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Çetin B, Çilesiz NC, Ozkan A, Onuk Ö, Kır G, Balci MBC, Özdemir E. Enhanced Recovery After Surgery (ERAS) Reduces Hospital Costs and Length of Hospital Stay in Radical Cystectomy: A Prospective Randomized Controlled Study. Cureus 2024; 16:e55460. [PMID: 38571847 PMCID: PMC10988186 DOI: 10.7759/cureus.55460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 04/05/2024] Open
Abstract
Enhanced recovery after surgery (ERAS) protocols challenge the conventional and rigid methods of surgery and anesthesia and bring about novel changes that are quite drastic. The core principle of the protocol is to minimize the metabolic disturbance caused by surgical injury, facilitate the restoration of functions in a brief period, and promote the resumption of normal activity at the earliest. To compare the outcomes of ERAS and standard protocol for patients who have undergone radical cystectomy (RC) with ileal conduit urinary diversion. This prospective randomized controlled study was performed between 2015 and 2023. The 77 patients were divided into two groups ERAS (n=39) and Standard (n=38) by sequential randomization. These two groups are divided according to protocols of bowel preparation, anesthesia, and postoperative nutrition. The clinical and demographic characteristics of the patients, and the American Society of Anesthesiologists (ASA) and Eastern Cooperative Oncology Group (ECOG) scores were recorded. Perioperative findings, the degree of complications according to the Clavien-Dindo classification, and the total cost of treatment were recorded and analyzed. Length of hospital stay (18.82±9.25 day vs 27.34±15.05 day), and cost of treatment (2168,2±933$ 2879±1806$) were higher in the standard group. The rate of nausea and vomiting and the use of antiemetics were higher in the ERAS group compared to the standard group. In patients undergoing RC, the ERAS protocol was found to shorten the duration of hospitalization and reduce the total cost of hospital stay.
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Affiliation(s)
- Buğra Çetin
- Urology, Altınbaş University Medicalpark Bahçelievler Hospital, Istanbul, TUR
| | | | | | - Özkan Onuk
- Urology, Biruni University Hospital, Istanbul, TUR
| | - Gülay Kır
- Anesthesiology and Reanimation, Koç University, Istanbul, TUR
| | - M B Can Balci
- Urology, Taksim Training and Research Hospital, Istanbul, TUR
| | - Enver Özdemir
- Urology, Gaziosmanpaşa Training and Research Hospital, Istanbul, TUR
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2
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Onder RO, Aslan S, Bekci T. Prevalence of Bladder Cancers Incidentally Detected During Multiparametric MRI Scans of the Prostate Gland and the Clinical Significance of Scoring Them According to VI-RADS: A Pictorial Single-Centre Study. J Belg Soc Radiol 2024; 108:7. [PMID: 38312149 PMCID: PMC10836167 DOI: 10.5334/jbsr.3318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/16/2024] [Indexed: 02/06/2024] Open
Abstract
Purpose To determine the prevalence of incidentally detected bladder cancers (BCs) on multiparametric magnetic resonance imaging (mpMRI) of the prostate and to highlight the clinical importance of scoring them according to the Vesical Imaging-Reporting and Data System (VI-RADS). Materials and Methods VI-RADS scores for incidental bladder lesions on mpMRI of the prostate were collected in 1693 patients with elevated prostate-specific antigen but no hematuria. The study included 19 patients with 28 incidental bladder lesions. Results During this period, 39 incidental bladder lesions were found in 30 patients, representing 1.7% of cases. Of the 28 lesions, 11 were categorized by VI-RADS as VI-RADS 1, 14 as VI-RADS 2, 1 as VI-RADS 3, 1 as VI-RADS 4, and 1 as VI-RADS 5. Histopathological examination revealed 1 benign lesion, 24 non-muscle invasive BCs, and 3 muscle-invasive BCs in the 19 patients. Impressively, 97% of the incidental lesions detected by prostate mpMRI and categorized by VI-RADS were BCs without apparent prostate cancer invasion. Notably, 93% of these lesions were consistent with histopathological findings of muscle invasion and extravesical spread. Conclusion Our study concludes the prevalence 1% incidental BC in prostate mpMRI. The research underscores a thorough bladder examination during prostate MRI scans. Utilizing mpMRI assists in distinguishing varying BC stages, aiding treatment decisions, and patient outcomes. VI-RADS categorization aligns with histopathological results, enhancing diagnosis, and healthcare communication. Early detection significantly influences patient care by enabling timely interventions and suitable treatment strategies, particularly for low-stage BCs linked to reduced progression and recurrence rates.
