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Maffezzini M, Fontana V, Pacchetti A, Dotta F, Cerasuolo M, Chiappori D, Guano G, Mantica G, Terrone C. Age above 70 years and Charlson Comorbidity Index higher than 3 are associated with reduced survival probabilities after radical cystectomy for bladder cancer. Data from a contemporary series of 334 consecutive patients. ACTA ACUST UNITED AC 2021; 93:15-20. [PMID: 33754602 DOI: 10.4081/aiua.2021.1.15] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/07/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess the joint effect of age and comorbidities on clinical outcomes of radical cystectomy (RC). METHODS 334 consecutive patients undergoing open RC for bladder cancer (BC) during the years 2005-2015 were analyzed. Pre-, peri- and post-operative parameters, including age at RC (ARC) and Charlson Comorbidity Index (CCI), were evaluated. Overall and cancer-specific survivals (OS, CSS) were assessed by univariate and multivariate modelling. Furthermore, a three-knot restricted cubic spline (RCS) was fitted to survival data to detect dependency between death-rate ratio (HR) and ARC. RESULTS Median follow-up time was 3.8 years (IQR = 1.3-7.5) while median OS was 5.9 years (95%CL = 3.8-9.1). Globally, 180 patients died in our cohort (53.8%), 112 of which (62.2%) from BC and 68 patients (37.8%) for unrelated causes. After adjusting for preoperative, pathological and perioperative parameters, patients with CCI > 3 showed significantly higher death rates (HR = 1.61; p = 0.022). The highest death rate was recorded in ARC = 71-76 years (HR = 2.25; p = 0.034). After fitting an RCS to both OS and CSS rates, two overlapping nonlinear trends, with common highest risk values included in ARC = 70-75 years, were observed. CONCLUSIONS Age over 70 years and CCI > 3 were significant factors limiting the survival of RC and should both be considered when comparing current RC outcomes.
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Affiliation(s)
- Massimo Maffezzini
- Department of Urology, Ospedale Nuovo Legnano, Ospedale Fornaroli Magenta, Milano.
| | - Vincenzo Fontana
- Clinical Epidemiology Unit, IRCCS Policlinico San Martino, University of Genova.
| | - Andrea Pacchetti
- Department of Urology, IRCCS Policlinico San Martino, University of Genova.
| | - Federico Dotta
- Department of Urology, IRCCS Policlinico San Martino, University of Genova.
| | - Mattia Cerasuolo
- Department of Urology, IRCCS Policlinico San Martino, University of Genova.
| | - Davide Chiappori
- Department of Urology, IRCCS Policlinico San Martino, University of Genova.
| | - Giovanni Guano
- Department of Urology, IRCCS Policlinico San Martino, University of Genova.
| | - Guglielmo Mantica
- Department of Urology, IRCCS Policlinico San Martino, University of Genova.
| | - Carlo Terrone
- Department of Urology, IRCCS Policlinico San Martino, University of Genova.
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102
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Shepherd C, Cookson M, Shore N. The Growth of Integrated Care Models in Urology. Urol Clin North Am 2021; 48:223-232. [PMID: 33795056 DOI: 10.1016/j.ucl.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
With heightened awareness of health care outcomes and efficiencies and reimbursement-based metrics, it is ever more important that urologists consider the effects of integrated care models on physicians/staff/clinics fulfillment and patient outcomes, and whether and how to optimally implement these models within their unique practice settings. Despite growing evidence that integrating care improves outcomes, uncertainty persists regarding which approach is most efficient and achievable in terms of specialty considerations and financial resources. In this article, we discuss strategies for integrating urologic care and its impact on current and future health care delivery.
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Affiliation(s)
- Caitlin Shepherd
- University of Oklahoma, 920 Stanton L. Young Boulevard, WP 2140, Oklahoma City, OK 73104, USA.
| | - Michael Cookson
- Department of Urology, University of Oklahoma, 920 Stanton L. Young Boulevard, WP 2140, Oklahoma City, OK, USA
| | - Neal Shore
- CPI, Carolina Research Center, 823 82nd Parkway, Myrtle Beach, SC 29572, USA
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103
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Tsai TL, Kuo CC, Hsu LI, Tsai SF, Chiou HY, Chen CJ, Hsu KH, Wang SL. Association between arsenic exposure, DNA damage, and urological cancers incidence: A long-term follow-up study of residents in an arseniasis endemic area of northeastern Taiwan. CHEMOSPHERE 2021; 266:129094. [PMID: 33310355 DOI: 10.1016/j.chemosphere.2020.129094] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/17/2020] [Accepted: 11/23/2020] [Indexed: 05/09/2023]
Abstract
Arsenic is a well-established human carcinogen and is considered a health risk worldwide, especially where groundwater is consumed as drinking water. In 2018, bladder and kidney cancers were the 14th and 17th leading causes of global cancer mortality, respectively. Our aim was to investigate the association between arsenic exposure, DNA damage, and the incidence of bladder and kidney cancers. A total of 788 participants aged ≥40 years were enrolled in a prospective cohort study in Taiwan between 1991 and 1994, with follow-up between 2011 and 2014. Well-water and first-morning spot urine samples were collected between 1991 and 1994 to estimate arsenic exposure, and the baseline urinary levels of 8-Oxo-2'-deoxyguanosine (8-OHdG) and N7-methylguanine (N7-MeG) were quantified to assess DNA lesions. The Cox proportional hazard model was used to estimate the effects of arsenic exposure and DNA adduct levels on the risk of bladder or kidney cancer. Urinary arsenic species were associated with significantly increased 8-OHdG and N7-MeG after adjusting for age, sex, and cigarette smoking. Only non-statistically significant mediation effects of 8-OHdG were observed. In a fully adjusted Cox model, participants with arsenic exposure and urinary 8-OHdG levels higher than the median had a higher risk of bladder cancer (HR = 4.60, confidence interval: 1.43-14.85). Overall, the combined effects of high cumulative arsenic exposure from artesian well-water and advanced DNA damage predicted the risk of bladder cancer.
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Affiliation(s)
- Tsung-Lin Tsai
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Chin-Chi Kuo
- Kidney Institute and Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Big Data Center, China Medical University, Taichung, Taiwan
| | - Ling-I Hsu
- Taiwan Blood Services Foundation, Taipei, Taiwan
| | - Shih-Fen Tsai
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Hung-Yi Chiou
- Department of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Chien-Jen Chen
- Genomics Research Center, Academia Sinica, Taipei, Taiwan.
| | - Kuang-Hung Hsu
- Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan; Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Laboratory for Epidemiology, Department of Health Care Management and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
| | - Shu-Li Wang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Graduate Institute of Life Sciences, National Defence Medical Center, Taipei, Taiwan; Department of Safety, Health and Environmental Engineering, National United University, Miaoli, Taiwan.
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104
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Yang J, Liu X, Dai G, Qu L, Tan B, Zhu B, Qi F, Gai X, Cheng B. CircNT5E promotes the proliferation and migration of bladder cancer via sponging miR-502-5p. J Cancer 2021; 12:2430-2439. [PMID: 33758619 PMCID: PMC7974885 DOI: 10.7150/jca.53385] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/13/2021] [Indexed: 02/07/2023] Open
Abstract
Accumulating evidence suggest that circRNA RNAs (circRNAs) play important roles in tumor formation and development. circNT5E has been shown to be an oncogenic gene in several types of cancer, and the high expression of circNT5E lead to tumorigenesis and cancer progression. However, the precise role of circNT5E in bladder cancer (Bca) has not been characterized. In this study, we observed that circNT5E expression was augmented in Bca tissues compared with that in adjacent normal tissues, and its expression level was positively associated with larger tumor size and lower survival rate. Further experiments showed that suppression of circNT5E restrained the growth and metastasis of Bca cells in vitro. circNT5E was mainly distributed in the cytoplasm and it captured miR-502-5p to increase HOXC8 mRNA and protein expression. Moreover, decreased miR-502-5p obviously reversed the circNT5E silencing-mediated inhibition of Bca cell growth and migration. Thus, this study suggested that circNT5E may act as a pro-oncogene in the development and progression of Bca and it may become a useful tumor biomarker and promising therapeutic target for Bca treatment.
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Affiliation(s)
- Jinhui Yang
- Urology and Andrology Department, Shengli OilFiled Central Hospital, Dongying, 257034, Shandong, China
| | - Xiaoyun Liu
- Urology and Andrology Department, Shengli OilFiled Central Hospital, Dongying, 257034, Shandong, China
| | - Guangcheng Dai
- Department of Urology, The Second Affiliated Hospital of Soochow University, 215004, Suzhou, China
| | - Lanying Qu
- Urology and Andrology Department, Shengli OilFiled Central Hospital, Dongying, 257034, Shandong, China
| | - Bo Tan
- Urology and Andrology Department, Shengli OilFiled Central Hospital, Dongying, 257034, Shandong, China
| | - Bo Zhu
- Urology and Andrology Department, Shengli OilFiled Central Hospital, Dongying, 257034, Shandong, China
| | - Fuming Qi
- Urology and Andrology Department, Shengli OilFiled Central Hospital, Dongying, 257034, Shandong, China
| | - Xinyu Gai
- Urology and Andrology Department, Shengli OilFiled Central Hospital, Dongying, 257034, Shandong, China
| | - Bo Cheng
- Urology and Andrology Department, Shengli OilFiled Central Hospital, Dongying, 257034, Shandong, China
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105
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Guan Y, Wang B, Zhang T, Gao S, Cao Z, Zhang M, Liang C. Integrated Analysis Revealed the MicroRNA-Based Prognostic Predicting Signature for Papillary Renal Cell Carcinoma. DNA Cell Biol 2021; 40:532-542. [PMID: 33625263 DOI: 10.1089/dna.2019.5306] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Renal cell carcinoma (RCC) is one of the most frequently occurring tumors worldwide. Herein, we established a microRNA (miRNA) predicting signature to assess the prognosis of papillary-type RCC (PRCC) patients. miR-1293, miR-34a, miR-551b, miR-937, miR-299, and miR-3199-2 were used in building the overall survival (OS)-related signature, whereas miR-7156, miR-211, and miR-301b were used to construct the formula of recurrence-free survival (RFS) with the help of LASSO Cox regression analysis. The Kaplan-Meier and receiver operating characteristic curves indicated good discrimination and efficiency of the two signatures. Functional annotation for the downstream genes of the OS/RFS-related miRNAs exposed the potential mechanisms of PRCC. Notably, the multivariate analyses suggested that the two signatures were independent risk factors for PRCC patients and had better prognostic capacity than any other classifier. In addition, the nomogram indicated synthesis effects and showed better predictive performance than clinicopathologic features and our signatures. We validated the OS and RFS prediction formulas in clinical samples and met our expectations. Finally, we established two novel miRNA-based OS and RFS predicting signatures for PRCC, which are reliable tools for assessing the prognosis of PRCC patients.
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Affiliation(s)
- Yu Guan
- Department of Urology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Bijun Wang
- Department of General Surgery, and Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Tao Zhang
- Department of Pathology, Anhui Medical University, Hefei, China
| | - Sifan Gao
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zichuan Cao
- Department of General Surgery, and Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Meng Zhang
- Department of Urology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Chaozhao Liang
- Department of Urology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
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106
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Bitiņa-Barlote Ē, Plonis J, Cauce V, Vjaters E, Gardovskis J, Miklaševičs E, Nakazawa-Miklaševiča M. Bladder cancer trends in Latvia during 1990-2017: incidence, mortality, and survival rates. Cent European J Urol 2021; 74:14-23. [PMID: 33976911 PMCID: PMC8097650 DOI: 10.5173/ceju.2021.0266.r2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/15/2021] [Accepted: 01/18/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction The aim of this article was to evaluate bladder cancer (BC) incidence, mortality and survival trends in Latvia over the past 28 years. Material and methods Our study included patients diagnosed with BC between 1990 and 2017. The data were obtained from the national population-based cancer registry. Joinpoint regression analysis was used to identify points where a significant change in incidence and mortality trends occurred, accordingly with the patient’s gender and age. Relative survival (RS) was estimated by Ederer I and II methods. Results Altogether, 9589 patients with initial BC diagnosis were included in the study. The age-standardised (ASR) incidence rates (per 100,000) increased from 6.8 in 1990 to 12.5 in 2014 followed by a statistically insignificant decrease continuing up to 2017. The ASR BC mortality rates (per 100,000) also rose from 3.9 in 1990 to 4.4 in 2017. However, there was a decline in BC mortality trends in the age-group 40–59 with annual percentage change (APC) -1.1%. RS rates increased from 55.0 % in 1990–2000 to 59.0% in years 2013–2017. Conclusions This study revealed that the incidence and mortality rates have been gradually increasing over the past 28 years. The exception being cancer-specific mortality in the age group 40–59, which tends to decrease. Although the 5-year RS rates improved over the reviewed period, there is still plenty of room for improvement.
