scholarly journals Recurrence and progression of non-muscle invasive bladder cancer following trans-urethral resection of bladder tumour with adjuvant intravesical chemo-immunotherapy

2020 ◽  
Vol 10 (3) ◽  
pp. 34-38
Author(s):  
Ashok Kumar Kunwar ◽  
Kabir Tiwari ◽  
Sanjesh Bhakta Shrestha ◽  
Srijana Thapa ◽  
Ashish Kumar Panthee ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Effective Treatment ◽  
Risk Group ◽  
Bladder Tumour ◽  
Low Risk ◽  
Invasive Bladder Cancer ◽  
Intermediate Risk ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

Background: Trans-urethral resection of bladder tumor is an essential diagnostic tool as well as effective treatment modality for non-muscle invasive bladder cancer. We aimed to evaluate the recurrence and progression of the non-muscle invasive bladder cancer in Nepalese patients. Methods: This was a retrospective study of 43 patients with non-muscle invasive bladder cancer, who underwent trans-urethral resection of bladder tumour followed by adjuvant intravesical instilla­tion of chemo or immunotherapy between January, 2013 to December, 2018. Patients were divided into low, intermediate and high-risk groups according to the clinical and pathological factors used by the European Organization for Research and Treatment of Cancer scoring system. Outcomes were calculated in terms of recurrence and progression in each group. Results: Out of 43 patients, 11 (25.58%) patients had low risk, 18 (41.86%) patients had intermediate risk and 14 (32.56%) patients had high risk of recurrence categories. No recurrence and progression of the disease noted in low risk group. In the intermediate risk group, out of 18 patients, 4 (22.2%) patients developed recurrence and 2 (11.1%) patients had progression of disease. In high risk group, out of 14 patients, 4 (26.8%) patients developed recurrence and 2 (14%) patients developed progres­sion of the disease. Conclusions: Even in a low volume centre of bladder cancer, effective treatment for non-muscle inva­sive bladder cancer with trans-urethral resection of bladder tumour followed by adjuvant intravesical chemo or immunotherapy can be given safely to reduce recurrence and progression of the disease.

scholarly journals Systematic analysis of gene expression profiles reveals prognostic stratification and underlying mechanisms for muscle-invasive bladder cancer

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ping-Bao Zhang ◽  
Zi-Li Huang ◽  
Yong-Hua Xu ◽  
Jin Huang ◽  
Xin-Yu Huang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Risk Prediction ◽  
Risk Group ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Gene Signatures ◽  
Muscle Invasive ◽  
Multiple Drugs ◽  
Worse Prognosis

Abstract Background Muscle-invasive bladder cancer (MIBC) is originated in the muscle wall of the bladder, and is the ninth most common malignancy worldwide. However, there are no reliable, accurate and robust gene signatures for MIBC prognosis prediction, which is of the importance in assisting oncologists to make a more accurate evaluation in clinical practice. Methods This study used univariable and multivariable Cox regression models to select gene signatures and build risk prediction model, respectively. The t-test and fold change methods were used to perform the differential expression analysis. The hypergeometric test was used to test the enrichment of the differentially expressed genes in GO terms or KEGG pathways. Results In the present study, we identified three prognostic genes, KLK6, TNS1, and TRIM56, as the best subset of genes for muscle-invasive bladder cancer (MIBC) risk prediction. The validation of this stratification method on two datasets demonstrated that the stratified patients exhibited significant difference in overall survival, and our stratification was superior to three other stratifications. Consistently, the high-risk group exhibited worse prognosis than low-risk group in samples with and without lymph node metastasis, distant metastasis, and radiation treatment. Moreover, the upregulated genes in high-risk MIBC were significantly enriched in several cancer-related pathways. Notably, PDGFRB, a receptor for platelet-derived growth factor of PI3K-Akt signaling pathway, and TUBA1A were identified as two targets of multiple drugs. In addition, the angiogenesis-related genes, as well as two marker genes of M2 macrophage, CD163 and MRC1, were highly upregulated in high-risk MIBC. Conclusions In summary, this study investigated the underlying molecular mechanism and potential therapeutic targets associated with worse prognosis of high-risk MIBC, which could improve our understanding of progression of MIBC and provide new therapeutic strategies for the MIBC patients.

scholarly journals Advancements in Intravesical Chemotherapy in Non-Muscle Invasive Bladder cancer

2021 ◽  
Author(s):  
Ankur Mittal ◽  
Vikas Kumar Panwar ◽  
Gurpremjit Singh
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Low Risk ◽  
Intravesical Chemotherapy ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Risk Patients ◽  
Bcg Failure ◽  
Significant Stage ◽  
Muscle Invasive