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Affiliation(s)
- Ramazan Orkun Onder
- Faculty of Medicine, Department of Radiology, Giresun University, Giresun, Turkey
| | - Serdar Aslan
- Faculty of Medicine, Department of Radiology, Giresun University, Giresun, Turkey
| | - Tümay Bekci
- Faculty of Medicine, Department of Radiology, Giresun University, Giresun, Turkey
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3
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Kizilgoz V, Kantarci M, Tonkaz G, Levent A, Ogul H. Incidental findings on prostate MRI: a close look at the field of view in this anatomical region. Acta Radiol 2022; 64:1676-1693. [PMID: 36226365 DOI: 10.1177/02841851221131243] [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: 11/15/2022]
Abstract
Magnetic resonance imaging (MRI) has been widely used as an advanced imaging modality to detect prostate cancer and indicate suspicious areas to guide biopsy procedures. The increasing number of prostate examinations with MRI has provided an opportunity to detect incidental lesions, and some might be very significant to elucidate patient symptoms or occult neoplastic process in the early stages. These incidental lesions might be located in the prostate gland, adjacent tissues, or organs around the prostate gland or out of the genitourinary system. The field of view of prostate MRI includes not only the prostate gland but also other critical pelvic organs in this specific anatomical region. Some of these incidental lesions might cause the same symptoms as prostate cancer and might explain the symptoms of the patient, and some might indicate early cancer stages located outside the prostate. Reporting these lesions might be life-saving by initiating early disease treatment. Awareness of the predicted locations of congenital anomalies would also be beneficial for the radiologists to mention these incidental findings.
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Affiliation(s)
- Volkan Kizilgoz
- Faculty of Medicine, Department of Radiology, 162315Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Mecit Kantarci
- Faculty of Medicine, Department of Radiology, 162315Erzincan Binali Yıldırım University, Erzincan, Turkey.,Faculty of Medicine, Department of Radiology, 37503Atatürk University, Erzurum, Turkey
| | - Gokhan Tonkaz
- Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Akin Levent
- Faculty of Medicine, Department of Radiology, 162315Erzincan Binali Yıldırım University, Erzincan, Turkey.,Faculty of Medicine, Department of Radiology, 37503Atatürk University, Erzurum, Turkey
| | - Hayri Ogul
- Faculty of Medicine, Department of Radiology, Düzce University, Düzce, Turkey
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4
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O’Meara S, Byrnes KG, Nic An Ríogh AU, Little DM, Davis NF. The use of an automated electronic registry for bladder cancer surveillance during the SARS-CoV-2 pandemic. JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/20514158211000197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: We aimed to develop and compare the utility of an automated registry of all patients undergoing surveillance for non-muscle invasive bladder cancer (NMIBC) during the severe acute respiratory virus coronavirus 2 (SARS-CoV-2) pandemic. Methods: We populated an electronic register of all patients undergoing bladder tumour surveillance (July–September 2019). The computerised ‘traffic-light’ system was implemented in September 2019 marking the beginning of phase 2. The register was audited at two- and six-months intervals during phase 2 (November 2019 and April 2020). Audit of the system In April 2020 allowed review of care given during the peak of the SARS-CoV-2 pandemic in Ireland. The primary outcome variable was the number of patients who had delayed surveillance cystoscopy in each group. Results: A total of 278 cases were reviewed, 96 in the first cohort and 91 at both intervals of second phase. During the first phase of the audit 17 patients (17.7%) had a missed cystoscopy. Phase 2 showed a sustained decrease in the number of patients with missed surveillance, with eight (8.8%) missing their procedure in both the November and April (SARS-CoV-2) cohorts (17 v. 8, X2 = 10.76, p = 0.0004). Overall, most patients had their procedure done within the recommended time interval (245, 88%). Conclusion: A centralised accessible computerised registry of patients with NMIBC undergoing surveillance is superior to traditional manual surveillance methods, especially during the period of SARS-CoV-2. Going forward we aim to have all patients undergo surveillance within schedule with a long-term goal of a centralised national registry. Level of evidence: Level 2c: “Outcomes Research”.