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Affiliation(s)
- Ērika Bitiņa-Barlote
- Rīga Stradiņš University, Institute of Oncology, Riga, Latvia.,Center of Urology, Pauls Stradiņš Clinical University Hospital, Riga, Latvia
| | - Juris Plonis
- Rīga Stradiņš University, Institute of Oncology, Riga, Latvia.,Center of Urology, Pauls Stradiņš Clinical University Hospital, Riga, Latvia
| | - Vinita Cauce
- Rīga Stradiņš University, Statistics Unit, Riga, Latvia
| | - Egils Vjaters
- Rīga Stradiņš University, Institute of Oncology, Riga, Latvia.,Center of Urology, Pauls Stradiņš Clinical University Hospital, Riga, Latvia
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107
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Hu X, Xiang L, He D, Zhu R, Fang J, Wang Z, Cao K. The long noncoding RNA KTN1-AS1 promotes bladder cancer tumorigenesis via KTN1 cis-activation and the consequent initiation of Rho GTPase-mediated signaling. Clin Sci (Lond) 2021; 135:555-574. [PMID: 33480975 DOI: 10.1042/cs20200908] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/07/2021] [Accepted: 01/22/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Accumulating evidence support the hypothesis that long noncoding RNAs (lncRNAs) are involved in several physiological and pathological conditions, including cancer. Here, we investigated the potential role of lncRNAs in bladder cancer. METHODS We first looked at available datasets retrieved from the TCGA database and discovered that the lncRNA KTN 1 antisense RNA 1 (KTN1-AS1) was significantly up-regulated in several cancer types including bladder cancer, but was decreased in some other tumors. Therefore, we focused our attention on KTN1-AS1. Using both in vitro and in vivo systems that allowed the modulation of KTN1-AS1 and expression of other relevant proteins, we investigated in-depth the role of KTN1-AS1 in bladder cancer (and the mechanism behind). We further investigated the potential KTN1-AS1-interacting proteins using RNA immunoprecipitation, and explored the KTN1-AS1-related epigenetic landscape (with a particular emphasis on acetylation) using chromatin immunoprecipitation (ChIP) assays. RESULTS KTN1-AS1 silencing inhibited the proliferation, invasion, and migration of bladder cancer cells, while KTN1-AS1 overexpression had the obvious opposite effects. Mechanistically, KTN1-AS1 promoted the recruitment of EP300, a histone acetyltransferase that enriched acetylation of histone H3 at lysine 27 (H3K27Ac) in the KTN1 promoter region. This epigenetic modulation contributed to the up-regulation of KTN1, which affected bladder cancer growth and progression via the regulation of Rho GTPase (RAC1, RHOA, and CDC42)-mediated signaling. CONCLUSION Overall, our data support the idea that the lncRNA KTN1-AS1 promotes bladder cancer tumorigenesis via modulation of the KTN1/Rho GTPase axis and is a promising new therapeutic target for the treatment of bladder cancer.
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Affiliation(s)
- Xueying Hu
- Department of Oncology, Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Liang Xiang
- Department of Oncology, Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Dong He
- Department of Respiratory, The Second People's Hospital of Hunan Province, Changsha 410007, China
| | - Rongrong Zhu
- Department of Oncology, Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Jianing Fang
- Department of Oncology, Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Zhanwang Wang
- Department of Oncology, Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Ke Cao
- Department of Oncology, Third Xiangya Hospital of Central South University, Changsha 410013, China
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108
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A multimodal molecular imaging approach targeting urokinase plasminogen activator receptor for the diagnosis, resection and surveillance of urothelial cell carcinoma. Eur J Cancer 2021; 146:11-20. [PMID: 33561783 DOI: 10.1016/j.ejca.2021.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/22/2020] [Accepted: 01/07/2021] [Indexed: 12/24/2022]
Abstract
With a 5-year recurrence rate of 30-78%, urothelial cell carcinoma (UCC) rates amongst the highest of all solid malignancies. Consequently, after transurethral resection, patients are subjugated to life-long endoscopic surveillance. A multimodal near-infrared (NIR) fluorescence-based imaging strategy can improve diagnosis, resection and surveillance, hence increasing quality of life. METHODS Expression of urokinase plasminogen activator receptor (uPAR) and epithelial cell adhesion molecule (EpCAM) are determined on paraffin-embedded human UCC using immunohistochemistry and on UCC cell lines by flow cytometry. MNPR-101, a humanised monoclonal antibody targeting uPAR is conjugated to IRDye800CW and binding is validated in vitro using surface plasmon resonance and cell-based binding assays. In vivo NIR fluorescence and photoacoustic three-dimensional (3D) imaging are performed with subcutaneously growing human UM-UC-3luc2 cells in BALB/c-nude mice. The translational potential is confirmed in a metastasising UM-UC-3luc2 orthotopic mouse model. Infliximab-IRDye800CW and rituximab-IRDye800CW are used as controls. RESULTS UCCs show prominent uPAR expression at the tumour-stroma interface and EpCAM on epithelial cells. uPAR and EpCAM are expressed by 6/7 and 4/7 UCC cell lines, respectively. In vitro, MNPR-101-IRDye800CW has a picomolar affinity for domain 2-3 of uPAR. In vivo fluorescence imaging with MNPR-101-IRDye800CW, specifically delineates both subcutaneous and orthotopic tumours with tumour-to-background ratios reaching as high as 6.8, differing significantly from controls (p < 0.0001). Photoacoustic 3D in depth imaging confirms the homogenous distribution of MNPR-101-IRDye800CW through the tumour. CONCLUSIONS MNPR-101-IRDye800CW is suitable for multimodal imaging of UCC, awaiting clinical translation.
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109
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Rebello RJ, Oing C, Knudsen KE, Loeb S, Johnson DC, Reiter RE, Gillessen S, Van der Kwast T, Bristow RG. Prostate cancer. Nat Rev Dis Primers 2021. [PMID: 33542230 DOI: 10.1038/s41572-020-0024.3-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2023]
Abstract
Prostate cancer is a complex disease that affects millions of men globally, predominantly in high human development index regions. Patients with localized disease at a low to intermediate risk of recurrence generally have a favourable outcome of 99% overall survival for 10 years if the disease is detected and treated at an early stage. Key genetic alterations include fusions of TMPRSS2 with ETS family genes, amplification of the MYC oncogene, deletion and/or mutation of PTEN and TP53 and, in advanced disease, amplification and/or mutation of the androgen receptor (AR). Prostate cancer is usually diagnosed by prostate biopsy prompted by a blood test to measure prostate-specific antigen levels and/or digital rectal examination. Treatment for localized disease includes active surveillance, radical prostatectomy or ablative radiotherapy as curative approaches. Men whose disease relapses after prostatectomy are treated with salvage radiotherapy and/or androgen deprivation therapy (ADT) for local relapse, or with ADT combined with chemotherapy or novel androgen signalling-targeted agents for systemic relapse. Advanced prostate cancer often progresses despite androgen ablation and is then considered castration-resistant and incurable. Current treatment options include AR-targeted agents, chemotherapy, radionuclides and the poly(ADP-ribose) inhibitor olaparib. Current research aims to improve prostate cancer detection, management and outcomes, including understanding the fundamental biology at all stages of the disease.
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Affiliation(s)
- Richard J Rebello
- Cancer Research UK Manchester Institute, University of Manchester, Manchester Cancer Research Centre, Manchester, UK
| | - Christoph Oing
- Cancer Research UK Manchester Institute, University of Manchester, Manchester Cancer Research Centre, Manchester, UK
- Department of Oncology, Haematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Centre Eppendorf, Hamburg, Germany
| | - Karen E Knudsen
- Sidney Kimmel Cancer Center at Jefferson Health and Thomas Jefferson University, Philadelphia, PA, USA
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, Manhattan, NY, USA
| | - David C Johnson
- Department of Urology, University of North Carolina, Chapel Hill, NC, USA
| | - Robert E Reiter
- Department of Urology, Jonssen Comprehensive Cancer Center UCLA, Los Angeles, CA, USA
| | | | - Theodorus Van der Kwast
- Laboratory Medicine Program, Princess Margaret Cancer Center, University Health Network, Toronto, Canada
| | - Robert G Bristow
- Cancer Research UK Manchester Institute, University of Manchester, Manchester Cancer Research Centre, Manchester, UK.
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110
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Abstract
Prostate cancer is a complex disease that affects millions of men globally, predominantly in high human development index regions. Patients with localized disease at a low to intermediate risk of recurrence generally have a favourable outcome of 99% overall survival for 10 years if the disease is detected and treated at an early stage. Key genetic alterations include fusions of TMPRSS2 with ETS family genes, amplification of the MYC oncogene, deletion and/or mutation of PTEN and TP53 and, in advanced disease, amplification and/or mutation of the androgen receptor (AR). Prostate cancer is usually diagnosed by prostate biopsy prompted by a blood test to measure prostate-specific antigen levels and/or digital rectal examination. Treatment for localized disease includes active surveillance, radical prostatectomy or ablative radiotherapy as curative approaches. Men whose disease relapses after prostatectomy are treated with salvage radiotherapy and/or androgen deprivation therapy (ADT) for local relapse, or with ADT combined with chemotherapy or novel androgen signalling-targeted agents for systemic relapse. Advanced prostate cancer often progresses despite androgen ablation and is then considered castration-resistant and incurable. Current treatment options include AR-targeted agents, chemotherapy, radionuclides and the poly(ADP-ribose) inhibitor olaparib. Current research aims to improve prostate cancer detection, management and outcomes, including understanding the fundamental biology at all stages of the disease.
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111
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Fallahi B, Khademi N, Karamzade-Ziarati N, Fard-Esfahani A, Emami-Ardekani A, Farzanefar S, Eftekhari M, Beiki D. 99mTc-PSMA SPECT/CT Versus 68Ga-PSMA PET/CT in the Evaluation of Metastatic Prostate Cancer. Clin Nucl Med 2021; 46:e68-e74. [PMID: 33234922 DOI: 10.1097/rlu.0000000000003410] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND 99mTc-prostate-specific membrane antigen (PSMA) SPECT/CT is less expensive and readily available modality compared with 68Ga-PSMA PET/CT for imaging prostate cancer (PC). The aim of this study is to compare the value of these 2 modalities in patients confirmed or suspicious to have metastatic prostate cancer. PATIENTS AND METHODS Twenty-two patients with the mean age of 66.6 ± 10.1 years were studied using 99mTc-PSMA SPECT/CT and 68Ga-PSMA PET/CT, with less than 7 days interval between the 2 imaging procedures. Whole-body PET/CT was done 60 minutes after IV injection of 185 MBq (5 mCi) of 68Ga-PSMA. 99mTc-PSMA SPECT/CT was performed 3 hours after IV injection of 555 to 740 MBq (15-20 mCi) of 99mTc-PSMA. The images of each modality were interpreted independently, and the results were compared according to patient-based as well as region-based analyses. RESULTS In patient-based evaluation, both 99mTc-PSMA SPECT/CT and 68Ga-PSMA PET/CT scans were positive in 95.45% (21/22). In region-based evaluation, 68Ga-PSMA PET/CT detected 53 regions (median of 2 regions per patient; range, 0-5), whereas 43 (median of 2 regions per patient; range, 0-5) were detected by 99mTc-PSMA SPECT/CT. Most of these differences could be explained by lower detection rate of 99mTc-PSMA SPECT/CT in prostate bed (n = 6). PET/CT detected more involved regions than SPECT/CT (P = 0.007), whereas similar frequency of extraprostatic lesions were diagnosed in both modalities (P = 0.102). Significant correlation was also demonstrated between serum prostate-specific antigen level and imaging parameters of disease extension detected by 2 modalities. CONCLUSIONS 99mTc-PSMA SPECT/CT could be a potential substitute for 68Ga-PSMA PET/CT in high-risk patients, except when evaluation of prostate bed is of major concern.
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Affiliation(s)
- Babak Fallahi
- From the Research Center for Nuclear Medicine, Shariati Hospital
| | - Niloufar Khademi
- From the Research Center for Nuclear Medicine, Shariati Hospital
| | | | | | | | - Saeed Farzanefar
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Davood Beiki
- From the Research Center for Nuclear Medicine, Shariati Hospital
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112
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Rammant E, Bultijnck R, Caperchione CM, Trinh L. The Use of Theory to Develop Physical Activity Interventions in Urological Cancer Survivors: A Narrative Review. Semin Oncol Nurs 2021; 37:151109. [PMID: 33516584 DOI: 10.1016/j.soncn.2020.151109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To summarize the current available evidence on the use of behavior change theories to explain and change physical activity behavior in urological cancer survivors. DATA SOURCES Five electronic databases including Medline, Web of Science, Embase, Cochrane, and Psych INFO and reference lists of key studies were searched between database inception and November 2020. Peer-reviewed articles on the use of behavior change theories to understand or change physical activity in urological cancer survivors were included. CONCLUSION The theory of planned behavior and the social cognitive theory were the most used theories to explain and change physical activity behavior in urological cancers, respectively. However, the use of behavior change theories in physical activity interventions for urological cancers is still low across all urological tumor groups. Planning frameworks such as the intervention mapping approach should be used to enhance the systematic use of behavior change theories during every phase of intervention development. In addition, more research is needed to identity which behavior change techniques are most effective to change physical activity behavior in urological cancer survivors. IMPLICATIONS FOR NURSING PRACTICE Nurses play a key role in the urological cancer patients' clinical pathway and should be able to motivate patients to engage in sufficient physical activity levels. Therefore, it is important that nurses understand the underlying reasons why patients (do not) engage in physical activity and which behavior change techniques are most effective in changing a patients' behavior.
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Affiliation(s)
- Elke Rammant
- Ghent University, Human Structure and Repair, Ghent, Belgium.
| | - Renée Bultijnck
- Ghent University, Human Structure and Repair, Ghent, Belgium; Research Foundation, Flanders (FWO), Brussels, Belgium
| | - Cristina M Caperchione
- Faculty of Health, Human Performance Research Centre, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Linda Trinh
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
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Zhan Y, Pan C, Zhao Y, Li J, Wu B, Bai S. Systematic Analysis of the Global, Regional and National Burden of Kidney Cancer from 1990 to 2017: Results from the Global Burden of Disease Study 2017. Eur Urol Focus 2021; 8:302-319. [PMID: 33509670 DOI: 10.1016/j.euf.2021.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/13/2020] [Accepted: 01/08/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Data on kidney cancer burden are valuable for health-related policy making. OBJECTIVE To report the results of the Global Burden of Disease 2017 study on global kidney cancer burden estimates grouped by gender, age, region, country or territory, and sociodemographic index (SDI) from 1990 to 2017. DESIGN, SETTING, AND PARTICIPANTS This study is based on the Global Burden of Disease database. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS We report here detailed estimates and temporal trends of the burden estimates of kidney cancer from 1990 to 2017, stratified by gender and age, in 195 countries and territories. We further evaluated the relationship between these estimates and the SDI, a composite indicator of income per person, years of education, and fertility as a measurement of the socioeconomic level of a country/region. The percentage change and estimated annual percentage change of incidence, mortality, and disability-adjusted life years (DALYs) were calculated to quantify temporal trends. RESULTS AND LIMITATIONS Globally, age-standardized incidence rates, age-standardized death rates, and DALYs of kidney cancer in males exhibited an increase of 0.387%/yr, 0.345%/yr, and 0.046%/yr, respectively, from 1990 to 2017. This trend was mainly due to the increase in middle and low-middle SDI quintile countries. However, in females, decreasing trends of -0.324%/yr, -0.330%/yr, and -0.669%/yr, respectively, were observed. These trends were mainly due to the decrease in high, high-middle, and middle SDI quintile countries. Study limitations included differences in data collection practices, coding systems, and quality of data sources. CONCLUSIONS The burden estimate pattern of kidney cancer trends varies widely between genders and throughout the world. Low-middle and middle SDI quintile countries face the highest burden estimates, especially for males. Efforts to increase health care investment are needed in these countries. PATIENT SUMMARY The global burden estimate of kidney cancer trends increased in males; however, it decreased in females.
