studying carcinogenesis. Bladder organoids are step towards personalised medicine, especially for testing effectiveness of chemo-/immunotherapeutics.

scholarly journals Evaluation of Second-Look Transurethral Resection in Re-Staging of Patients With Superficial Bladder Cancer

2020 ◽  
Vol 18 (1) ◽  
pp. 16-22
Author(s):  
Md Masud Zaman ◽  
Md Sajid Hasan ◽  
Golam Mowla Chowdhury ◽  
Md Shafiqur Rahman ◽  
AKM Mahbubur Rahman
Keyword(s):  
Risk Factors ◽  
Bladder Cancer ◽  
Transurethral Resection ◽  
Treatment Strategy ◽  
Superficial Bladder Cancer ◽  
Bladder Tumour ◽  
Malignant Tissue ◽  
Second Look ◽  
Muscle Invasive ◽  
Initial Resection

Objective: The Objective of this study was to evaluate the second-look transurethral resection (TUR) from the base of the previously resected bladder tumour in avoidance of staging errors, possibility of changing treatment strategy, and determination of risk factors of up-staging in patients with a diagnosis of superficial bladder cancer. Materials and Methods: In this cross sectional study, 50 cases of superficial bladder cancers (pTa and pT1) were included where muscle coat were absent in histopathologic report of first TURBT. A second-look TUR from the tumour site were done after 4 weeks following the initial resection. At the second-look TUR, resection from the base of the previously resected area was performed for restaging. Finally, histopathologic findings of the second TURBT were compared with those of the initial one by appropriate statistical analysis. Results: Out of 50 patients, 27 (54%) had residual malignant tissue in histopathological report of second-look TUR, while 23 (46%) were tumour free (no residual malignant tissue) at second-look TUR. In this study, total up-staging of tumour found in 18 (36%) patients. Out of them, 6 (12%) and 2(4%) patients were up-staged from pTa to pT1 and PT2 respectively. 10 (20%) were up-staged from PT1 to muscle-invasive (pT2). So, total percentage of staging errors (under staging) detected in second-look TUR was 36% cases. Appearance (sessile), size (>3 cm) and stage (pT1) of the tumour at the initial resection were independent risk factors for up-staging to muscle invasive disease detected at second-look TURBT. Conclusions: Second-look TURBT is a valuable procedure for detection of residual tumour and accurate staging of non-muscle invasive bladder tumour. It also changed the treatment strategy of a significant proportion of patients. It is useful for tumours at high risk of recurrence and progression such as large size, sessile, multiple and T1 high grade tumours, particularly when there is inadequate or no muscularis propria in the specimen. Bangladesh Journal of Urology, Vol. 18, No. 1, Jan 2015 p.16-22

Can urologists accurately stage and grade urothelial bladder cancer by assessing endoscopic photographs?

2017 ◽  
Vol 24 (9) ◽  
pp. 603-607 ◽  
Author(s):  
Snir Dekalo ◽  
Haim Matzkin ◽  
Nicola J Mabjeesh
Keyword(s):  
Bladder Cancer ◽  
Sensitivity And Specificity ◽  
Transurethral Resection ◽  
Bladder Tumour ◽  
Intravesical Therapy ◽  
Low Grade ◽  
Tumour Stage ◽  
Urothelial Bladder Cancer ◽  
Urothelial Bladder ◽  
Muscle Invasive

Introduction Assessment of urothelial bladder cancer during cystoscopy or transurethral resection of bladder tumour has a significant impact on the urologist's decision-making: treatment with simple outpatient fulguration, required depth of resection, and need of immediate post-surgical intravesical therapy. These choices depend heavily on the urologist's ability to accurately assess pre-biopsy tumour stage and grade. The aim of the study was to determine whether evaluation of photographs taken during transurethral resection of bladder tumour can reliably characterize a tumour’s stage and grade. Methods Smartphone photographs of 50 urothelial bladder cancer cases were taken at the beginning of transurethral resection of bladder tumour and individually presented to seven senior urologists. All urologists were blinded to the final pathological report and to any other urological evaluation. Each one was asked to rate the tumour as low vs high grade and noninvasive Ta vs noninvasive T1 or muscle invasive. Results were compared with final pathology. Individual appraisal and the majority's opinion were evaluated. Results Urologists have correctly predicted tumour stage and grade in 63.5% of cases (222 of 350, average of 32 out of 50 accurate assessments). The final majority assessment was correct in 40 of 50 cases (80%). Sensitivity and specificity of the final results for the diagnosis of T1 or higher were 80% and 88.6%, respectively. Sensitivity and specificity for Ta low grade were 83.3% and 80%, respectively. Conclusions To the best of our knowledge, this is the first documented attempt to evaluate urologists' ability to assess urothelial bladder cancer stage and grade using endoscopic photographs. Urologists can usually identify stage and grade of urothelial bladder cancer but accuracy increases when multiple senior urologists examine the same photographs and achieve majority consensus. Presenting photographs of urothelial bladder cancer to a team of urologists may lead to an excellent decision regarding type and extent of surgical treatment and substantiate appropriate post-surgical management.

scholarly journals Overnight continuous saline irrigation after transurethral resection for non-muscle-invasive bladder cancer is helpful in prevention of early recurrence

2018 ◽  
Vol 12 (11) ◽  
Author(s):  
Jungmo Do ◽  
Sin Woo Lee ◽  
Seong Uk Jeh ◽  
Jeong Seok Hwa ◽  
Jae Seog Hyun ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Bladder Tumour ◽  
Early Recurrence ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Saline Irrigation ◽  
Significant Difference ◽  
Basic Characteristics ◽  
Muscle Invasive

Introduction: It has been reported that many methods prevent recurrence after transurethral resection of bladder tumour (TURBT) for non-muscle-invasive bladder cancer (NMIBC), but it has rarely been reported that overnight continuous saline irrigation is effective in preventing recurrence. The purpose of this study was to evaluate the efficacy of overnight continuous saline irrigation in preventing recurrence after TURBT.Methods: We retrospectively studied patients with NMIBC who underwent TURBT from January 2010 to May 2015 at our institution. Patients who underwent cystoscopy every 12 weeks during the first year after surgery were included. Patients with cancer stage ≥pT2, lymph node metastasis, or distant metastasis were excluded. The overnight continuous saline irrigation (OCSI) group and the no irrigation group were compared and analyzed.Results: A total of 332 patients were included in the study. There were no differences in the basic characteristics of the patients between the two groups. In the OCSI group, the recurrence-free survival rate was higher than that in the no irrigation group, indicating that there was a significant difference between the two groups (p=0.032).Conclusions: After TURBT surgery, OCSI may help prevent early recurrence of NMIBC.

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