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Affiliation(s)
- S O’Meara
- Department of Urology, Beaumont Hospital, Ireland
| | - KG Byrnes
- Department of Urology, Beaumont Hospital, Ireland
| | | | - DM Little
- Department of Urology, Beaumont Hospital, Ireland
| | - NF Davis
- Department of Urology, Beaumont Hospital, Ireland
- Department of Surgery, The Royal College of Surgeons in Ireland, Ireland
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5
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Kavukoglu Ö, Coskun A, Sabuncu K, Çamur E, Faydaci G. Is it possible to reduce the complications and mortality of patients undergoing radical cystectomy? Effectiveness of pre-operative parameters. A prospective study. Arch Ital Urol Androl 2021; 93:379-384. [PMID: 34933521 DOI: 10.4081/aiua.2021.4.379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/09/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the relationship between serum albumin, hematocrit (HTC), age-dependent Charlson comorbidity index, body mass index (BMI), and deleted operation time in predicting mortality and complications associated with radical cystectomy. MATERIALS AND METHODS All patients planned for radical cystectomy owing to bladder cancer were investigated prospectively between 2015 and 2016 in our clinic. A total of 55 cases were included in the study. Patients' characteristics, preoperative serum albumin values, hematocrit level, age-dependent Charlson comorbidity index (CCI), body mass index and deleted operation time, drainage catheter time, gas-stool expulsion time were recorded. The patients were followed up for 90 days. RESULTS Age of cases, Charlson comorbidity index scores, and HCT were not different in patients with or without complications (overall) or severe complications nor in patients who died or survived after the procedure. The albumin value of the cases with observed mortality and complications was significantly lower than that of the cases with no mortality and complications. In multivariate and univariate analysis, low albumin level was established to be meaningful in predicting mortality and serious complications. The cut-off point for albumin, according to mortality, was found to be 4.1. Mortality within 90 days was 16.3% (n = 9). CONCLUSIONS We have evaluated albumin as a marker that could indicate both mortality and the presence of severe complications after radical cystectomy and urinary diversion.
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Affiliation(s)
- Övünç Kavukoglu
- Department of Urology, University of Health Sciences, Kartal Dr. Lutfi Kırdar City Hospital, Istanbul.
| | - Alper Coskun
- Department of Urology, University of Health Sciences, Kartal Dr. Lutfi Kırdar City Hospital, Istanbul.
| | - Kubilay Sabuncu
- Department of Urology, University of Health Sciences, Kartal Dr. Lutfi Kırdar City Hospital, Istanbul.
| | - Emre Çamur
- Department of Urology, University of Health Sciences, Kartal Dr. Lutfi Kırdar City Hospital, Istanbul.
| | - Gökhan Faydaci
- Department of Urology, University of Health Sciences, Kartal Dr. Lutfi Kırdar City Hospital, Istanbul.
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6
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Afify H, Ghoneum A, Almousa S, Abdulfattah AY, Warren B, Langsten K, Gonzalez D, Casals R, Bharadwaj M, Kridel S, Said N. Metabolomic credentialing of murine carcinogen-induced urothelial cancer. Sci Rep 2021; 11:22085. [PMID: 34764423 PMCID: PMC8585868 DOI: 10.1038/s41598-021-99746-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/28/2021] [Indexed: 11/24/2022] Open
Abstract
Bladder cancer (BCa) is the most common malignancy of the urinary system with increasing incidence, mortality, and limited treatment options. Therefore, it is imperative to validate preclinical models that faithfully represent BCa cellular, molecular, and metabolic heterogeneity to develop new therapeutics. We performed metabolomic profiling of premalignant and non-muscle invasive bladder cancer (NMIBC) that ensued in the chemical carcinogenesis N-butyl-N-(4-hydroxybutyl)-nitrosamine (BBN) mouse model. We identified the enriched metabolic signatures that associate with premalignant and NMIBC. We found that enrichment of lipid metabolism is the forerunner of carcinogen-induced premalignant and NMIBC lesions. Cross-species analysis revealed the prognostic value of the enzymes associated with carcinogen-induced enriched metabolic in human disease. To date, this is the first study describing the global metabolomic profiles associated with early premalignant and NMIBC and provide evidence that these metabolomic signatures can be used for prognostication of human disease.