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Affiliation(s)
- Yunhong Zhan
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chunyu Pan
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yueyang Zhao
- Department of Library, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bin Wu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Song Bai
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China.
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Cao J, Li J, Yang X, Li P, Yao Z, Han D, Ying L, Wang L, Tian J. Transcriptomics analysis for the identification of potential age-related genes and cells associated with three major urogenital cancers. Sci Rep 2021; 11:641. [PMID: 33436826 PMCID: PMC7803945 DOI: 10.1038/s41598-020-80065-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/16/2020] [Indexed: 02/08/2023] Open
Abstract
Age is one of the most important risk factors of the occurrence for tumor patients. The majority of patients with urogenital cancers are the elderly, whose clinical characteristics are greatly affected by age and ageing. Our study aimed to explore age-related genes, cells, and biological changes in three common urogenital cancers via integrative bioinformatics analysis. First, mRNA (count format) and clinical data for bladder cancer, prostate cancer and renal cell carcinoma were downloaded from the Cancer Genome Atlas (TCGA). Through the comparison of clinicopathological characteristics, genes expression and cells infiltration between the old group and the young group, it was found that the clinical characteristics, genes and cells in the tumor microenvironment of different ages were quite different. And 4 key cells, 14 hub genes and some potential pathways were identified and considered as important factors. More importantly, we analyzed the differential landscape of the genes and cells from different perspectives, and confirmed its importance. In conclusion, we identified genes and cell types associated with age-related changes in the tumour microenvironment in urogenital cancer patients. These genes and cell types may play a critical role in the age-associated differences in clinicopathological characteristics among urogenital cancers, thus providing a link between ageing and cancer occurrence. The findings of this study may pave the way for the development of age-tailored approaches to treat cancer and other age-related diseases.
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Affiliation(s)
- Jinlong Cao
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Urological Diseases of Gansu Provincial, Lanzhou, 730000, People's Republic of China
| | - Jianpeng Li
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Urological Diseases of Gansu Provincial, Lanzhou, 730000, People's Republic of China
| | - Xin Yang
- Reproductive Medicine Center, The Second Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Pan Li
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Urological Diseases of Gansu Provincial, Lanzhou, 730000, People's Republic of China
| | - Zhiqiang Yao
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Urological Diseases of Gansu Provincial, Lanzhou, 730000, People's Republic of China
| | - Dali Han
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Urological Diseases of Gansu Provincial, Lanzhou, 730000, People's Republic of China
| | - Lijun Ying
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Urological Diseases of Gansu Provincial, Lanzhou, 730000, People's Republic of China
| | - Lijie Wang
- Department of Gynecology, The Second Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Junqiang Tian
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China.
- Key Laboratory of Urological Diseases of Gansu Provincial, Lanzhou, 730000, People's Republic of China.
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Effectiveness of Docetaxel for Metastatic Hormone-sensitive Prostate Cancer in Clinical Practice. EUR UROL SUPPL 2021; 24:25-33. [PMID: 34337492 PMCID: PMC8317901 DOI: 10.1016/j.euros.2020.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2020] [Indexed: 12/01/2022] Open
Abstract
Background Addition of docetaxel to androgen deprivation therapy (ADT) for the treatment of metastatic hormone-sensitive prostate cancer (mHSPC) has been proved to be effective with an overall survival (OS) benefit in phase III clinical trials. The effectiveness of docetaxel with ADT in the general patient population remains unknown. Objective The purpose of this study is to report the clinical experience in mHSPC patients treated with 3rd-weekly docetaxel plus ADT in routine practice at two Danish institutions. Design, setting and participants A two-center retrospective study including consecutive mHSPC patients treated with 3rd-weekly docetaxel plus ADT was conducted. Outcome measurements and statistical analysis Outcomes of interest were OS, and biochemical and clinical progression-free survival. Results and limitations A total of 173 consecutive patients with mHSPC who received docetaxel every 3rd week plus ADT between June 2015 and February 2018 were included. Most patients had high-volume disease (85%). All six planned docetaxel cycles were delivered in 149 cases (86%). Of the patients, 106 (61%) were alive at the last follow-up. At a median follow-up of 42 (37.8–58.6) mo, the median OS was 51.6 (41.5–56.3) mo. Castration-resistant prostate cancer (CRPC) developed in 46% within 1 yr, with a median time to CRPC of 15.6 (13.0–18.1) mo. Prostate-specific antigen nadir ≤0.2 ng/l was achieved in 15% of patients after 6 mo of ADT and in 19% after 12 mo. Conclusions The effect of docetaxel for mHSPC patients treated in routine practice appears comparable with the overall efficacy reported in the literature. Selection of patients will influence the results in clinical practice and clinical studies. Patient summary In this report, we looked at the clinical effectiveness of docetaxel combined with androgen deprivation therapy in men with metastatic hormone-sensitive prostate cancer (mHSPC) in a Danish population. We found the effect of docetaxel treatment for mHSPC in the general population to be comparable with the overall efficacy reported in published studies.
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Identification of a novel immune microenvironment signature predicting survival and therapeutic options for bladder cancer. Aging (Albany NY) 2020; 13:2780-2802. [PMID: 33408272 PMCID: PMC7880321 DOI: 10.18632/aging.202327] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/15/2020] [Indexed: 12/26/2022]
Abstract
Few studies have investigated the potential of tumor immune microenvironment genes as indicators of urinary bladder cancer. Here, we sought to establish an immune-related gene signature for determining prognosis and treatment options. We developed a ten-gene tumor immune microenvironment signature and evaluated its prognostic capacity on internal and external cohorts. Multivariate Cox regression and nomogram analyses revealed the prognostic risk model as an independent and effective indicator of prognosis. We observed lower proportions of CD8+ T cells, dendritic cells, regulatory T cells, higher proportions of macrophages and neutrophils in high UBC risk group. UBC tissues with high-risk score tend to exhibit high TP53 and RB1 mutation rates, high PD1/PD-L1 expression and poor-survival basal squamous subtypes, while those with low-risk score tend to have high FGFR3 mutation rates and luminal papillary subtypes. Unexpectedly, we found a highly significant positive correlation between glycolytic genes and risk score, highlighting metabolic competition in tumor ecosystem and potential therapeutic avenues. Our study thus revealed a tumor immune microenvironment signature for predicting prognostic and response to immune checkpoint inhibitors against bladder cancer. Prospective studies are required to further test the predictive capacity of this model.
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Hypomethylation of PlncRNA-1 promoter enhances bladder cancer progression through the miR-136-5p/Smad3 axis. Cell Death Dis 2020; 11:1038. [PMID: 33288752 PMCID: PMC7721747 DOI: 10.1038/s41419-020-03240-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 02/07/2023]
Abstract
Apart from being potential prognostic biomarkers and therapeutic targets, long non-coding RNAs (lncRNAs) modulate the development and progression of multiple cancers. PlncRNA-1 is a newly discovered lncRNA that exhibits the above properties through multiple regulatory pathways. However, the clinical significance and molecular mechanisms of PlncRNA-1 in bladder cancer have not been established. PlncRNA-1 was found to be overexpressed in 71.43% of bladder cancer tissues. Moreover, the expression level correlated with tumor invasion, T stage, age, and number of tumors, but not with gender, recurrent status, preoperative treatment, pathological grade, and tumor size. The expression level of PlncRNA-1 can, to a certain extent, be used as a predictor of the degree of tumor invasion and T stage among BC patients. Inhibiting PlncRNA-1 expression impaired the proliferation, migration, and invasion of T24 and 5637 bladder cancer cells in vitro and in vivo. Specifically, PlncRNA-1 promoter in BC tissues was found to be hypomethylated at position 131 (36157603 on chromosome 21). PlncRNA-1 promoter hypomethylation induces the overexpression of PlncRNA-1. In addition, PlncRNA-1 modulated the expression of smad3 and has-miR-136-5p (miR-136). Conversely, miR-136 regulated the expression of PlncRNA-1 and smad3. PlncRNA-1 mimics competitive endogenous RNA (ceRNA) in its regulation of smad3 expression by binding miR-136. Rescue analysis further revealed that modulation of miR-136 could reverse the expression of smad3 and epithelial–mesenchymal transition (EMT) marker proteins impaired by PlncRNA-1. In summary, PlncRNA-1 has important clinical predictive values and is involved in the post-transcriptional regulation of smad3. The PlncRNA-1/miR-136/smad3 axis provides insights into the regulatory mechanism of BC, thus may serve as a potential therapeutic target and prognostic biomarker for cancer.
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118
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Ding L, Jiang M, Wang R, Shen D, Wang H, Lu Z, Zheng Q, Wang L, Xia L, Li G. The emerging role of small non-coding RNA in renal cell carcinoma. Transl Oncol 2020; 14:100974. [PMID: 33395751 PMCID: PMC7719974 DOI: 10.1016/j.tranon.2020.100974] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/14/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022] Open
Abstract
SncRNAs contribute to the progress of renal cell carcinoma. SncRNAs are promising biomarkers for diagnosis and prognosis of renal cell carcinoma. Despite the potential of sncRNA-based cancer therapy, some obstacles remain, including several severe adverse effect.
Noncoding RNAs are transcribed in the most regions of the human genome, divided into small noncoding RNAs (less than 200 nt) and long noncoding RNAs (more than 200 nt) according to their size. Compelling evidences suggest that small noncoding RNAs play critical roles in tumorigenesis and tumor progression, especially in renal cell carcinoma. MiRNA, the most famous small noncoding RNA, has been comprehensively explored for its fundamental role in cancer. And several miRNA-based therapeutic strategies have been applied to several ongoing clinical trials. However, piRNAs and tsRNAs, have not received as much research attention, because of several technological limitations. Nevertheless, some studies have revealed the presence of aberration of piRNAs and tsRNAs in renal cell carcinoma, highlighting a potentially novel mechanism for tumor onset and progression. In this review, we provide an overview of three classes of small noncoding RNA: miRNAs, piRNAs and tsRNAs, that have been reported dysregulation in renal cell carcinoma and have the potential for advancing diagnosis, prognosis and therapeutic applications of this disease.
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Affiliation(s)
- Lifeng Ding
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Minxiao Jiang
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Ruyue Wang
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Danyang Shen
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Huan Wang
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Zeyi Lu
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Qiming Zheng
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Liya Wang
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Liqun Xia
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Gonghui Li
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
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Update analysis on the association between Methionine synthase rs1805087 A/G variant and risk of prostate cancer. Sci Rep 2020; 10:13384. [PMID: 32770085 PMCID: PMC7414883 DOI: 10.1038/s41598-020-70223-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 07/24/2020] [Indexed: 12/24/2022] Open
Abstract
Previous studies have investigated the association of the rs1805087 A/G variant of Methionine synthase gene with the susceptibility to prostate cancer (PCa). Nevertheless, the conclusions remain divergent. We performed a systemic analysis with odds ratios (ORs) and 95% confidence intervals (95% CIs) to assess Methionine synthase rs1805087 A/G variant and PCa risk. Furthermore, we utilized in silico analysis to investigate the relationship between Methionine synthase expression and the overall survival (OS) time. Totally, 10,666 PCa patients and 40,750 controls were included. We observed that Methionine synthase rs1805087 A/G variant is associated with an elevated risk of PCa (G-allele vs. A-allele: OR = 1.06, 95% CI = 1.01–1.11, P = 0.013; heterozygous model: OR = 1.08, 95% CI = 1.02–1.14, P = 0.009; dominant model: OR = 1.08, 95% CI = 1.02–1.14, P = 0.007). During stratified analysis, similar results were obtained in Asian populations, hospital-based, high quality studies and that with large sample size. Moreover, in silico analysis indicated the Methionine synthase expression is down-regulated in both young and old PCa subjects (P < 0.05). Compared with the normal subjects, the down-regulated expression of Methionine synthase was found in PCa cases with Gleason score 6 to 9. Our study showed that Methionine synthase rs1805087 A/G variant may be associated with susceptibility of PCa, especially in Asian populations, hospital-based studies and that with high quality and large sample size. Furthermore, Methionine synthase rs1805087 A/G variant may be related to the prognosis of PCa.
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He H, Xie H, Chen Y, Li C, Han D, Xu F, Lyu J. Global, regional, and national burdens of bladder cancer in 2017: estimates from the 2017 global burden of disease study. BMC Public Health 2020; 20:1693. [PMID: 33176751 PMCID: PMC7659112 DOI: 10.1186/s12889-020-09835-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/04/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The aim of this study is to describe the prevalence and mortality of bladder cancer (BCa) using data obtained in the Global Burden of Disease study performed in 2017 (GBD 2017). METHODS Data on BCa for 2017, including prevalence, mortality, and disability-adjusted life years (DALYs), were obtained from GBD 2017 at the global, regional, and national levels. We also analyzed the association of BCa burden with the country development level. RESULTS There were 2.63 million BCa cases estimated from the GBD 2017 data, with 200,000 persons dying of BCa, resulting in 3.60 million DALYs in 2017. The age-standardized prevalence (ASP) of BCa was 32.91/100,000 persons, and age-standardized death rate (ASDR) was 2.57/100,000 persons. The ASP and ASDR of BCa were higher in males than in females, and higher in people older than 60 years. The ASP and ASDR of BCa were higher in Western Europe and Central Europe than in South Asia, Andean Latin America, and Central Latin America, and higher in countries with a higher sociodemographic index (SDI). Correlation analysis identified that the ASP and ASDR of BCa were positively correlated with the country SDI (P < 0.0001 and ρ = 0.68 for ASP, and P = 0.0048 and ρ = 0.20 for ASDR). In addition, 33.72% deaths and 36.80% DALYs caused by BCa could be attributed to smoking globally. CONCLUSION The prevalence and mortality of BCa were very high in 2017, especially in high-SDI countries. Smoking-cessation strategies should be strengthened to control the burden associated with BCa.
