scholarly journals New Insights into the Diagnosis, Molecular Taxonomy, and Treatment of Bladder Cancer

2021 ◽  
Vol 50 (1) ◽  
pp. 143
Author(s):  
Monika Ulamec ◽  
Jure Murgić ◽  
Luka Novosel ◽  
Miroslav Tomić ◽  
Robert Terlević ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Complex Disease ◽  
Molecular Taxonomy ◽  
Good Prognosis ◽  
Molecular Diagnostic ◽  
High Morbidity ◽  
Therapeutic Modalities ◽  
Hand Muscle ◽  
Muscle Invasive ◽  
Muscle Invasive Tumor

<p>This review aims to emphasize new insights into the diagnosis, classification, and therapy of bladder cancer (BC). Bladder cancer is a heterogeneous, complex disease on a morphological, molecular, diagnostic, and prognostic level. Cancer stage is still the most important attribute for prognosis and treatment, while early detection with optimal and rapid individual therapeutic and surveillance approach is crucial. The vast majority of patients have a superficial, non-muscle-invasive tumor associated with a good prognosis after resection and adjuvant intravesical maintenance immuno or chemotherapy if needed. On the other hand, muscle-invasive bladder cancer is a highly aggressive disease with high morbidity and mortality. However, it has become a model for oncology success over the last five years with many available targeted therapeutic modalities. Metastatic BC is now amenable to multimodal treatment combining cystectomy and neoadjuvant chemotherapy and immunotherapy and is a target for precision medicine.</p><p><strong>Conclusion</strong>. A new molecular taxonomy for bladder cancer has been proposed and provided insight into BC’s carcinogenesis, with some possible effects on therapy decisions. However, this classification is still not applicable in routine clinical practice. It opens new questions regarding the interplay between tumor genetic signature, intratumoral heterogeneity, therapy implications, and tumor progression.</p>

scholarly journals Biomarkers for Bladder Cancer Diagnosis and Surveillance: A Comprehensive Review

Diagnostics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 39 ◽  
Author(s):  
Rui Batista ◽  
Nuno Vinagre ◽  
Sara Meireles ◽  
João Vinagre ◽  
Hugo Prazeres ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Treatment Response ◽  
Cancer Diagnosis ◽  
Complex Disease ◽  
Molecular Biomarkers ◽  
Clinical Staging ◽  
Response Monitoring ◽  
High Morbidity ◽  
Non Invasive

Bladder cancer (BC) ranks as the sixth most prevalent cancer in the world, with a steady rise in its incidence and prevalence, and is accompanied by a high morbidity and mortality. BC is a complex disease with several molecular and pathological pathways, thus reflecting different behaviors depending on the clinical staging of the tumor and molecular type. Diagnosis and monitoring of BC is mainly performed by invasive tests, namely periodic cystoscopies; this procedure, although a reliable method, is highly uncomfortable for the patient and it is not exempt of comorbidities. Currently, there is no formal indication for the use of molecular biomarkers in clinical practice, even though there are several tests available. There is an imperative need for a clinical non-invasive testing for early detection, disease monitoring, and treatment response in BC. In this review, we aim to assess and compare different tests based on molecular biomarkers and evaluate their potential role as new molecules for bladder cancer diagnosis, follow-up, and treatment response monitoring.

The efficacy of trimodal chemoradiotherapy with gemcitabine and cisplatin as a bladder-preserving strategy for the treatment of muscle invasive bladder cancer: A single-arm prospective study.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 516-516
Author(s):  
Hiroaki Matsumoto ◽  
Kazuhiro Nagao ◽  
Sho Ozawa ◽  
Masahiro Samoto ◽  
Junichi Mori ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Clinical Stage ◽  
Good Prognosis ◽  
Response To Treatment ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Bladder Preservation ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Muscle Invasive