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Affiliation(s)
- Hesham Afify
- Department of Cancer Biology, Medical Center Boulevard, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
| | - Alia Ghoneum
- Department of Cancer Biology, Medical Center Boulevard, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
| | - Sameh Almousa
- Department of Cancer Biology, Medical Center Boulevard, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
| | - Ammar Yasser Abdulfattah
- Department of Cancer Biology, Medical Center Boulevard, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
| | - Bailey Warren
- Department of Cancer Biology, Medical Center Boulevard, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
| | - Kendall Langsten
- Department of Cancer Biology, Medical Center Boulevard, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
| | - Daniela Gonzalez
- Department of Cancer Biology, Medical Center Boulevard, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
| | - Randy Casals
- Department of Cancer Biology, Medical Center Boulevard, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
- Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
| | - Manish Bharadwaj
- Cell Analysis Division, Agilent Technologies, Inc, Santa Clara, CA, 95051, USA
| | - Steven Kridel
- Department of Cancer Biology, Medical Center Boulevard, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
- Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
- Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, 27157, USA
| | - Neveen Said
- Department of Cancer Biology, Medical Center Boulevard, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA.
- Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA.
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA.
- Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, 27157, USA.
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7
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Panebianco V, Pecoraro M, Del Giudice F, Takeuchi M, Muglia VF, Messina E, Cipollari S, Giannarini G, Catalano C, Narumi Y. VI-RADS for Bladder Cancer: Current Applications and Future Developments. J Magn Reson Imaging 2020; 55:23-36. [PMID: 32939939 DOI: 10.1002/jmri.27361] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 01/07/2023] Open
Abstract
Bladder cancer (BCa) is among the ten most frequent cancers globally. It is the tumor with the highest lifetime treatment-associated costs, and among the tumors with the heaviest impacts on postoperative quality of life. The purpose of this article is to review the current applications and future perspectives of the Vesical Imaging Reporting and Data System (VI-RADS). VI-RADS is a newly developed scoring system aimed at standardization of MRI acquisition, interpretation, and reporting for BCa. An insight will be given on the BCa natural history, current MRI applications for local BCa staging with assessment of muscle invasiveness, and clinical implications of the score for disease management. Future applications include risk stratification of nonmuscle invasive BCa, surveillance, and prediction and monitoring of therapy response. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Valeria Panebianco
- Department of Radiological Sciences, Oncology and Pathology, Sapienza/Policlinico Umberto I, Rome, Italy
| | - Martina Pecoraro
- Department of Radiological Sciences, Oncology and Pathology, Sapienza/Policlinico Umberto I, Rome, Italy
| | - Francesco Del Giudice
- Department of Maternal-Infant and Urological Sciences, Sapienza/Policlinico Umberto I, Rome, Italy
| | | | - Valdair F Muglia
- Department of Medical Images, Radiation Therapy and Oncohematology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Emanuele Messina
- Department of Radiological Sciences, Oncology and Pathology, Sapienza/Policlinico Umberto I, Rome, Italy
| | - Stefano Cipollari
- Department of Radiological Sciences, Oncology and Pathology, Sapienza/Policlinico Umberto I, Rome, Italy
| | - Gianluca Giannarini
- Urology Unit, Academic Medical Centre "Santa Maria della Misericordia", Udine, Italy
| | - Carlo Catalano
- Department of Radiological Sciences, Oncology and Pathology, Sapienza/Policlinico Umberto I, Rome, Italy
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8
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Bourn J, Pandey S, Uddin J, Marnett L, Cekanova M. Detection of tyrosine kinase inhibitors-induced COX-2 expression in bladder cancer by fluorocoxib A. Oncotarget 2019; 10:5168-5180. [PMID: 31497247 PMCID: PMC6718263 DOI: 10.18632/oncotarget.27125] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 07/17/2019] [Indexed: 01/02/2023] Open
Abstract