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Affiliation(s)
- Hairong He
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Hongjun Xie
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yule Chen
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Chengzhuo Li
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Didi Han
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Fengshuo Xu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Jun Lyu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China.
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Patient-derived tumour models for personalized therapeutics in urological cancers. Nat Rev Urol 2020; 18:33-45. [PMID: 33173206 DOI: 10.1038/s41585-020-00389-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2020] [Indexed: 12/24/2022]
Abstract
Preclinical knowledge of dysregulated pathways and potential biomarkers for urological cancers has undergone limited translation into the clinic. Moreover, the low approval rate of new anticancer drugs and the heterogeneous drug responses in patients indicate that current preclinical models do not always reflect the complexity of malignant disease. Patient-derived tumour models used in preclinical uro-oncology research include 3D culture systems, organotypic tissue slices and patient-derived xenograft models. Technological innovations have enabled major improvements in the capacity of these tumour models to reproduce the clinical complexity of urological cancers. Each type of patient-derived model has inherent advantages and limitations that can be exploited, either alone or in combination, to gather specific knowledge on clinical challenges and address unmet clinical needs. Nevertheless, few opportunities exist for patients with urological cancers to benefit from personalized therapeutic approaches. Clinical validation of experimental data is needed to facilitate the translation and implementation of preclinical knowledge into treatment decision making.
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Clinical Impact of Tumor-Infiltrating Lymphocytes and PD-L1-Positive Cells as Prognostic and Predictive Biomarkers in Urological Malignancies and Retroperitoneal Sarcoma. Cancers (Basel) 2020; 12:cancers12113153. [PMID: 33121123 PMCID: PMC7692684 DOI: 10.3390/cancers12113153] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/15/2020] [Accepted: 10/24/2020] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Two host-dependent biological characteristics, “avoiding immune destruction” and “tumor-promoting inflammation” have been added to cancer hallmarks in 2011. The interaction and cross-talk among tumor cells and several immune cells in a tumor microenvironment are dynamic and complex processes. The purpose of this review is to discuss the prognostic impact of tumor-infiltrating lymphocytes and predictive biomarkers for immune checkpoint inhibitors in four urological solid tumors, the urothelial carcinoma, renal cell carcinoma, prostate cancer, and retroperitoneal sarcoma, through summarizing the findings of observation studies and clinical trials. Abstract Over the past decade, an “immunotherapy tsunami”, more specifically that involving immune checkpoint inhibitors (ICIs), has overtaken the oncological field. The interaction and cross-talk among tumor cells and several immune cells in the tumor microenvironment are dynamic and complex processes. As immune contexture can vary widely across different types of primary tumors and tumor microenvironments, there is still a significant lack of clinically available definitive biomarkers to predict patient response to ICIs, especially in urogenital malignancies. An increasing body of evidence evaluating urological malignancies has proven that tumor-infiltrating lymphocytes (TILs) are a double-edged sword in cancer. There is an urgent need to shed light on the functional heterogeneity in the tumor-infiltrating immune system and to explore its prognostic impact following surgery and other treatments. Notably, we emphasized the difference in the immunological profile among urothelial carcinomas arising from different primary origins, the bladder, renal pelvis, and ureter. Significant differences in the density of FOXP3-positive TILs, CD204-positive tumor-infiltrating macrophages, PD-L1-positive cells, and colony-stimulating factors were observed. This review discusses two topics: (i) the prognostic impact of TILs and (ii) predictive biomarkers for ICIs, to shed light on lymphocyte migration in four solid tumors, the urothelial carcinoma, renal cell carcinoma, prostate cancer, and retroperitoneal sarcoma.
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Mohammadi E, Aminorroaya A, Fattahi N, Azadnajafabad S, Rezaei N, Farzi Y, Naderimagham S, Rezaei N, Larijani B, Farzadfar F. Epidemiologic pattern of cancers in Iran; current knowledge and future perspective. J Diabetes Metab Disord 2020; 20:825-829. [PMID: 34222092 DOI: 10.1007/s40200-020-00654-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/06/2020] [Indexed: 12/21/2022]
Abstract
Iran is a developing country facing demographic transition. Cancers are among the major non-communicable disorders with remarkable budern on the health-care governing systems. Extended life expectancy of Iranian population, change in living style, as well as promoted diagnostic and treatment methods have resulted into significant malignancies emergence and detection. Understanding the trend of this epidemiologic transition is required for proper allotment of resources. In this manuscript, overall epidemiologic pattern of cancers and their burden transition is reviewed. In addition, more concerning neoplasia (gastrointestinal, breast, thyroid, urologic, and respiratory system cancers) are reviewed in more details.
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Affiliation(s)
- Esmaeil Mohammadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713137 Iran
| | - Arya Aminorroaya
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713137 Iran
- Universal Scientific Education and Research Network, Tehran, Iran
| | - Nima Fattahi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713137 Iran
| | - Sina Azadnajafabad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713137 Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713137 Iran
| | - Yosef Farzi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713137 Iran
| | - Shohreh Naderimagham
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713137 Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713137 Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713137 Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Yang J, Chen J, Wu S, Fei X, Wang X, Wang K. <p>Microarray Expression Profiles and Bioinformatics Analyses Reveal Aberrant Circular RNAs Expression in Bladder Cancer</p>. Onco Targets Ther 2020; 13:10889-10899. [PMID: 33149606 PMCID: PMC7602908 DOI: 10.2147/ott.s270747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/24/2020] [Indexed: 11/23/2022] Open
Abstract
Background Increasing evidence shows that circular RNAs (circRNAs) are involved in many biological processes, functioning as microRNA (miRNA) sponges. The aim of this study is to identify differentially expressed circRNAs in bladder cancer (BCa). Methods The transcriptome of circRNAs in BCa was assayed by microarray. Quantitative real-time PCR was performed to verify the results. Then, potential miRNA response elements (MREs) between circRNAs and miRNAs were predicted. Pathway and ontology enrichment analyses were performed to identify mechanisms related to the gene regulation of differentially expressed circRNAs. Results Three hundred and eighty-six up-regulated and 394 down-regulated circRNAs were identified, and their potential MREs were predicted in BCa. Conclusion The differentially expressed circRNAs indicate that circRNAs could play important roles in the molecular pathogenesis of BCa.
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Affiliation(s)
- Jun Yang
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang110004, People’s Republic of China
| | - Junwen Chen
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang110004, People’s Republic of China
| | - Si Wu
- Department of Biobank, Shengjing Hospital of China Medical University, Shenyang110004, People’s Republic of China
| | - Xiang Fei
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang110004, People’s Republic of China
| | - Xia Wang
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang110004, People’s Republic of China
| | - Kefeng Wang
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang110004, People’s Republic of China
- Correspondence: Kefeng WangDepartment of Urology, Shengjing Hospital of China Medical University, 36# Sanhao Street, Heping District, Shenyang, Liaoning, People’s Republic of ChinaTel +86 18940254849Fax +86 24 31939077 Email
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Yee CH, Yuen-Chun J, Chan ESY. Current evidence for robotic surgery in radical cystectomy. Turk J Urol 2020; 47:S1-S8. [PMID: 32976090 DOI: 10.5152/tud.2020.20355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 08/10/2020] [Indexed: 12/18/2022]
Abstract
Robotic-assisted radical cystectomy (RARC) has been gaining momentum as an alternative to its conventional open radical cystectomy (ORC) for the management of invasive bladder cancer. Although RARC, in general, demonstrated less blood loss and shorter hospital stay than ORC, whether there is any significant difference in the overall complication rate still requires further investigation. Thus, both RARC and ORC share a similar oncology outcome, with comparable positive surgical margin rates, disease-free survival, and overall survival. Techniques of intracorporeal urinary diversion (ICUD) have not yet been standardized. ICUD may result in a lower risk of ureteroileal anastomotic stricture than extracorporeal urinary diversion (ECUD). However, ECUD is still a valid and commonly practiced option according to the available data. In general, RARC has been demonstrated to provide promising results. Long-term data and functional outcome after RARC and ICUD are needed to further validate the role of RARC in the management of bladder cancer.
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Affiliation(s)
- Chi Hang Yee
- Department of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong
| | - Jeremy Yuen-Chun
- Department of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong
| | - Eddie Shu-Yin Chan
- Department of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong
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Lundon DJ, Kelly BD, Shukla D, Bolton DM, Wiklund P, Tewari A. A Decision Aide for the Risk Stratification of GU Cancer Patients at Risk of SARS-CoV-2 Infection, COVID-19 Related Hospitalization, Intubation, and Mortality. J Clin Med 2020; 9:jcm9092799. [PMID: 32872607 PMCID: PMC7563697 DOI: 10.3390/jcm9092799] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/23/2020] [Accepted: 08/28/2020] [Indexed: 01/08/2023] Open
Abstract
Treatment decisions for both early and advanced genitourinary (GU) malignancies take into account the risk of dying from the malignancy as well as the risk of death due to other causes such as other co-morbidities. COVID-19 is a new additional and immediate risk to a patient’s morbidity and mortality and there is a need for an accurate assessment as to the potential impact on of this syndrome on GU cancer patients. The aim of this work was to develop a risk tool to identify GU cancer patients at risk of diagnosis, hospitalization, intubation, and mortality from COVID-19. A retrospective case showed a series of GU cancer patients screened for COVID-19 across the Mount Sinai Health System (MSHS). Four hundred eighty-four had a GU malignancy and 149 tested positive for SARS-CoV-2. Demographic and clinical variables of >38,000 patients were available in the institutional database and were utilized to develop decision aides to predict a positive SARS-CoV-2 test, as well as COVID-19-related hospitalization, intubation, and death. A risk tool was developed using a combination of machine learning methods and utilized BMI, temperature, heart rate, respiratory rate, blood pressure, and oxygen saturation. The risk tool for predicting a diagnosis of SARS-CoV-2 had an AUC of 0.83, predicting hospitalization for management of COVID-19 had an AUC of 0.95, predicting patients requiring intubation had an AUC of 0.97, and for predicting COVID-19-related death, the risk tool had an AUC of 0.79. The models had an acceptable calibration and provided a superior net benefit over other common strategies across the entire range of threshold probabilities.
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Affiliation(s)
- Dara J. Lundon
- Department of Urology, Icahn School of Medicine, Mount Sinai Hospitals, New York, NY 10029, USA; (D.J.L.); (D.S.); (P.W.)
| | - Brian D. Kelly
- Department of Urology, Austin Health, Melbourne, VIC 3084, Australia; (B.D.K.); (D.M.B.)
| | - Devki Shukla
- Department of Urology, Icahn School of Medicine, Mount Sinai Hospitals, New York, NY 10029, USA; (D.J.L.); (D.S.); (P.W.)
| | - Damien M. Bolton
- Department of Urology, Austin Health, Melbourne, VIC 3084, Australia; (B.D.K.); (D.M.B.)
| | - Peter Wiklund
- Department of Urology, Icahn School of Medicine, Mount Sinai Hospitals, New York, NY 10029, USA; (D.J.L.); (D.S.); (P.W.)
| | - Ash Tewari
- Department of Urology, Icahn School of Medicine, Mount Sinai Hospitals, New York, NY 10029, USA; (D.J.L.); (D.S.); (P.W.)
- Correspondence:
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Gil M, Guerra J, Andrade V, Medeiros M, Guimarães T, Bernardino R, Falcão G, Calais da Silva F, Campos Pinheiro L. The impact of multidisciplinary team conferences in urologic cancer in a tertiary hospital. Int Urol Nephrol 2020; 53:41-47. [PMID: 32816157 DOI: 10.1007/s11255-020-02608-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/10/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Multidisciplinary team (MDT) conferences are currently the standard of care in cancer patients' management. Despite evidence supporting benefits to the majority of malignancies, a paucity of data exists examining the impact in urinary and male genital cancers. This study aims to evaluate the impact of MDT conferences in urologic cancer practice. METHODS Clinical plans discussed in urologic MDT conferences in Centro Hospitalar Universitário de Lisboa Central between January 2019 and December 2019 were retrospectively analysed. Clinical plans were categorized as accepted, changed, rejected (cases that had to be re-presented to the MDT because of insufficient staging or administrative issues) or no plan. MDT conferences' impact was assessed according to type of consultation, referral medical specialty and primary tumour type. RESULTS 710 clinical plans were discussed at the MDT conferences. 61.8% were accepted, 10.6% were changed, 16.5% were rejected and 11.1% of cases referred to MDT discussion had no defined clinical plan. First consultations had a higher rate of accepted clinical plans (63.4%) versus subsequent consultations (56.4%). Referrals by the urology specialty had the highest rate of acceptances (64.3%). On the stratification by primary tumour site, testicular cancer had the highest acceptance rate (70.3%), whereas bladder cancer had the lowest (47.8%). CONCLUSIONS MDT conferences had an important impact in the management of 38.2% of cases. Therefore, all patients with urologic malignancies should be referred to MDT review to ensure optimal clinical care.