516 Background: Radical cystectomy is still the standard treatment for muscle-invasive bladder cancer (MIBC), while the patients with MIBC are not always appropriate candidates due to multiple comorbidities. We establish novel treatment strategy by trimodal treatment. Methods: The regimen was gemcitabine 300 mg/m2, and cisplatin 30mg/m2 in day 1 and concomitant irradiation 2Gy/Fr, 5 fraction per week. Irradiation was administered to whole pelvis up to 30Gy, then boost to true pelvis until total 48Gy to 54Gy. Extensive transurethral resection (TURBT) was performed and we confirmed pathological stage ≥T2. TURBT was also performed after chemoradiotherapy to evaluate the pathological response to treatment. This study was approved in our institutional review board (ID: H23-89) and the information was opened on UMIN (ID: UMIN000006363). We analyzed their treatment efficacy and survival. Results: The patients were 29 men and 9 women, median age was 76.5 y.o. and median follow up was 23 months (1 - 112). Clinical stage T2, T3, T4, N1 and N2 were 23, 10, 5, 4, 2 cases, respectively. The 2- and 5-year metastatic-free survival (MFS), bladder-recurrence free survival (bRFS), cancer-specific survival (CSS), and overall survival (OS) rates after treatment were 91.7 and 84.0%, 59.7 and 42.6%, 87.3 and 87.3%, and 87.3 and 81.8%, respectively. Salvage cystectomy was performed 3 patients and they were still alive. CR rate was 78.9% and overall response rate was 92.1%. cT stage and valiant histology was not associated with treatment response. The patients achieved CR had significant good prognosis in CSS (p=0.0149) and OS (p=0.0149) compared with non-responders. In cox hazard model, CR achievement was significant prognostic factors for OS (p =0.0015, HR 6.804e+26, 95% CI 56.94-1.631e+86). Patients were able to receive 3 to 5 cycle GC radiation and any grade 3 or more adverse event was 7 (18.4%) cases. no treatment related death was recorded. Conclusions: In selected patients, GC radiation for MIBC may provide good oncological outcomes as bladder preservation strategy.

scholarly journals Complications and Discharge after Radical Cystectomy for Older Patients with Muscle-Invasive Bladder Cancer: The ELCAPA-27 Cohort Study

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 6010
Author(s):  
Romain Geiss ◽  
Lucrezia Sebaste ◽  
Rémi Valter ◽  
Johanne Poisson ◽  
Soraya Mebarki ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Geriatric Assessment ◽  
Complication Rate ◽  
Older Patients ◽  
Univariate Analysis ◽  
Invasive Bladder Cancer ◽  
High Morbidity ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

Radical cystectomy is the standard of care for localized bladder cancer but is associated with high morbidity and mortality rates—especially among older patients with comorbidities. The association between geriatric assessment parameters on post-operative complications and discharge has not previously been investigated. The present analysis of the Elderly Cancer Patient (ELCAPA) prospective cohort included all patients aged ≥70 having undergone a geriatric assessment and then radical cystectomy for localized muscle-invasive bladder cancer between 2007 and 2018. The primary endpoint was the proportion of patients with one or more complications in the first 30 days after cystectomy. The secondary endpoints were the length of hospital stay (LOS), the 30-day mortality, and discharge rates. Sixty-two patients (median age: 81; range: 79–83.8) were included. The 30-day complication rate was 73%, and 49% of the patients had experienced a major complication, according to the Clavien-Dindo classification. The 30-day mortality rate was 4%. None of the geriatric, oncological, or laboratory parameters were significantly associated with the occurrence or severity of complications. The median (interquartile range) LOS was 18 days (15–23) overall and was longer in patients with complications (19 days vs. 15 days in those without complications; p = 0.013). Thirty days after cystectomy, 25 patients (53%) had been discharged to home and 22 (47%) were still in a rehabilitation unit. In a univariate analysis, a Geriatric-8 score ≤14, a loss of one point on the Activities of Daily Living Scale, anemia, at least one grade ≥3 comorbidity on the Cumulative Illness Rating Scale-Geriatric, and an inpatient geriatric assessment were associated with a risk of not being discharged to home. In older patients having undergone a geriatric assessment, radical cystectomy is associated with a high complication rate, a longer LOS, and functional decline at 30 days.