Among challenges of targeted therapies is the activation of alternative pro-survival signaling pathways in cancer cells, resulting in an acquired drug resistance. Cyclooxygenase-2 (COX-2) is overexpressed in bladder cancer cells, making it an attractive molecular target for the detection and treatment of cancer. Fluorocoxib A is an optical imaging agent that selectively targets COX-2. In this study, we evaluated the ability of fluorocoxib A to monitor the responses of bladder cancer to targeted therapies in vivo. The effects of several tyrosine kinase inhibitors (TKIs: axitinib, AB1010, toceranib, imatinib, erlotinib, gefitinib, imatinib, sorafenib, vandetanib, SP600125, UO126, and AZD 5438) on COX-2 expression were validated in ten human and canine bladder cancer cell lines (J82, RT4, T24, UM-UC-3, 5637, SW780, TCCSUP, K9TCC#1Lillie, K9TCC#2Dakota, K9TCC#5Lilly) in vitro. The effects of TKIs on bladder cancer in vivo were evaluated using the COX-2-expressing K9TCC#5Lilly xenograft mouse model and detected by fluorocoxib A. The increased COX-2 expression was detected by all tested TKIs in at least one of the tested COX-2-expressing bladder cancer cell lines (5637, SW780, TCCSUP, K9TCC#1Lillie, K9TCC#2Dakota, and K9TCC#5Lilly) in vitro. In addition, fluorocoxib A uptake correlated with the AB1010- and imatinib-induced COX-2 expression in the K9TCC#5Lilly xenografts in vivo. In conclusion, these results indicate that fluorocoxib A could be used for the monitoring the early responses to targeted therapies in COX-2-expressing bladder cancer.
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Affiliation(s)
- Jennifer Bourn
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN 37996, USA.,University of Tennessee and Oak Ridge National Laboratory, Graduate School of Genome Science and Technology, The University of Tennessee, Knoxville, TN 37996, USA.,Current address: Department of Cancer Biology, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Sony Pandey
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN 37996, USA
| | - Jashim Uddin
- A. B. Hancock, Jr., Memorial Laboratory for Cancer Research, Departments of Biochemistry, Chemistry and Pharmacology, Vanderbilt Institute of Chemical Biology, Center for Molecular Toxicology and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Lawrence Marnett
- A. B. Hancock, Jr., Memorial Laboratory for Cancer Research, Departments of Biochemistry, Chemistry and Pharmacology, Vanderbilt Institute of Chemical Biology, Center for Molecular Toxicology and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Maria Cekanova
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN 37996, USA.,University of Tennessee and Oak Ridge National Laboratory, Graduate School of Genome Science and Technology, The University of Tennessee, Knoxville, TN 37996, USA
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9
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Rayn KN, Hale GR, Bloom JB, Gold SA, Carvalho FLF, Mehralivand S, Czarniecki M, Wood BJ, Merino MJ, Choyke P, Türkbey B, Pinto PA, Agarwal PK. Incidental bladder cancers found on multiparametric MRI of the prostate gland: a single center experience. ACTA ACUST UNITED AC 2019; 24:316-320. [PMID: 30211685 DOI: 10.5152/dir.2018.18102] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE In the era of multiparametric magnetic resonance imaging (mpMRI) of the prostate gland, incidental findings are occasionally discovered on imaging. We aimed to report our experience of detecting incidental bladder cancers on mpMRI of the prostate in asymptomatic patients without irritative voiding symptoms or microscopic or gross hematuria. METHODS A retrospective review was performed on a prospectively maintained database of all men who underwent prostate mpMRI at our institution from 2012 to 2018. Patients who were found to have incidental bladder lesions were identified and baseline demographics, imaging and histopathologic data were recorded. All patients with incidental bladder lesion detection on mpMRI, not attributable to extension of prostate cancer, underwent cystoscopy in addition to a biopsy and/or transurethral resection of bladder tumor (TURBT) if warranted on cystoscopy. RESULTS There were 3147 prostate mpMRIs performed during this period and 25 cases (0.8%) of incidental bladder lesions were detected. These patients did not have any presenting symptoms such as gross or microscopic hematuria to prompt bladder lesion workup. The largest diameter of incidentally discovered bladder lesions ranged from 0.4 cm to 1.7 cm. Of the 25 cases of incidental bladder lesions, five were suspected to be due to prostate cancer invasion into the bladder. Only two of these five patients underwent biopsy, which confirmed prostate adenocarcinoma in both cases. Of the 20 patients without suspected prostate cancer invasion of the bladder, four had no suspicious lesions on cystoscopy to warrant a biopsy. The remaining 16 patients had bladder lesions seen on cystoscopy and underwent a biopsy and/or TURBT. Three of these patients had benign features on pathology (urachal remnant, amyloidosis and inflammation) and the remaining 13 had stage Ta urothelial carcinoma. Seven of these patients had low-grade Ta tumors and six had high-grade Ta tumors. All patients were treated with standard management of TURBT with or without intravesical BCG. There have been no reported cases of recurrence or progression in any of the patients in our cohort at the median follow-up of 26 months (interquartile range,19-40 months). CONCLUSION mpMRI of the prostate may yield incidental findings, such as small bladder tumors. Awareness of the possibility of incidental bladder lesions is important as 65% of lesions reported in the bladder, not attributable to extension of prostate cancer, proved to be bladder cancer. This may allow for early intervention for asymptomatic patients with undetected bladder cancer prior to disease progression.