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Affiliation(s)
- Miguel Gil
- Urology Department, Centro Hospitalar Universitário de Lisboa Central, EPE, Rua José António Serrano, 1150-199, Lisbon, Portugal.
| | - João Guerra
- Urology Department, Centro Hospitalar Universitário de Lisboa Central, EPE, Rua José António Serrano, 1150-199, Lisbon, Portugal
| | - Vanessa Andrade
- Urology Department, Centro Hospitalar Universitário de Lisboa Central, EPE, Rua José António Serrano, 1150-199, Lisbon, Portugal
| | - Mariana Medeiros
- Urology Department, Centro Hospitalar Universitário de Lisboa Central, EPE, Rua José António Serrano, 1150-199, Lisbon, Portugal
| | - Thiago Guimarães
- Urology Department, Centro Hospitalar Universitário de Lisboa Central, EPE, Rua José António Serrano, 1150-199, Lisbon, Portugal
| | - Rui Bernardino
- Urology Department, Centro Hospitalar Universitário de Lisboa Central, EPE, Rua José António Serrano, 1150-199, Lisbon, Portugal
| | - Gil Falcão
- Urology Department, Centro Hospitalar Universitário de Lisboa Central, EPE, Rua José António Serrano, 1150-199, Lisbon, Portugal
| | - Fernando Calais da Silva
- Urology Department, Centro Hospitalar Universitário de Lisboa Central, EPE, Rua José António Serrano, 1150-199, Lisbon, Portugal
| | - Luís Campos Pinheiro
- Urology Department, Centro Hospitalar Universitário de Lisboa Central, EPE, Rua José António Serrano, 1150-199, Lisbon, Portugal
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Safiri S, Kolahi AA, Mansournia MA, Almasi-Hashiani A, Ashrafi-Asgarabad A, Sullman MJM, Bettampadi D, Qorbani M, Moradi-Lakeh M, Ardalan M, Mokdad A, Fitzmaurice C. The burden of kidney cancer and its attributable risk factors in 195 countries and territories, 1990-2017. Sci Rep 2020; 10:13862. [PMID: 32807856 PMCID: PMC7431911 DOI: 10.1038/s41598-020-70840-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 08/03/2020] [Indexed: 01/04/2023] Open
Abstract
Kidney cancer globally accounts for more than 131,000 deaths each year and has been found to place a large economic burden on society. However, there are no recent articles on the burden of kidney cancer across the world. The aim of this study was to present a status report on the incidence, mortality and disability-adjusted life years (DALYs) associated with kidney cancer in 195 countries, from 1990 to 2017. Vital registration and cancer registry data (total of 23,660 site-years) were used to generate the estimates. Mortality was estimated first and the incidence and DALYs were calculated based on the estimated mortality values. All estimates were presented as counts and age-standardised rates per 100,000 population. The estimated rates were calculated by age, sex and according to the Socio-Demographic Index (SDI). In 2017, kidney cancer accounted for 393.0 thousand (95% UI: 371.0-404.6) incident cases, 138.5 thousand (95% UI: 128.7-142.5) deaths and 3.3 million (95% UI: 3.1-3.4) DALYs globally. The global age-standardised rates for the incidence, deaths and DALY were 4.9 (95% UI: 4.7-5.1), 1.7 (95% UI: 1.6-1.8) and 41.1 (95% UI: 38.7-42.5), respectively. Uruguay [15.8 (95% UI: 13.6-19.0)] and Bangladesh [1.5 (95% UI: 1.0-1.8)] had highest and lowest age-standardised incidence rates, respectively. The age-standardised death rates varied substantially from 0.47 (95% UI: 0.34-0.58) in Bangladesh to 5.6 (95% UI: 4.6-6.1) in the Czech Republic. Incidence and mortality rates were higher among males, than females, across all age groups, with the highest rates for both sexes being observed in the 95+ age group. Generally, positive associations were found between each country's age-standardised DALY rate and their corresponding SDI. The considerable burden of kidney cancer was attributable to high body mass index (18.5%) and smoking (16.6%) in both sexes. There are large inter-country differences in the burden of kidney cancer and it is generally higher in countries with a high SDI. The findings from this study provide much needed information for those in each country that are making health-related decisions about priority areas, resource allocation, and the effectiveness of prevention programmes. The results of our study also highlight the need for renewed efforts to reduce exposure to the kidney cancer risk factors and to improve the prevention and the early detection of this disease.
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Affiliation(s)
- Saeid Safiri
- Social Determinants of Health Research Center, Department of Community Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. .,Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Almasi-Hashiani
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Ahad Ashrafi-Asgarabad
- Department of Epidemiology, School of Health, Bam University of Medical Sciences, Bam, Iran
| | - Mark J M Sullman
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus.,Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Deepti Bettampadi
- Center for Immunization and Infection Research in Cancer (CIIRC), H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ali Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Christina Fitzmaurice
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.,Department of Medicine, Division of Hematology, University of Washington, Seattle, WA, USA
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Kiełbik A, Szlasa W, Saczko J, Kulbacka J. Electroporation-Based Treatments in Urology. Cancers (Basel) 2020; 12:E2208. [PMID: 32784598 PMCID: PMC7465806 DOI: 10.3390/cancers12082208] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/03/2020] [Accepted: 08/05/2020] [Indexed: 02/06/2023] Open
Abstract
The observation that an application of a pulsed electric field (PEF) resulted in an increased permeability of the cell membrane has led to the discovery of the phenomenon called electroporation (EP). Depending on the parameters of the electric current and cell features, electroporation can be either reversible or irreversible. The irreversible electroporation (IRE) found its use in urology as a non-thermal ablative method of prostate and renal cancer. As its mechanism is based on the permeabilization of cell membrane phospholipids, IRE (as well as other treatments based on EP) provides selectivity sparing extracellular proteins and matrix. Reversible EP enables the transfer of genes, drugs, and small exogenous proteins. In clinical practice, reversible EP can locally increase the uptake of cytotoxic drugs such as cisplatin and bleomycin. This approach is known as electrochemotherapy (ECT). Few in vivo and in vitro trials of ECT have been performed on urological cancers. EP provides the possibility of transmission of genes across the cell membrane. As the protocols of gene electrotransfer (GET) over the last few years have improved, EP has become a well-known technique for non-viral cell transfection. GET involves DNA transfection directly to the cancer or the host skin and muscle tissue. Among urological cancers, the GET of several plasmids encoding prostate cancer antigens has been investigated in clinical trials. This review brings into discussion the underlying mechanism of EP and an overview of the latest progress and development perspectives of EP-based treatments in urology.
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Affiliation(s)
- Aleksander Kiełbik
- Faculty of Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland; (A.K.); (W.S.)
| | - Wojciech Szlasa
- Faculty of Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland; (A.K.); (W.S.)
| | - Jolanta Saczko
- Department of Molecular and Cellular Biology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Julita Kulbacka
- Department of Molecular and Cellular Biology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
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Park EY, Baek DH, Lee MW, Kim GH, Park DY, Song GA. Long-Term Outcomes of T1 Colorectal Cancer after Endoscopic Resection. J Clin Med 2020; 9:jcm9082451. [PMID: 32751830 PMCID: PMC7464364 DOI: 10.3390/jcm9082451] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 12/17/2022] Open
Abstract
Background and Aims: Endoscopic resection (ER) for submucosal invasive colorectal cancer (T1 CRC) can be grouped as curative ER (C-ER) and non-curative ER (NC-ER). Little is known about the long-term outcomes of patients in these two groups. Therefore, we have evaluated the long-term outcomes in endoscopically resected T1 CRC patients in C-ER and NC-ER groups. Methods: We conducted a retrospective study on 220 patients with T1 CRC treated with ER from January 2007 to December 2017. First, we investigated the long-term outcomes (5-year overall survival [OS] and recurrence-free survival [RFS]) in the C-ER group (n = 49). In the NC-ER group (n = 171), we compared long-term outcomes between patients who underwent additional surgical resection (ASR) (n = 117) and those who did not (surveillance-only, n = 54). Results: T1 CRC patients in the C-ER and NC-ER groups had a median follow-up of 44 (interquartile range 32–69) months. There was no risk of tumor recurrence and cancer-related deaths in patients with C-ER. In the NC-ER group, the 5-year OS rates were 75.3% and 92.6% in the surveillance-only and ASR subgroups, respectively. The hazard ratio (HR) for ASR in NC-ER vs. surveillance-only in NC-ER was statistically insignificant. However, RFS rates were significantly different between the ASR (97.2%) and surveillance-only (84.0%) subgroups. Multivariate analysis indicated a submucosal invasion depth (SID) of >2500 µm and margin positivity to be associated with recurrence. Conclusions: The surveillance-only approach can be considered as an alternative surgical option for T1 CRCs in selected patients undergoing NC-ER.
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Affiliation(s)
- Eun Young Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan 49421, Korea; (E.Y.P.); (M.W.L.); (G.H.K.); (G.A.S.)
- Biomedical Research Institute, Pusan National University Hospital, Busan 49421, Korea
| | - Dong Hoon Baek
- Department of Internal Medicine, Pusan National University School of Medicine, Busan 49421, Korea; (E.Y.P.); (M.W.L.); (G.H.K.); (G.A.S.)
- Biomedical Research Institute, Pusan National University Hospital, Busan 49421, Korea
- Correspondence: ; Tel.: +82-51-2407869; Fax: +82-51-2448180
| | - Moon Won Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan 49421, Korea; (E.Y.P.); (M.W.L.); (G.H.K.); (G.A.S.)
- Biomedical Research Institute, Pusan National University Hospital, Busan 49421, Korea
| | - Gwang Ha Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan 49421, Korea; (E.Y.P.); (M.W.L.); (G.H.K.); (G.A.S.)
- Biomedical Research Institute, Pusan National University Hospital, Busan 49421, Korea
| | - Do Youn Park
- Biomedical Research Institute, Pusan National University Hospital, Busan 49421, Korea
- Department of Pathology, Pusan National University School of Medicine, Busan 49421, Korea;
| | - Geun Am Song
- Department of Internal Medicine, Pusan National University School of Medicine, Busan 49421, Korea; (E.Y.P.); (M.W.L.); (G.H.K.); (G.A.S.)
- Biomedical Research Institute, Pusan National University Hospital, Busan 49421, Korea
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Sun CY, Huang CC, Tsai YS, Chang YT, Ou CH, Su WC, Fan SY, Wang ST, Yang DC, Huang CC, Chang CM. Clinical Frailty Scale in Predicting Postoperative Outcomes in Older Patients Undergoing Curative Surgery for Urologic Malignancies: A Prospective Observational Cohort Study. Urology 2020; 144:38-45. [PMID: 32711011 DOI: 10.1016/j.urology.2020.06.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/07/2020] [Accepted: 06/28/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To examine the utility of the Clinical Frailty Scale (CFS) in predicting outcomes in older adults with urologic malignancies undergoing curative surgeries. METHODS This prospective observational cohort study was conducted in a university-based tertiary medical center. Patients aged 75 years or older who were scheduled to undergo curative surgery for a urologic malignancy from January 2017 to December 2017 were recruited. Patients were grouped according to the CFS scores. The primary postoperative outcome measures were a major complication within 30 days and a decline in the activities of daily living (ADL) within 30 days and 90 days. Multivariable analyses and the area under the receiver operating characteristic curve were performed to investigate the association between the CFS and postoperative outcomes. RESULTS A total of 82 patients, 50% women, were enrolled with mean age 81.6 years. The CFS was significantly associated with postoperative outcomes in a dose-response relationship. When compared with those with a CFS <5, patients with CFS scores ≥5 had a 10.3-times higher risk for a major complication, 8.5-times and 21.4-times higher risk for a decline in ADL within 30 days and 90 days. The area under the receiver operating characteristic curves for the CFS to predict a major complication, the 30-day decline in ADL and the 90-day decline in ADL were 0.60, 0.73, and 0.79. CONCLUSION A higher CFS score predicted a higher risk of poor outcomes in this population. It is recommended that patients with higher CFS scores, especially above 5, are needed to receive further multidisciplinary perioperative care.
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Affiliation(s)
- Chien-Yao Sun
- Division of Geriatrics and Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Cheng Huang
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Senior Services, Southern Taiwan University of Science and Technology, Tainan, Taiwan; Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yuh-Shyan Tsai
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Tzu Chang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Hui Ou
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wu-Chou Su
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Yu Fan
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shan-Tair Wang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Deng-Chi Yang
- Division of Geriatrics and Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chi-Chang Huang
- Division of Geriatrics and Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Ming Chang
- Division of Geriatrics and Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Liu CP, Li X, Lai GN, Li JH, Jia WY, Cao YY, Xu WX, Tan QL, Zhou CY, Luo M, Zhang XY, Yuan DQ, Tian JY, Zhang X, Zeng X. Mechanisms of Macrophage Immunomodulatory Activity Induced by a New Polysaccharide Isolated From Polyporus umbellatus (Pers.) Fries. Front Chem 2020; 8:581. [PMID: 32850623 PMCID: PMC7399574 DOI: 10.3389/fchem.2020.00581] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 06/05/2020] [Indexed: 12/18/2022] Open
Abstract
Bladder cancer is one of the most malignant tumors closely associated with macrophage immune dysfunction. The Chinese medicine polyporus has shown excellent efficacy in treating bladder cancer, with minimal side effects. However, its material basis and mechanism of action remain unclear. A new water-soluble polysaccharide (HPP) with strong immunomodulatory activity was isolated from the fungus Polyporus umbellatus (Pers.) Fries. HPP had an average molecular weight of 6.88 kDa and was composed mainly of an <-(1 → 4)-linked D-galactan backbone. The immunomodulatory activity of HPP was determined in vitro, and the results revealed that it could obviously increase the secretion of immune factors by IFN-γ-stimulated macrophages, including nitric oxide (NO), interleukin-6 (IL-6), interleukin-1β (IL-1β), RANTES and interleukin-23 (IL-23), and the expression of the cell membrane molecule CD80. In addition, HPP was recognized by Toll-like receptor 2 (TLR2) and activated the signaling pathways of NF-κB and NLRP3 in a bladder cancer microenvironment model, indicating that HPP could enhance host immune system function. These findings demonstrated that HPP may be a potential immune modulator in the treatment of immunological diseases or bladder cancer therapy.
