Immunological Status of Bladder Cancer Patients Based on Urine Leukocyte Composition at Radical Cystectomy

Background: Bladder cancer (BC) is the ninth most common malignancy worldwide, with high rates of recurrence. The use of urine leukocyte composition at the time of radical cystectomy (RC) as a marker for the study of patients’ immunological status and to predict the recurrence of muscle-invasive bladder cancer (MIBC) has received little attention. Methods: Urine and matched peripheral blood samples were collected from 24 MIBC patients at the time of RC. Leukocyte composition and expression of PD-L1 and PD-1 in each subpopulation were determined by flow cytometry. Results: All MIBC patients had leukocytes in urine. There were different proportions of leukocyte subpopulations. The expression of PD-L1 and PD-1 on each subpopulation differed between patients. Neoadjuvant chemotherapy (NAC), smoking status, and the affectation of lymph nodes influenced urine composition. We observed a link between leukocytes in urine and blood circulation. Recurrent patients without NAC and with no affectation of lymph nodes had a higher proportion of lymphocytes, macrophages, and PD-L1+ neutrophils in urine than non-recurrent patients. Conclusions: Urine leukocyte composition may be a useful tool for analyzing the immunological status of MIBC patients. Urine cellular composition allowed us to identify a new subgroup of LN− patients with a higher risk of recurrence.

Download Full-text

Clinical characteristics of long-term recurrence free survivors after radical cystectomy with pelvic lymphadenectomy in muscle invasive bladder cancer with lymph nodes metastasis

European Urology Supplements ◽

10.1016/s1569-9056(16)30491-2 ◽

2016 ◽

Vol 15 (13) ◽

pp. e1722-e1724

Author(s):

J. Nam ◽

Y.H. Choi ◽

D.H. Lee ◽

T.N. Kim ◽

S.W. Park ◽

...

Keyword(s):

Bladder Cancer ◽

Lymph Nodes ◽

Radical Cystectomy ◽

Clinical Characteristics ◽

Pelvic Lymphadenectomy ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

Lymph Nodes Metastasis ◽

Muscle Invasive

Download Full-text

789 Adjuvant chemotherapy after radical cystectomy for muscle-invasive bladder cancer: A comparative study using inverse-probability-of-treatment weighting (IPTW)

European Urology Supplements ◽

10.1016/s1569-9056(14)60777-6 ◽

2014 ◽

Vol 13 (1) ◽

pp. e789

Author(s):

T. Kwon ◽

I.G. Jeong ◽

D. You ◽

B. Lim ◽

K-S. Han ◽

...

Keyword(s):

Bladder Cancer ◽

Adjuvant Chemotherapy ◽

Comparative Study ◽

Radical Cystectomy ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

Inverse Probability ◽

Muscle Invasive

Download Full-text

Intratumoral heterogeneity of surrogate molecular subtypes in urothelial carcinoma in situ of the urinary bladder: implications for prognostic stratification of high-risk non-muscle-invasive bladder cancer

Virchows Archiv ◽

10.1007/s00428-021-03054-0 ◽

2021 ◽

Author(s):

Stefan Garczyk ◽

Felix Bischoff ◽

Ursula Schneider ◽

Reinhard Golz ◽

Friedrich-Carl von Rundstedt ◽

...

Keyword(s):

Bladder Cancer ◽

High Risk ◽

Carcinoma In Situ ◽

Molecular Subtypes ◽

Smoking Status ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

Prognostic Stratification ◽

Muscle Invasive

AbstractReliable factors predicting the disease course of non-muscle-invasive bladder cancer (NMIBC) with carcinoma in situ (CIS) are unavailable. Molecular subtypes have potential for prognostic stratification of muscle-invasive bladder cancer, while their value for CIS patients is unknown. Here, the prognostic impact of both clinico-pathological parameters, including CIS focality, and immunohistochemistry-based surrogate subtypes was analyzed in a cohort of high-risk NMIBC patients with CIS. In 128 high-risk NMIBC patients with CIS, luminal (KRT20, GATA3, ERBB2) and basal (KRT5/6, KRT14) surrogate markers as well as p53 were analyzed in 213–231 biopsies. To study inter-lesional heterogeneity of CIS, marker expression in independent CIS biopsies from different bladder localizations was analyzed. Clinico-pathological parameters and surrogate subtypes were correlated with recurrence-free (RFS), progression-free (PFS), cancer-specific (CSS), and overall survival (OS). Forty-six and 30% of CIS patients exhibited a luminal-like (KRT20-positive, KRT5/6-negative) and a null phenotype (KRT20-negative, KRT5/6-negative), respectively. A basal-like subtype (KRT20-negative, KRT5/6-positive) was not observed. A significant degree of inter-lesional CIS heterogeneity was noted, reflected by 23% of patients showing a mixed subtype. Neither CIS surrogate subtype nor CIS focality was associated with patient outcome. Patient age and smoking status were the only potentially independent prognostic factors predicting RFS, PFS, OS, and PFS, respectively. In conclusion, further clarification of heterogeneity of surrogate subtypes in HR NMIBC and their prognostic value is of importance with regard to potential implementation of molecular subtyping into clinical routine. The potential prognostic usefulness of patient age and smoking status for high-risk NMIBC patients with CIS needs further validation.

Download Full-text