scholarly journals Imaging and Management of Bladder Cancer

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1396
Author(s):  
Vincenzo K. Wong ◽  
Dhakshinamoorthy Ganeshan ◽  
Corey T. Jensen ◽  
Catherine E. Devine
Keyword(s):  
Bladder Cancer ◽  
Complex Disease ◽  
Checkpoint Inhibitors ◽  
Imaging Techniques ◽  
Rapid Change ◽  
The United States ◽  
Cochrane Library ◽  
Ct Urography ◽  
Advanced Imaging ◽  
Muscle Invasive

Methods: Keyword searches of Medline, PubMed, and the Cochrane Library for manuscripts published in English, and searches of references cited in selected articles to identify additional relevant papers. Abstracts sponsored by various societies including the American Urological Association (AUA), European Association of Urology (EAU), and European Society for Medical Oncology (ESMO) were also searched. Background: Bladder cancer is the sixth most common cancer in the United States, and one of the most expensive in terms of cancer care. The overwhelming majority are urothelial carcinomas, more often non-muscle invasive rather than muscle-invasive. Bladder cancer is usually diagnosed after work up for hematuria. While the workup for gross hematuria remains CT urography and cystoscopy, the workup for microscopic hematuria was recently updated in 2020 by the American Urologic Association with a more risk-based approach. Bladder cancer is confirmed and staged by transurethral resection of bladder tumor. One of the main goals in staging is determining the presence or absence of muscle invasion by tumor which has wide implications in regards to management and prognosis. CT urography is the main imaging technique in the workup of bladder cancer. There is growing interest in advanced imaging techniques such as multiparametric MRI for local staging, as well as standardized imaging and reporting system with the recently created Vesicle Imaging Reporting and Data System (VI-RADS). Therapies for bladder cancer are rapidly evolving with immune checkpoint inhibitors, particularly programmed death ligand 1 (PD-L1) and programmed cell death protein 1 (PD-1) inhibitors, as well as another class of immunotherapy called an antibody-drug conjugate which consists of a cytotoxic drug conjugated to monoclonal antibodies against a specific target. Conclusion: Bladder cancer is a complex disease, and its management is evolving. Advances in therapy, understanding of the disease, and advanced imaging have ushered in a period of rapid change in the care of bladder cancer patients.

scholarly journals CARCINOMA UROTELIAL DA BEXIGA: RELATO DE CASO

2020 ◽  
Vol 12 (3) ◽  
pp. 82-85
Author(s):  
Gabriel Bandeira Santos ◽  
Felipe Iankelevich Baracat ◽  
Oscar Rubini Ávila
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Bladder Neoplasms ◽  
Kidney Injury ◽  
Disease Recurrence ◽  
Good Prognosis ◽  
Pelvic Lymphadenectomy ◽  
Common Symptom ◽  
Macroscopic Hematuria ◽  
Muscle Invasive

Among male patients, bladder cancer is the fourth most common and is rarely identified in young individuals. The most common symptom is macroscopic hematuria and the initial treatment is transurethral resection of the bladder, in which the stage and classification are identified. Smoking is known to be the main risk factor for bladder cancers. Radical cystectomy and bilateral pelvic lymphadenectomy are the “gold standard” treatment for muscle-invasive bladder cancer. Around 25% of bladder neoplasms are muscle-invasive at diagnosis, but the patients have a good prognosis with this kind of treatment. The Bricker technique is the most used for the reconstruction of the neobladder. In this paper we report the case of a male patient, 55 years old, with invasive high-grade bladder cancer, treated with a radical cystectomy, lymphadenectomy and neobladder using the Bricker technique. After the surgical procedure, the patient remained in the Intensive Care Unit for two days, presenting acute kidney injury and the need for three hemodialysis sessions. The recovery was adequate, with a good postoperative evolution. We emphasize the importance of reporting to the patient about the indispensable clinical follow-up, which must be done until medical discharge, to avoid disease recurrence and the need for more aggressive treatments, as we will see in this case.

scholarly journals PBX1 Participated in Estrogen Mediated Bladder Cancer Progression and Chemo-Resistance through Affecting Estrogen Receptors