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Affiliation(s)
- Chun-Ping Liu
- Department of Integrated Chinese Medicine Immunization, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Cardiovascular Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Xiong Li
- Department of Integrated Chinese Medicine Immunization, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ge-Na Lai
- Department of Integrated Chinese Medicine Immunization, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jin-Hua Li
- Department of Integrated Chinese Medicine Immunization, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wen-Yu Jia
- Department of Integrated Chinese Medicine Immunization, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ying-Ying Cao
- Department of Integrated Chinese Medicine Immunization, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wen-Xing Xu
- Department of Integrated Chinese Medicine Immunization, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qing-Long Tan
- Department of Integrated Chinese Medicine Immunization, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chang-Yuan Zhou
- Department of Integrated Chinese Medicine Immunization, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Min Luo
- Department of Integrated Chinese Medicine Immunization, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xue-Ying Zhang
- Department of Integrated Chinese Medicine Immunization, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dao-Qing Yuan
- Department of Integrated Chinese Medicine Immunization, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jin-Ying Tian
- Department of Integrated Chinese Medicine Immunization, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xian Zhang
- Department of Integrated Chinese Medicine Immunization, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xing Zeng
- Department of Integrated Chinese Medicine Immunization, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
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133
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Zhou Y, Zhang ZL, Luo MH, Yang H. Transurethral needle electrode resection and transurethral holmium laser resection of bladder cancer. World J Surg Oncol 2020; 18:166. [PMID: 32669107 PMCID: PMC7364503 DOI: 10.1186/s12957-020-01943-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/03/2020] [Indexed: 12/23/2022] Open
Abstract
Purpose The aim of the present study was to explore the efficacy and safety of transurethral needle electrode resection and transurethral holmium laser resection of non-muscular invasive bladder cancer (NMIBC). Patients and methods In this prospective, case-control study, patients from the Urinary Surgery or Oncology Department who met the inclusion and exclusion criteria received transurethral needle electrode resection (n = 52) or transurethral holmium laser resection (n = 51). Results A total of 103 patients with NMIBC were included in the present study, with 68 males and 35 females. Their mean age was 57.3 years. Sixty-two patients had Ta, 15 patients had T1, and 26 patients had Tis. Operative time, intraoperative blood loss, postoperative gross hematuria time, bladder irrigation time, and postoperative hospitalization time were all significantly lower in the transurethral holmium laser resection group than the transurethral needle electrode resection group. After resection, transurethral holmium laser resection significantly decreased the value of HGF, TSH, and TNF-α versus the transurethral needle electrode resection group. The incidence of obturator reflex was significantly lower in the transurethral holmium laser resection group than the transurethral needle electrode resection group. There was no significant difference in disease-free survival rate and progression-free survival rate between the two groups. Conclusions Transurethral holmium laser resection has clinical advantages in the treatment of NMIBC.
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Affiliation(s)
- Yu Zhou
- Department of Urology, Renmin Hospital, Hubei University of Medicine, No. 39 Chaoyang Middle Road, Maojian District, Shiyan, 442000, Hubei, China
| | - Zheng-Long Zhang
- Department of Urology, Renmin Hospital, Hubei University of Medicine, No. 39 Chaoyang Middle Road, Maojian District, Shiyan, 442000, Hubei, China
| | - Mao-Hua Luo
- Department of Urology, Renmin Hospital, Hubei University of Medicine, No. 39 Chaoyang Middle Road, Maojian District, Shiyan, 442000, Hubei, China
| | - Hua Yang
- Department of Urology, Renmin Hospital, Hubei University of Medicine, No. 39 Chaoyang Middle Road, Maojian District, Shiyan, 442000, Hubei, China.
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134
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Liu Z, Yang Y, Yang Z, Xia S, Lin D, Xiao B, Xiu Y. Novel circRNA_0071196/miRNA‑19b‑3p/CIT axis is associated with proliferation and migration of bladder cancer. Int J Oncol 2020; 57:767-779. [PMID: 32705161 PMCID: PMC7384843 DOI: 10.3892/ijo.2020.5093] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 06/19/2020] [Indexed: 12/14/2022] Open
Abstract
Circular RNAs (circRNAs) are non-coding RNAs that are connected at the 3′ and 5′ ends by an exon or intron. Studies increasingly show that circRNAs play an important role in tumorigenesis by acting as a 'sponge' for microRNAs (miRNAs), which abrogates the latter's effect on their target mRNAs. To identify a possible circRNA/miRNA/mRNA network in bladder cancer (BCa), we analyzed the circRNA and mRNA expression profiles of BCa and adjacent normal bladder tissues. A total of 127 circRNAs and 1,612 mRNAs were differentially expressed in the tumor tissues, and were primarily associated with cancer-related pathways. A competing endogenous RNAs (ceRNA) network was then constructed which predicted a regulatory axis of circRNA_0071196, miRNA-19b-3p and its target gene citron Rho-interacting serine/threonine kinase (CIT). Luciferase reporter assay validated the relationship between circRNA_0071196 and miRNA-19b-3p and of the latter with CIT. Furthermore, CIT was overexpressed in the BCa tissues, and was found to be correlated with metastasis and tumor histological grade. Knockdown of CIT in the human bladder cancer cell line 5367 significantly inhibited the proliferation, migration and colony formation capacity of the cells, and also upregulated the mediators of the p53 and RhoA-ROCK signaling cascades that regulate cell cycle and migration. Taken together, our findings indicate that circRNA-0071196 upregulates CIT levels in BCa by sponging off miRNA-19b-3p, and the circRNA_0071196/miRNA-19b-3p/CIT axis is a potential therapeutic target in BCa.
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Affiliation(s)
- Zan Liu
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Yang Yang
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Zhe Yang
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Shunyao Xia
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Dasen Lin
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Bang Xiao
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Youcheng Xiu
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
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135
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Gul ZG, Liaw CW, Mehrazin R. Gender Differences in Incidence, Diagnosis, Treatments, and Outcomes in Clinically Localized Bladder and Renal Cancer. Urology 2020; 151:176-181. [PMID: 32561364 DOI: 10.1016/j.urology.2020.05.067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/18/2020] [Accepted: 05/25/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To review differences in bladder and renal cell cancer (RCC) incidence, diagnosis, treatment, and outcomes between men and women, and to summarize the evidence that explains these differences. METHODS A review of the current literature was performed using PubMed and Google Scholar. RESULTS The incidence of bladder cancer and RCC is higher in men. Historically higher smoking rates among men explain some but not all of the difference in incidence. Hormonal and genetic factors also contribute. In bladder cancer, the androgen receptor and estrogen receptor beta have been associated with gender and tumor characteristics. In RCC the relationships are less well defined. In both bladder cancer and RCC, differences in gene mutation patterns among men and women, particularly among genes located on the X-chromosome, have also been identified. Differences in the work-up and treatment of men and women with bladder cancer and RCC also contribute to gender disparities. CONCLUSION Research to better delineate how the hormonal axis and genetics contribute to disparities in bladder cancer and RCC incidence and outcomes will allow for more individualized medicine. Appreciation of barriers to diagnosis and treatment will identify opportunities to improve patient care.
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Affiliation(s)
- Zeynep G Gul
- Department of Urology, Icahn School of Medicine at Mount Sinai, York, NY
| | - Christine W Liaw
- Department of Urology, Icahn School of Medicine at Mount Sinai, York, NY
| | - Reza Mehrazin
- Department of Urology, Icahn School of Medicine at Mount Sinai, York, NY.
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136
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Hu X, Shao YX, Yang ZQ, Dou WC, Xiong SC, Li X. Preoperative systemic immune-inflammation index predicts prognosis of patients with non-metastatic renal cell carcinoma: a propensity score-matched analysis. Cancer Cell Int 2020; 20:222. [PMID: 32523427 PMCID: PMC7281921 DOI: 10.1186/s12935-020-01320-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/03/2020] [Indexed: 02/08/2023] Open
Abstract
Background A novel systemic immune-inflammation index (SII), based on the neutrophils, lymphocytes and platelet counts, is associated with the prognosis of several cancers. The present study evaluates the prognostic significance of SII in non-metastatic renal cell carcinoma (RCC). Method The present study retrospectively reviewed the medical record of patients with non-metastatic RCC who underwent nephrectomy between 2010 and 2013. Receiver operating characteristic (ROC) curve analysis was performed to identify the optimal cut-off value. In addition, the propensity score matching (PSM) was performed with a matching ratio of 1:1. Univariate and multivariate Cox proportional hazards models were used to identify the prognostic factors. The results were reported by hazard ratio (HR) with 95% confidence interval (95% CI). Results A total of 646 patients were included in the final analysis. High SII group (> 529) was significantly associated with older age (P = 0.014), larger tumor (P < 0.001), higher pathological T stage (P < 0.001), higher tumor grade (P < 0.001) and more tumor necrosis (P < 0.001). Multivariate Cox regression analysis demonstrated that the higher preoperative SII was significantly associated with worse overall survival (OS) (HR = 2.26; 95% CI 1.44–3.54; P < 0.001) and cancer-specific survival (CSS) (HR = 2.17; 95% CI 1.33–3.55; P = 0.002). After PSM, elevated preoperative SII was an independent predictor of poor OS (HR = 1.78; 95% CI 1.1–2.87; P = 0.018) and CSS (HR = 1.8; 95% CI 1.07–3.03; P = 0.027). Conclusion In conclusion, preoperative SII is associated with adverse factors for RCC. Furthermore, higher preoperative SII is an independent predictor of poor OS and CSS in surgically treated patients with non-metastatic RCC. More prospective and large scale studies are warranted to validate our findings.
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Affiliation(s)
- Xu Hu
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041 People's Republic of China
| | - Yan-Xiang Shao
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041 People's Republic of China
| | - Zhi-Qiang Yang
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041 People's Republic of China
| | - Wei-Chao Dou
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041 People's Republic of China
| | - San-Chao Xiong
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041 People's Republic of China
| | - Xiang Li
- Department of Urology, West China Hospital, West China Medical School, Sichuan University, 37 Guoxue Street, Chengdu, 610041 People's Republic of China
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Yan YL, Huang ZN, Zhu Z, Cui YY, Li MQ, Huang RM, Yan J, Shen B. Downregulation of TET1 Promotes Bladder Cancer Cell Proliferation and Invasion by Reducing DNA Hydroxymethylation of AJAP1. Front Oncol 2020; 10:667. [PMID: 32528872 PMCID: PMC7253684 DOI: 10.3389/fonc.2020.00667] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 04/09/2020] [Indexed: 12/20/2022] Open
Abstract
Ten-eleven translocation 1 (TET1) is a member of methylcytosine dioxygenase, which catalyzes 5-methylcytosine (5 mC) to 5-hydroxymethylcytosine (5 hmC) to promote the demethylation process. The dysregulated TET1 protein and 5 hmC level were reported to either suppress or promote carcinogenesis in a cancer type-dependent manner. Currently, the role of TET1 in the development of urinary bladder cancer (UBC) and its underlying molecular mechanisms remain unclear. Herein, we found that TET1 expression was downregulated in UBC specimens compared with normal urothelium and was inversely related to tumor stage and grade and overall survival, suggesting its negative association with UBC progression. TET1 silencing in UBC cells increased cell proliferation and invasiveness while the ectopic expression of wild-type TET1-CD, but not its enzymatic inactive mutant, reversed these effects and suppressed tumorigenicity in vivo. In addition, as a direct regulator of TET1 activity, vitamin C treatment increased 5 hmC level and inhibited the anchorage-independent growth and tumorigenicity of UBC cells. Furthermore, we found that TET1 maintained the hypomethylation in the promoter of the AJAP1 gene, which codes for adherens junction-associated protein 1. The downregulation of AJAP1 reversed TET1-CD-induced nuclear translocation of β-catenin, thus inhibiting the expression of its downstream genes. In human UBC specimens, AJAP1 is frequently downregulated and positively associated with TET1. Notably, low expression levels of both TET1 and AJAP1 predict poor prognosis in UBC patients. In conclusion, we found that the frequently downregulated TET1 level reduces the hydroxymethylation of AJAP1 promoter and subsequently activates β-catenin signaling to promote UBC development. The downregulation of both TET1 and AJAP1 might be a promising prognostic biomarker for UBC patients.
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Affiliation(s)
- Yi-Lin Yan
- Department of Urology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zheng-Nan Huang
- Department of Urology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhen Zhu
- Model Animal Research Center of Nanjing University, Nanjing, China
| | - Yang-Yan Cui
- Model Animal Research Center of Nanjing University, Nanjing, China
| | - Mei-Qian Li
- Model Animal Research Center of Nanjing University, Nanjing, China
| | - Rui-Min Huang
- Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Jun Yan
- Department of Laboratory Animal Science, Fudan University, Shanghai, China
| | - Bing Shen
- Department of Urology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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138
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Du Z, Chen W, Xia Q, Shi O, Chen Q. Trends and projections of kidney cancer incidence at the global and national levels, 1990-2030: a Bayesian age-period-cohort modeling study. Biomark Res 2020; 8:16. [PMID: 32435498 PMCID: PMC7222434 DOI: 10.1186/s40364-020-00195-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/03/2020] [Indexed: 02/07/2023] Open
Abstract
Background Identifying the temporal trends of kidney cancer (KC) incidence in both the past and the future at the global and national levels is critical for KC prevention. Methods We retrieved annual KC case data between 1990 and 2017 from the Global Burden of Disease (GBD) online database. The average annual percentage change (AAPC) was used to quantify the temporal trends of KC age-standardized incidence rates (ASRs) from 1990 to 2017. Bayesian age-period-cohort models were used to predict KC incidence through 2030. Results Worldwide, the number of newly diagnosed KC cases increased from 207.3 thousand in 1990 to 393.0 thousand in 2017. The KC ASR increased from 4.72 per 100,000 to 4.94 per 100,000 during the same period. Between 2018 and 2030, the number of KC cases is projected to increase further to 475.4 thousand (95% highest density interval [HDI] 423.9, 526.9). The KC ASR is predicted to decrease slightly to 4.46 per 100,000 (95% HDI 4.06, 4.86). A total of 90, 2, and 80 countries or territories are projected to experience increases, remain stable, and experience decreases in KC ASR between 2018 and 2030, respectively. In most developed countries, the KC incidence is forecasted to decrease irrespective of past trends. In most developing countries, the KC incidence is predicted to increase persistently through 2030. Conclusions KC incidence is predicted to decrease in the next decade, and this predicted decrease is mainly driven by the decreases in developed countries. More attention should be placed on developing countries.