The treatment for non-muscle-invasive bladder cancer is transurethral resection of bladder cancer followed by intravesical chemotherapy or BCG. There have been various advancements in low risk, intermediate risk, high risk, and BCG failure cases of non-muscle invasive bladder cancer. There has been increased research on hyperthermia and intravesical chemotherapy, new agents like apaziquone, use of gemcitabine in low-risk cases, and combination chemotherapy in cases of BCG failure. Combining docetaxel and gemcitabine has taken a significant stage because of BCG shortage in some parts of the world. This chapter will discuss the latest advancements in intravesical chemotherapy in low, intermediate, and high-risk patients.

scholarly journals A Novel Immune-Gene Pair Signature Revealing the Tumor Microenvironment Features and Immunotherapy Prognosis of Muscle-Invasive Bladder Cancer

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaonan Zheng ◽  
Xianghong Zhou ◽  
Hang Xu ◽  
Di Jin ◽  
Lu Yang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Gene Pair ◽  
Risk Group ◽  
Low Risk ◽  
Survival Outcomes ◽  
Related Gene ◽  
Muscle Invasive Bladder Cancer ◽  
Immune Related Gene ◽  
Muscle Invasive

Immunotherapy has been a milestone for muscle-invasive bladder cancer (MIBC), but only a small portion of patients can benefit from it. Therefore, it is crucial to develop a robust individualized immune-related signature of MIBC to identify patients potentially benefiting from immunotherapy. The current study identified patients from the Cancer Genome Atlas (TCGA) and immune genes from the ImmPort database, and used improved data analytical methods to build up a 45 immune-related gene pair signature, which could classify patients into high-risk and low-risk groups. The signature was then independently validated by a Gene Expression Omnibus (GEO) dataset and IMvigor210 data. The subsequent analysis confirmed the worse survival outcomes of the high-risk group in both training (p < 0.001) and validation cohorts (p = 0.018). A signature-based risk score was proven to be an independent risk factor of overall survival (p < 0.001) and could predict superior clinical net benefit compared to other clinical factors. The CIBERSORT algorithm revealed the low-risk group had increased CD8+ T cells plus memory-activated CD4+ T-cell infiltration. The low-risk group also had higher expression of PDCD1 (PD-1), CD40, and CD27, and lower expression of CD276 (B7-H3) and PDCD1LG2 (PD-L2). Importantly, IMvigor210 data indicated that the low-risk group had higher percentage of “inflamed” phenotype plus less “desert” phenotype, and the survival outcomes were significantly better for low-risk patients after immunotherapy (p = 0.014). In conclusion, we proposed a novel and promising prognostic immune-related gene pair (IRGP) signature of MIBC, which could provide us a panoramic view of the tumor immune microenvironment of MIBC and independently identify MIBC patients who might benefit from immunotherapy.

scholarly journals Significance of mutations in FGFR3, PIK3CA, TERT and TP53 genes in assessing the prognosis of non-muscle invasive bladder cancer

2020 ◽  
pp. 68-69
Author(s):  
Д.С. Михайленко ◽  
И.Н. Заборский ◽  
С.А. Сергиенко ◽  
К.Н. Сафиуллин ◽  
Е.Б. Кузнецова ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Disease Progression ◽  
Tumor Grade ◽  
Risk Groups ◽  
Invasive Bladder Cancer ◽  
Intermediate Risk ◽  
Muscle Invasive Bladder Cancer ◽  
Tp53 Mutations ◽  
Muscle Invasive

Имеющиеся сейчас прогностические классификаторы не всегда могут четко выделить группы низкого и высокого риска прогрессии рака мочевого пузыря (РМП). Нами проведен анализ мутаций FGFR3, PIK3CA, TERT и TP53 у 101 пациента с РМП. Показана обратная корреляция мутаций FGFR3, PIK3CA и/или TERT и прямая - ТР53 с увеличением злокачественности опухоли; до 25% пациентов в группах низкого и промежуточного риска немышечно-инвазивного РМП могут иметь мутации, ассоциированные с прогрессией заболевания. Сurrently available prognostic classifications cannot clearly identify the cases of low and high risk of bladder cancer (BC) progression. We have analyzed the FGFR3, PIK3CA, TERT, and TP53 mutations in 101 BC patients. The correlation of TP53 mutations and absence of mutations in FGFR3, PIK3CA and/or TERT with tumor grade was observed; up to 25% of non-muscle invasive BC cases in low and intermediate risk groups harbor the mutations associated with the disease progression.

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