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Affiliation(s)
- Kareem N Rayn
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Graham R Hale
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jonathan B Bloom
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Samuel A Gold
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Filipe L F Carvalho
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA; Department of Urology MedStar Georgetown University Hospital, Washington, DC, USA
| | - Sherif Mehralivand
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Marcin Czarniecki
- Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Bradford J Wood
- Center for Interventional Oncology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Maria J Merino
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Peter Choyke
- Molecular Imaging Program National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Barış Türkbey
- Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Peter A Pinto
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Piyush K Agarwal
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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10
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Said N. Roles of SPARC in urothelial carcinogenesis, progression and metastasis. Oncotarget 2018; 7:67574-67585. [PMID: 27564266 PMCID: PMC5341897 DOI: 10.18632/oncotarget.11590] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 07/27/2016] [Indexed: 12/12/2022] Open
Abstract
Secreted Protein Acidic and Rich in Cysteine (SPARC) is a matricellular glycoprotein that is implicated in myriad physiological and pathological conditions characterized by extensive remodeling and plasticity. The functions and disease association of SPARC in cancer is being increasingly appreciated as it plays multi-faceted contextual roles depending on the cancer type, cell of origin and the unique cancer milieu at both primary and metastatic sites. Herein we will review our current knowledge of the role of SPARC in the multistep cascades of urinary bladder carcinogenesis, progression and metastasis from preclinical models and clinical data and shine the light on its prognostic and therapeutic potentials.
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Affiliation(s)
- Neveen Said
- Department of Cancer Biology, Wake Forest University Health Sciences, Winston Salem, NC, USA
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11
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Flat Intraurothelial Neoplasia Exhibiting Diffuse Immunoreactivity for CD44 and Cytokeratin 5 (Urothelial Stem Cell/Basal Cell Markers): A Variant of Intraurothelial Neoplasia Commonly Associated With Muscle-invasive Urothelial Carcinoma. Appl Immunohistochem Mol Morphol 2017; 25:505-512. [DOI: 10.1097/pai.0000000000000334] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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12
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Khare SR, Aprikian A, Black P, Blais N, Booth C, Brimo F, Chin J, Chung P, Drachenberg D, Eapen L, Fairey A, Fleshner N, Fradet Y, Gotto G, Izawa J, Jewett M, Kulkarni G, Lacombe L, Moore R, Morash C, North S, Rendon R, Saad F, Shayegan B, Siemens R, So A, Sridhar SS, Traboulsi SL, Kassouf W. Quality indicators in the management of bladder cancer: A modified Delphi study. Urol Oncol 2017; 35:328-334. [PMID: 28065393 DOI: 10.1016/j.urolonc.2016.12.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 11/12/2016] [Accepted: 12/06/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Survival in patients with bladder cancer has only moderately improved over the past 2 decades. A potential reason for this is nonadherence to clinical guidelines and best practice, leading to wide variations in care. Common quality indicators (QIs) are needed to quantify adherence to best practice and provide data for benchmarking and quality improvement. OBJECTIVE To produce an evidence- and consensus-based list of QIs for the management of bladder cancer. METHODS A modified Delphi method was used to develop the indicator list. Candidate indicators were extracted from the literature and rated by a 27-member Canadian expert panel in several rounds until consensus was reached on the final list of indicators. In rounds with numeric ratings, a frequency analysis was performed. RESULTS A total of 86 indicators were rated, 52 extracted from the literature and 34 suggested by the panel. After iterative rounds of ratings and discussion, a final list of 60 QIs spanning several disciplines and phases of the cancer care continuum was developed. CONCLUSIONS This is the first study to comprehensively produce common QIs representing structure, process, and outcome measures in bladder cancer management. Though developed in Canada, these indicators can be used in other countries with slight modifications to track performance and improve care.