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Affiliation(s)
- Zhebin Du
- 1Department of Urology, Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200127 China
| | - Wei Chen
- 1Department of Urology, Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200127 China
| | - Qier Xia
- 2Department of Urology, Pudong New Area People's Hospital, Shanghai, China
| | - Oumin Shi
- 3Health Science Center, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518020 China
| | - Qi Chen
- 1Department of Urology, Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200127 China
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139
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Mancini M, Righetto M, Baggio G. Gender-Related Approach to Kidney Cancer Management: Moving Forward. Int J Mol Sci 2020; 21:E3378. [PMID: 32397685 PMCID: PMC7246979 DOI: 10.3390/ijms21093378] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/05/2020] [Accepted: 05/08/2020] [Indexed: 12/15/2022] Open
Abstract
Men are more frequently diagnosed with kidney cancer than women, with a more aggressive histology, larger tumors, a higher grade and stage, and worse oncological outcomes. Smoking habits and sex steroid hormones seem to have a possible role in explaining these gender disparities. Moreover, the expression of genes involved in tumor growth and immune response in kidney cancer varies between men and women, having an impact on the gender-related response to oncological therapy, such as anti-angiogenic drugs and immunotherapy. Recent advances have been made in our understanding of the molecular and genetic mechanisms involved in kidney cancer, which could partially explain the gender differences, and they are summarized in this paper. However, other key mechanisms, which fully clarify the striking clinical gender-related differences observed in kidney cancer, are not completely understood at present. We reviewed and summarized the most relevant publications about the relationship between gender and kidney cancer. Efforts should be made to progress in bench and clinical research on gender-related signatures and disparities, and their impact on the clinical management of kidney cancer.
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Affiliation(s)
- Mariangela Mancini
- Department of Surgical, Oncological and Gastroenterological Sciences, Urological Clinic, University of Padua, 35128 Padua, Italy;
| | - Marialaura Righetto
- Department of Surgical, Oncological and Gastroenterological Sciences, Urological Clinic, University of Padua, 35128 Padua, Italy;
| | - Giovannella Baggio
- Department of Molecular Medicine, School of Medicine and Surgery, University of Padua, 35128 Padua, Italy;
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Shi YR, Wu Z, Xiong K, Liao QJ, Ye X, Yang P, Zu XB. Circular RNA circKIF4A Sponges miR-375/1231 to Promote Bladder Cancer Progression by Upregulating NOTCH2 Expression. Front Pharmacol 2020; 11:605. [PMID: 32457613 PMCID: PMC7225260 DOI: 10.3389/fphar.2020.00605] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/17/2020] [Indexed: 12/16/2022] Open
Abstract
Circular RNAs (circRNAs) have been found to be important mediators of many biological processes in the growth and metastasis of various cancers. However, the potential roles of most circRNAs in the progression of bladder cancer remain unclear. In this research, we investigate the role of circKIF4A (hsa_circ_0007255) in the development and progression of bladder cancer. Detected by qRT-PCR analysis, circKIF4A was significantly upregulated in bladder cancer tissues and cell lines. We conducted CCK-8, colony-formation, transwell and mouse xenograft assays to explore the function of circKIF4A in bladder cancer. Functionally, knockdown of circKIF4A inhibited the proliferation and colony-formation ability of bladder cancer cells. Migration and metastatic ability were dramatically decreased after transfection with small interfering RNA targeting circKIF4A in both in vitro and in vivo assays. Mechanically, luciferase reporter assays and RNA immunoprecipitation assays were carried out to elucidate the underlying molecular mechanism of circKIF4A. The results revealed that circKIF4A sponges miR-375/1231 to promote bladder cancer progression by upregulating NOTCH2. Generally, our research unveils the essential role of circKIF4A-miR-375/1231-NOTCH2 axis in bladder cancer progression possibly via the competing endogenous RNA mechanism.
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Affiliation(s)
- Ying-Rui Shi
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China.,Department of Radiation Oncology, Hunan Cancer Hospital & the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Zheng Wu
- Department of Radiation Oncology, Hunan Cancer Hospital & the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Kun Xiong
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Qian-Jin Liao
- Central Laboratory, Hunan Cancer Hospital & the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Xu Ye
- Department of Radiation Oncology, Hunan Cancer Hospital & the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Pei Yang
- Department of Radiation Oncology, Hunan Cancer Hospital & the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Xiong-Bing Zu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
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141
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Ghafouri S, Burkenroad A, Pantuck M, Almomani B, Stefanoudakis D, Shen J, Drakaki A. VEGF inhibition in urothelial cancer: the past, present and future. World J Urol 2020; 39:741-749. [PMID: 32361873 DOI: 10.1007/s00345-020-03213-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 04/11/2020] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To describe the role of anti-angiogenic agents that have been used as a treatment approach for locally advanced or metastatic urothelial cancers and to propose future directions. METHODS PubMed/MEDLINE was searched for articles related to VEGF inhibition and locally advanced or metastatic urothelial cancer. RESULTS Angiogenesis is a fundamental process for urothelial cancer initiation and progression. First-line therapy for locally advanced or metastatic urothelial cancer includes cisplatin-based chemotherapy combinations; subsequent systemic therapy includes taxanes, nanoparticle albumin-bound (nab) paclitaxel, or pemetrexed. More recently, several anti-PD-L1 and anti-PD-1 antibodies have shown promising activity in the first-line and post-platinum setting; however, immunotherapy remains ineffective in most patients. FGFR inhibitor erdafitinib was recently approved in the third-line setting. Studies on bevacizumab, pazopanib and ramucirumab have shown improved response rates when added to chemotherapy in selected patients, but have not led to overall survival (OS) benefit in randomized controlled studies. CONCLUSION Anti-angiogenic agents have shown promise in recent studies treating locally advanced or metastatic urothelial cancer. However, further work is needed to elucidate ideal treatment combinations in selected patient populations to maximize benefit, with the ultimate goal of being added to the FDA-approved treatment armamentarium for this disease.
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Affiliation(s)
- Sanaz Ghafouri
- Division of Hematology and Oncology, David Geffen School of Medicine, UCLA, Los Angeles, USA
| | - Aaron Burkenroad
- Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, USA
| | - Morgan Pantuck
- Lewis Katz School of Medicine, Temple University, Philadelphia, USA
| | - Bara Almomani
- Division of Hematology and Oncology, David Geffen School of Medicine, UCLA, Los Angeles, USA
| | | | - John Shen
- Division of Hematology and Oncology, David Geffen School of Medicine, UCLA, Los Angeles, USA
| | - Alexandra Drakaki
- Division of Hematology and Oncology, David Geffen School of Medicine, UCLA, Los Angeles, USA.
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Luo H, Yang L, Liu C, Wang X, Dong Q, Liu L, Wei Q. TMPO-AS1/miR-98-5p/EBF1 feedback loop contributes to the progression of bladder cancer. Int J Biochem Cell Biol 2020; 122:105702. [PMID: 32087328 DOI: 10.1016/j.biocel.2020.105702] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 01/20/2020] [Accepted: 01/28/2020] [Indexed: 02/05/2023]
Abstract
As reported in numerous studies, long non-coding RNAs (lncRNAs) exert significant effect on the regulation of tumor development. LncRNA TMPO antisense RNA 1 (TMPO-AS1) has been confirmed to be implicated in the development of several cancers. However, its clinical significance is still largely unknown in bladder cancer (BCa). In this study, high expression of TMPO-AS1 was revealed in BCa tissues and cell lines, and TMPO-AS1 predicted poor prognosis. Moreover, TMPO-AS1 facilitated cell growth. Additionally, TMPO-AS1 also boosted the migration and invasion of BCa cells. Mechanistically, overexpressed EBF transcription factor 1 (EBF1) in BCa cell was verified to promote the transcription of TMPO-AS1. Later, we found that TMPO-AS1 was a cytoplasmic RNA and could sponge miR-98-5p. Besides, it was validated that EBF1 is a target gene of miR-98-5p and negatively correlated with miR-98-5p in terms of expression level. According to the results of rescue experiments, we observed that EBF1 overexpression restored the repressive effect of TMPO-AS1 silencing on BCa development. Our research is the first to disclose the biological role and molecular mechanism of TMPO-AS1 in BCa, and TMPO-AS1 might be identified as a new therapeutic target for BCa patients.
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Affiliation(s)
- Hua Luo
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, No.37 Guoxue Alley, Chengdu, 610000, Sichuan, PR China; Department of Urology, The Second Peoples Hospital of Deyang City, Deyang, 618000, Sichuan, PR China
| | - Lu Yang
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, No.37 Guoxue Alley, Chengdu, 610000, Sichuan, PR China
| | - Chen Liu
- Department of Urology, The Second Peoples Hospital of Deyang City, Deyang, 618000, Sichuan, PR China
| | - Xiaobo Wang
- Department of Urology, The Second Peoples Hospital of Deyang City, Deyang, 618000, Sichuan, PR China
| | - Qiang Dong
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, No.37 Guoxue Alley, Chengdu, 610000, Sichuan, PR China
| | - Liangren Liu
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, No.37 Guoxue Alley, Chengdu, 610000, Sichuan, PR China
| | - Qiang Wei
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, No.37 Guoxue Alley, Chengdu, 610000, Sichuan, PR China.
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143
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Alqurashi L, Al-Hajeili M, Alsayyed E, Salman B, Mashat H, Bokhary R. The outcomes of renal cell carcinoma in a single tertiary care facility in Saudi Arabia. Urol Ann 2020; 12:163-166. [PMID: 32565655 PMCID: PMC7292425 DOI: 10.4103/ua.ua_142_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 09/26/2019] [Indexed: 11/24/2022] Open
Abstract
Background: Amidst an era of rising malignancies worldwide, renal cell carcinoma (RCC) is the 7th most commonly detected, owing to 144,000 cancer-related deaths annually. Demographic knowledge of such cases in Saudi Arabia is poorly portrayed. According to the 2014 Saudi Cancer Registry, RCC has rated the 10th most common malignancy among males, posing a significant disease burden. Global studies have depicted a great discrepancy of 15 folds in the incidence of RCC among different countries, which is commonly attributed to variations in each countries development. We aimed to assess the overall survival (OS) and disease-free survival (DFS) in patients who underwent nephrectomy in our health-care facility. Materials and Methods: This is a retrospective study done at a tertiary care facility of all cases of RCC as per the pathology department database for the period of 2007–2017. The OS and DFS were statistically determined using Stata/SE 15.0. Results: Overall, 109 RCC patients were included in the study. Mean age at diagnosis was 53.8 (range: 24–89) years. Demographic data revealed a total of 71 (65.14%) males included in the study and 38 (34.86%) females. The OS at 2 years and 5 years was noted to be 95.3% and 92.6%, respectively. The DFS was found to be 90.8% at 2 years and 85.4% at 5 years. On multivariate analysis of the results, step-wise model was utilized to eliminate irrelevant variables affecting the OS, with a probability to eliminate variables with P > 0.2. Metastasis (M) was found to be a relevant variable (hazards ratio [HR]: 52.25 [P = 0.003]; 95% confidence interval [CI]: 3.75–728.88). On multivariate analysis of the DFS, variables were found to be significant which include gender (HR: 0.15 [P = 0.063]; 95% CI: 0.02–1.105), nationality (HR: 16.1 [P = 0.034]; 95% CI: 1.24–209.13), age at diagnosis (HR: 0.93 [P = 0.031]; 95% CI: 0.87–0.99), and pathological stage (T) (HR: 7.89 [P = 0.003]; 95% CI: 1.98–31.36). Conclusions: Our results revealed a notable discrepancy in the 5-year OS and the 5-year DFS as compared to studies in the literature. However, our study was limited to a single center and the majority of our patients were diagnosed at a rather early stage. With the rising number of RCC cases worldwide and in Saudi, this further necessitates extensive disease surveillance for trends in all parameters.
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Affiliation(s)
- Lujain Alqurashi
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Marwan Al-Hajeili
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ehab Alsayyed
- Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Budoor Salman
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hibatallah Mashat
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rana Bokhary
- Department of Pathology, King Abdulaziz University, Jeddah, Saudi Arabia
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144
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Jürgens H, Ojamaa K, Pokker H, Innos K, Padrik P. Changes in therapy and survival of metastatic renal cell carcinoma in Estonia. BMC Cancer 2020; 20:201. [PMID: 32164576 PMCID: PMC7068934 DOI: 10.1186/s12885-020-6685-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 02/26/2020] [Indexed: 12/19/2022] Open
Abstract
Background Before the era of targeted therapies, cytokines were the main therapy for metastatic renal cell carcinoma (mRCC). Our aim was to analyze the changes in treatments and overall survival (OS) of all mRCC patients in Estonia in relation to the introduction of new medications. Methods All patients with mRCC who started medical therapy in Estonia during the years 2004–2012 were identified using the database of the Estonian Health Insurance Fund. Tumor and treatment data were gathered from medical records. Vital status data were obtained from the Estonian Population Registry. The only available therapy before 2008 was interferon alpha-2A (INFa2A), targeted agents added from 2008. For survival analysis, patients were divided into 2 groups: INFa therapy only (group 1) and INFa followed by targeted agents or targeted agents therapy only (group 2). Results Out of 416 identified patients, 380 were eligible for analysis. The most common 1st-line treatments were INFa (55%), sunitinib (32%) and INFa+bevacizumab (13%). 28% of patients received 2nd-line therapies and 15% 3rd-line treatments. Median survival of all patients was 13.7 months [95% confidence interval (CI) 11.3–16.2]; 7.6 months (CI 6.4–8.6) for group 1 and 19.8 months (CI 15.6–22.9) for group 2. In multivariate analysis, group 1 had nearly four times higher risk of dying than group 2 [hazard ration (HR) 3.88, 95% CI 2.64–5.72]. Conclusions The implementation of targeted therapies significantly changed the outcomes of mRCC in Estonia: it prolonged median survival, reduced the risk of death and also enlarged the proportion of patients who received medical therapy.