2021 ◽  
Author(s):  
Yang Zhao ◽  
Jizhong Che ◽  
Aimin Tian ◽  
Gang Zhang ◽  
Yankai Xu ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Estrogen Receptors ◽  
Cancer Progression ◽  
Epithelial Mesenchymal Transition ◽  
High Morbidity ◽  
Promoting Effect ◽  
Mesenchymal Transition ◽  
Survival Status ◽  
Underlying Mechanisms ◽  
Muscle Invasive

Abstract Bladder cancer (BCa) is a common cancer associated with high morbidity and mortality worldwide. Pre-B-cell leukemia transcription factor 1 (PBX1) has been reported to be involved in tumor progression. The aim of the study was to explore the specific role of PBX1 in BCa and its underlying mechanisms. The relative expressions of PBX1 in muscle-invasive BCa tissues and cell lines were analyzed through RT-qPCR and Western blotting. Kaplan–Meier analysis was used to analyze the relationship between PBX1 levels and survival status. Co-immunoprecipitation (CO-IP) and chromatin immunoprecipitation (ChIP)-qPCR assay were adopted to verify the interaction between PBX1 and Estrogen receptors (ERs), and explore the ER-dependent genes transcription. The results shown that PBX1 was upregulated in invasive BCa patients and BCa cells, positively associated with tumor size, lymph node metastasis, distant metastasis and poorer survival status. Overexpression of PBX1 promoted cell growth, invasion, epithelial-mesenchymal transition (EMT) process and cisplatin resistance in BCa cells, while the silence of PBX1 showed opposite effects. Further, PBX1 interacted with Estrogen receptors (ERs) and was required for the ER function. Overexpression of PBX1 aggravated the tumor-promoting effect of estrogen on BCa cells, while partially suppressed the inhibitory effects of ER antagonist AZD9496 on BCa cells. In summary, this study revealed that PBX1 participated in estrogen mediated BCa progression and chemo-resistance through binding and activating estrogen receptors. Hence, PBX1 may serve as a potential prognostic and therapeutic target for BCa treatment.

High ORAI3 expression correlates with good prognosis in human muscle-invasive bladder cancer

Gene ◽  
2021 ◽  
pp. 145994
Author(s):  
Jing Yan ◽  
Wei Yu ◽  
Chang Lu ◽  
Chen Liu ◽  
Guoliang Wang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Good Prognosis ◽  
Human Muscle ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

scholarly journals Comprehensive Analysis of Correlations in the Expression of miRNA Genes and Immune Checkpoint Genes in Bladder Cancer Cells

2021 ◽  
Vol 22 (5) ◽  
pp. 2553
Author(s):  
Przemysław A. Stempor ◽  
Dror Avni ◽  
Raya Leibowitz ◽  
Yechezkel Sidi ◽  
Maria Stępień ◽  
...  
Keyword(s):  
Gene Expression ◽  
Bladder Cancer ◽  
Genome Instability ◽  
Expression Profiles ◽  
Personalised Medicine ◽  
Regulation Of Gene Expression ◽  
Good Prognosis ◽  
Response To Treatment ◽  
Therapeutic Modalities ◽  
Cancer Pathogenesis

Personalised medicine is the future and hope for many patients, including those with cancers. Early detection, as well as rapid, well-selected treatment, are key factors leading to a good prognosis. MicroRNA mediated gene regulation is a promising area of development for new diagnostic and therapeutic methods, crucial for better prospects for patients. Bladder cancer is a frequent neoplasm, with high lethality and lacking modern, advanced therapeutic modalities, such as immunotherapy. MicroRNAs are involved in bladder cancer pathogenesis, proliferation, control and response to treatment, which we summarise in this perspective in response to lack of recent review publications in this field. We further performed a correlation-based analysis of microRNA and gene expression data in bladder cancer (BLCA) TCGA dataset. We identified 27 microRNAs hits with opposite expression profiles to genes involved in immune response in bladder cancer, and 24 microRNAs hits with similar expression profiles. We discuss previous studies linking the functions of these microRNAs to bladder cancer and assess if they are good candidates for personalised medicine therapeutics and diagnostics. The discussed functions include regulation of gene expression, interplay with transcription factors, response to treatment, apoptosis, cell proliferation and angiogenesis, initiation and development of cancer, genome instability and tumour-associated inflammatory reaction.

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