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Affiliation(s)
- Satya R Khare
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Armen Aprikian
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada
| | - Peter Black
- Department of Urology, University of British Columbia, Vancouver, BC, Canada
| | - Normand Blais
- Division of Medical Oncology, University of Montreal, Montreal, QC, Canada
| | - Chris Booth
- Department of Oncology, Queen's University, Kingston, ON, Canada
| | - Fadi Brimo
- Department of Pathology, McGill University Health Centre, Montreal, QC, Canada
| | - Joseph Chin
- Division of Urology, Western University, London, ON, Canada
| | - Peter Chung
- Department of Radiation Oncology, Princess Margaret Cancer Centre and the University Health Network, University of Toronto, Toronto, ON, Canada
| | | | - Libni Eapen
- Division of Radiation Oncology, University of Ottawa, Ottawa, ON, Canada
| | - Adrian Fairey
- Division of Urology, University of Alberta, Edmonton, AB, Canada
| | - Neil Fleshner
- Departments of Surgery (Urology), Princess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada; Department of Surgical Oncology, Princess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada
| | - Yves Fradet
- Division of Urology, Laval University, Quebec City, QC, Canada
| | - Geoffrey Gotto
- Division of Urology, University of Calgary, Calgary, AB, Canada
| | - Jonathan Izawa
- Division of Urology, Western University, London, ON, Canada
| | - Michael Jewett
- Departments of Surgery (Urology), Princess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada; Department of Surgical Oncology, Princess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada
| | - Girish Kulkarni
- Departments of Surgery (Urology), Princess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada; Department of Surgical Oncology, Princess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada
| | - Louis Lacombe
- Division of Urology, Laval University, Quebec City, QC, Canada
| | - Ron Moore
- Division of Urology, University of Alberta, Edmonton, AB, Canada
| | - Chris Morash
- Division of Urology, University of Ottawa, Ottawa, ON, Canada
| | - Scott North
- Division of Medical Oncology, University of Alberta, Edmonton, AB, Canada
| | - Ricardo Rendon
- Division of Urology, Dalhousie University, Halifax, NS, Canada
| | - Fred Saad
- Division of Urology, University of Montreal, QC, Canada
| | - Bobby Shayegan
- Division of Urology, McMaster University, Hamilton, ON, Canada
| | - Robert Siemens
- Department of Oncology, Queen's University, Kingston, ON, Canada; Department of Urology, Queen's University, Kingston, ON, Canada
| | - Alan So
- Department of Urology, University of British Columbia, Vancouver, BC, Canada
| | - Srikala S Sridhar
- Department of Medical Oncology, Princess Margaret Cancer Centre and the University Health Network, University of Toronto, Toronto, ON, Canada
| | - Samer L Traboulsi
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada
| | - Wassim Kassouf
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada.