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Affiliation(s)
- Hannes Jürgens
- Tartu University Hospital, Clinic of Hematology & Oncology, Puusepa 8, Tartu, Estonia. .,University of Tartu, Clinic of Hematology & Oncology, Tartu, Estonia.
| | | | - Helis Pokker
- North Estonian Regional Hospital, Tallinn, Estonia
| | - Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Peeter Padrik
- Tartu University Hospital, Clinic of Hematology & Oncology, Puusepa 8, Tartu, Estonia.,University of Tartu, Clinic of Hematology & Oncology, Tartu, Estonia
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145
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Parsons SR, Hill GT, Warren KS, Burden HP. Bladder cancer in the elderly: A retrospective analysis of bladder cancer in individuals older than 85 years. JOURNAL OF CLINICAL UROLOGY 2020. [DOI: 10.1177/2051415819851709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: Current life expectancy in the United Kingdom is 79.2 years in men and 82.9 years in women. Average age at diagnosis of bladder cancer is 73 years, but incidence continues to rise with age. Elderly patients represent a unique cohort of patients; they often have multiple medical co-morbidities, and may have different wishes and treatment aims as opposed to younger patients. We describe our current bladder cancer practice in patients older than 85 years. Methods: A retrospective review was conducted of patients older than 85 years, first diagnosed with bladder cancer between December 2012 and June 2016. Results: A total of 102 patients were analysed from our database. Mean age at diagnosis was 88.34 years. Staging at diagnosis was: 75 non–muscle-invasive bladder cancer (NMIBC) (17 low, 13 intermediate, 45 high risk), 23 muscle-invasive bladder cancer (MIBC), and four metastatic disease. Of patients with NMIBC, 29/75 patients had a recurrence, 4/75 were upstaged, and 9/75 progressed to MIBC. Twenty-nine of 75 of the NMIBC patients declined treatment or ongoing surveillance. Overall, 53% (53/102) have died of any cause, with a mean of 2.0 years since diagnosis, 31 of bladder cancer. In NMIBC patients, 38.7% (29/102) have died of any cause since diagnosis, at a mean interval of 1.8 years following diagnosis. Conclusion: In our cohort of bladder cancer patients older than 85 years, there is a high all-cause mortality rate within a relatively short time period following diagnosis. These data should aid well-informed discussions with our elderly bladder cancer patients and their relatives when considering treatment and surveillance options. Level of evidence: Not applicable for this single centre audit.
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Affiliation(s)
- SR Parsons
- Bristol Urological Institute, Southmead Hospital, UK
| | - GT Hill
- Bristol Urological Institute, Southmead Hospital, UK
| | - KS Warren
- Bristol Urological Institute, Southmead Hospital, UK
| | - HP Burden
- Bristol Urological Institute, Southmead Hospital, UK
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146
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Zhan Y, Chen Z, He S, Gong Y, He A, Li Y, Zhang L, Zhang X, Fang D, Li X, Zhou L. Long non-coding RNA SOX2OT promotes the stemness phenotype of bladder cancer cells by modulating SOX2. Mol Cancer 2020; 19:25. [PMID: 32019566 PMCID: PMC6998848 DOI: 10.1186/s12943-020-1143-7] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 01/20/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Accumulating evidence indicates that long non-coding RNAs (lncRNAs) are potential biomarkers and key regulators of tumour development and progression. SOX2 overlapping transcript (SOX2OT) is a novel lncRNA that acts as a potential biomarker and is involved in the development of cancer and cancer stem cells. However, the clinical significance and molecular mechanism of SOX2OT in bladder cancer are still unknown. METHODS The expression level of SOX2OT was determined by RT-qPCR in a total of 106 patients with urothelial bladder cancer and in different bladder cancer cell (BCC) lines. Bladder cancer stem cells (BCSCs) were isolated from BCCs using flow cytometry based on the stem cell markers CD44 and ALDH1. Loss-of-function experiments were performed to investigate the biological roles of SOX2OT in the stemness phenotype of BCSCs. Comprehensive transcriptional analysis, RNA FISH, dual-luciferase reporter assays and western blots were performed to explore the molecular mechanisms underlying the functions of SOX2OT. RESULTS SOX2OT was highly expressed in bladder cancer, and increased SOX2OT expression was positively correlated with a high histological grade, advanced TNM stage and poor prognosis. Further experiments demonstrated that knockdown of SOX2OT inhibited the stemness phenotype of BCSCs. Moreover, inhibition of SOX2OT delayed xenograft tumour growth and decreased metastases in vivo. Mechanistically, we found that SOX2OT was mainly distributed in the cytoplasm and positively regulated SOX2 expression by sponging miR-200c. Furthermore, SOX2 overexpression reversed the SOX2OT silencing-induced inhibition of the BCSC stemness phenotype. CONCLUSION This study is the first to demonstrate that SOX2OT plays an important regulatory role in BCSCs and that SOX2OT may serve as a potential diagnostic biomarker and therapeutic target in bladder cancer.
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Affiliation(s)
- Yonghao Zhan
- Department of Urology, Peking University First Hospital, The Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku street, Beijing, 100034, China.,Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China.,Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Zhicong Chen
- Department of Urology, Peking University First Hospital, The Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku street, Beijing, 100034, China.,Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China
| | - Shiming He
- Department of Urology, Peking University First Hospital, The Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku street, Beijing, 100034, China.,Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China
| | - Yanqing Gong
- Department of Urology, Peking University First Hospital, The Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku street, Beijing, 100034, China.,Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China
| | - Anbang He
- Department of Urology, Peking University First Hospital, The Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku street, Beijing, 100034, China.,Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China
| | - Yifan Li
- Department of Urology, Peking University First Hospital, The Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku street, Beijing, 100034, China.,Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China
| | - Lianghao Zhang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Xuepei Zhang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Dong Fang
- Department of Urology, Peking University First Hospital, The Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku street, Beijing, 100034, China. .,Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China.
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, The Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku street, Beijing, 100034, China. .,Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China.
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, The Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku street, Beijing, 100034, China. .,Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China.
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147
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Lobo J, Jerónimo C, Henrique R. Targeting the Immune system and Epigenetic Landscape of Urological Tumors. Int J Mol Sci 2020; 21:E829. [PMID: 32012885 PMCID: PMC7037817 DOI: 10.3390/ijms21030829] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/18/2020] [Accepted: 01/27/2020] [Indexed: 02/06/2023] Open
Abstract
In the last years, we have witnessed remarkable advances in targeted therapies for cancer patients. There is a growing effort to either replace or reduce the dose of unspecific, systemic (chemo)therapies, given the associated short- and long-term side effects, by introducing more specific targeted therapies as single or combination agents. Due to the well-known implications of the immune system and epigenetic landscape in modulating cancer development, both have been explored as potential targets in several malignancies, including those affecting the genitourinary tract. As the immune system function is also epigenetically regulated, there is rationale for combining both strategies. However, this is still rather underexplored, namely in urological tumors. We aim to briefly review the use of immune therapies in prostate, kidney, bladder, and testicular cancer, and further describe studies providing supporting evidence on their combination with epigenetic-based therapies.
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Affiliation(s)
- João Lobo
- Department of Pathology, Portuguese Oncology Institute of Porto (IPOP), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Cancer Biology and Epigenetics Group, Research Center of Portuguese Oncology Institute of Porto (GEBC CI-IPOP) and Porto Comprehensive Cancer Center (P.CCC), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal;
- Department of Pathology and Molecular Immunology, Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), Rua Jorge Viterbo Ferreira 228, 4050-513 Porto, Portugal
| | - Carmen Jerónimo
- Cancer Biology and Epigenetics Group, Research Center of Portuguese Oncology Institute of Porto (GEBC CI-IPOP) and Porto Comprehensive Cancer Center (P.CCC), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal;
- Department of Pathology and Molecular Immunology, Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), Rua Jorge Viterbo Ferreira 228, 4050-513 Porto, Portugal
| | - Rui Henrique
- Department of Pathology, Portuguese Oncology Institute of Porto (IPOP), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Cancer Biology and Epigenetics Group, Research Center of Portuguese Oncology Institute of Porto (GEBC CI-IPOP) and Porto Comprehensive Cancer Center (P.CCC), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal;
- Department of Pathology and Molecular Immunology, Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), Rua Jorge Viterbo Ferreira 228, 4050-513 Porto, Portugal
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148
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Ciarimboli G, Theil G, Bialek J, Edemir B. Contribution and Expression of Organic Cation Transporters and Aquaporin Water Channels in Renal Cancer. Rev Physiol Biochem Pharmacol 2020; 181:81-104. [PMID: 32772272 DOI: 10.1007/112_2020_34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The body homeostasis is maintained mainly by the function of the kidneys, which regulate salt and water balance and excretion of metabolism waste products and xenobiotics. This important renal function is determined by the action of many transport systems, which are specifically expressed in the different parts of the nephron, the functional unit of the kidneys. These transport systems are involved, for example, in the reabsorption of sodium, glucose, and other important solutes and peptides from the primary urine. They are also important in the reabsorption of water and thereby production of a concentrated urine. However, several studies have shown the importance of transport systems for different tumor entities. Transport systems, for example, contributed to the proliferation and migration of cancer cells and thereby on tumor progression. They could also serve as drug transporters that could enable drug resistance by outward transport of, for example, chemotherapeutic agents and other drugs. Although many renal transporters have been characterized in detail with respect to the significance for proper kidney function, their role in renal cancer progression is less known. Here, we describe the types of renal cancer and review the studies that analyzed the role of organic cation transporters of the SLC22-family and of the aquaporin water channel family in kidney tumors.
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Affiliation(s)
- Giuliano Ciarimboli
- Medicine Clinic D, Experimental Nephrology, University Hospital of Münster, Münster, Germany
| | - Gerit Theil
- Clinic of Urology, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Joanna Bialek
- Clinic of Urology, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Bayram Edemir
- Department of Medicine, Hematology and Oncology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
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149
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Tan WS, Trinh QD, Hayn MH, Marchese M, Lipsitz SR, Nabi J, Kilbridge KL, Vale JA, Khoubehi B, Kibel AS, Sun M, Chang SL, Sammon JD. Delayed nephrectomy has comparable long-term overall survival to immediate nephrectomy for cT1a renal cell carcinoma: A population-based analysis. Urol Oncol 2019; 38:74.e13-74.e20. [PMID: 31864937 DOI: 10.1016/j.urolonc.2019.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/06/2019] [Accepted: 11/25/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Early surgical resection remains the recommended treatment option for most small renal mass (≤4 cm). We examined the long-term overall survival (OS) of patients managed with delayed and immediate nephrectomy of cT1a renal cancer. PATIENT AND METHODS We utilized the National Cancer Database (2005-2010) to identify 14,677 patients (immediate nephrectomy: 14,050 patients vs. late nephrectomy: 627 patients) aged <70 years with Charlson Comorbidity Index 0 and cT1aN0M0 renal cell carcinoma. Immediate nephrectomy and late nephrectomy were defined as nephrectomy performed <30 days and >180 days from diagnosis, respectively. Inverse probability of treatment weighting-adjusted Kaplan-Meier curves and Cox proportional hazards regression analyses were used to compare OS of patients in the 2 treatment arms. Influence of patient age and Charlson Comorbidity Index on treatment effect was tested by interactions. Sensitivity analysis was performed to explore the outcome of delaying nephrectomy for >12 months. RESULTS Median patient age was 55 years with a median follow-up of 82.5 months. Inverse probability of treatment weighting-adjusted Kaplan-Meier curves suggest no significant difference between treatment arms (immediate nephrectomy [<30 days] vs. delayed nephrectomy [>180 days]) (Hazard ratio 0.96; 95% confidence interval 0.73-1.26; P = 0.77). This outcome was consistent between all patients regardless of age (P = 0.48). Sensitivity analysis reports no difference in OS even if nephrectomy was delayed by >12 months (P = 0.60). CONCLUSIONS We report that delayed and immediate nephrectomy for cT1a renal cell carcinoma confers comparable long-term OS. These findings suggest that a period of observation of between 6 and 12 months is safe to allow identification of renal masses, which will benefit from surgical resection.
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Affiliation(s)
- Wei Shen Tan
- Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Division of Surgery & Interventional Science, Department of Urology, University College London, London, United Kingdom; Department of Urology, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Quoc-Dien Trinh
- Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA.
| | - Matthew H Hayn
- Division of Urology, Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME
| | - Maya Marchese
- Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Stuart R Lipsitz
- Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Junaid Nabi
- Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Kerry L Kilbridge
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Justin A Vale
- Department of Urology, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Bijan Khoubehi
- Department of Urology, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Adam S Kibel
- Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Maxine Sun
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Steven L Chang
- Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Jesse D Sammon
- Division of Urology, Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME
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150
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Ribeiro AMB, Lima ENP, Rocha MM. Fibrous dysplasia as a possible false-positive finding in 68Ga-labeled prostate-specific membrane antigen positron emission tomography/computed tomography study in the follow-up of prostate cancer. World J Nucl Med 2019; 18:409-412. [PMID: 31933558 PMCID: PMC6945358 DOI: 10.4103/wjnm.wjnm_111_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 12/21/2018] [Indexed: 01/20/2023] Open
Abstract
Positron emission tomography/computed tomography (PET/CT) using 68Ga-labeled prostate-specific membrane antigen (68Ga-PSMA) has become an important tool in restaging patients with prostate cancer (PCa). Despite its high sensitivity and specificity, this method may produce false-positive findings, as indicated by previous studies. This case report aims to warn nuclear medicine physicians, oncologists, and urologists about the possibility of false-positive findings using this imaging modality, especially when the detected site is unusual for bone metastasis. A 68-year-old man with PCa underwent restaging tests after presenting with increased prostate-specific antigen. 68Ga-PSMA PET/CT imaging revealed abnormal uptake in the left humeral head, which anatomically corresponded to the intramedullary and cortical sclerotic area. A biopsy was performed, and the pathology showed a lesion consisting of hard bone tissue with a small focal spot of fibrous dysplasia. Diagnostic issues related to 68Ga-PSMA PET/CT imaging should be disseminated to help physicians make appropriate treatment choices for each patient.
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