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Abdulmajed MI, Sancak EB, Reşorlu B, Al-Chalaby GZ. What are the currently available and in development molecular markers for bladder cancer? Will they prove to be useful in the future? Turk J Urol 2015; 40:228-32. [PMID: 26328183 DOI: 10.5152/tud.2014.60973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 05/05/2014] [Indexed: 11/22/2022]
Abstract
Urothelial carcinoma is the 9(th) most common cancer worldwide. Most urothelial tumors are non-muscle invasive on presentation. However, two-thirds of non-invasive bladder cancers will eventually recur with a 25% risk of progression to muscle-invasive bladder cancer. Tumor stage, histological grade and pathological invasion of blood vessels and lymphatic tissue are the main indicators for urothelial cancer prognosis. The gold standard for diagnosing bladder cancer is conventional white-light cystoscopy and biopsy. Urine cytology is a highly specific, sensitive test for high-grade tumors or carcinoma in situ (CIS). Urinary NMP22 has an overall sensitivity and specificity for detecting bladder cancer of 49% and 87%, respectively. However, there are false-positive results in the presence of urinary tract infection or hematuria. The detection of specific gene mutations related to urothelial cancers has been studied and employed to reproduce markers helpful for diagnosis. According to current studies, molecular markers can be used to predict tumor recurrence. From a prognostic point of view, new molecular markers have yet to be established as reliable indicators of tumor aggressiveness. We aimed to review the molecular markers with possible prognostic significance that have been discussed in the literature. This review examined the literature for various molecular markers under development for bladder cancer in an attempt to optimize patient care and reduce the costs of treating these patients.
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Affiliation(s)
- Mohamed Ismat Abdulmajed
- Department of Urology, Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board, Wrexham, Wales, United Kingdom
| | - Eyüp Burak Sancak
- Department of Urology, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Berkan Reşorlu
- Department of Urology, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey
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Chamie K, Ballon-Landa E, Daskivich TJ, Bassett JC, Lai J, Hanley JM, Konety BR, Litwin MS, Saigal CS. Treatment and survival in patients with recurrent high-risk non-muscle-invasive bladder cancer. Urol Oncol 2014; 33:20.e9-20.e17. [PMID: 25443267 DOI: 10.1016/j.urolonc.2014.08.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 08/27/2014] [Accepted: 08/29/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Multiple recurrences develop in patients with high-risk non-muscle-invasive bladder cancer. As neither the association of recurrences with survival nor the subsequent aggressive treatment in individuals with recurrent high-grade non-muscle-invasive bladder cancer has ever been quantified, we sought to determine whether the increasing number of recurrences is associated with higher subsequent treatment and mortality rates. METHODS Using linked Surveillance, Epidemiology, and End Results-Medicare data, we identified subjects with recurrent high-grade, non-muscle-invasive disease diagnosed in 1992 to 2002 and followed up until 2007. Using competing-risks regression analyses, we quantified the incidence of radical cystectomy, radiotherapy, and systemic chemotherapy after each recurrence. We then performed a propensity-score adjusted competing-risks regression analysis to determine whether the increasing recurrences portend worse survival. RESULTS Of 4,521 subjects, 2,694 (59.6%) had multiple recurrences within 2 years of diagnosis. Compared with patients who only had 1 recurrence, those with ≥ 4 recurrences were less likely to undergo radical cystectomy (hazard ratio [HR] = 0.73, 95% CI: 0.58-0.92), yet more likely to undergo radiotherapy (HR = 1.51, 95% CI: 1.23-1.85) and systemic chemotherapy (HR = 1.58, 95% CI: 1.15-2.18). For patients with ≥ 4 recurrences, only 25% were treated with curative intent. The 10-year cancer-specific mortality rates were 6.9%, 9.7%, 13.7%, and 15.7% for those with 1, 2, 3, and ≥ 4 recurrences, respectively. CONCLUSIONS Only 25% of patients with high-risk non-muscle-invasive bladder cancer who experienced recurrences at least 4 times underwent radical cystectomy or radiotherapy. Despite portending worse outcomes, increasing recurrences do not necessarily translate into higher treatment rates.
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Affiliation(s)
- Karim Chamie
- Health Services Research Group, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.
| | - Eric Ballon-Landa
- Health Services Research Group, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Timothy J Daskivich
- Health Services Research Group, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Jeffrey C Bassett
- Health Services Research Group, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | | | | | | | - Mark S Litwin
- Health Services Research Group, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA; RAND Corporation, Santa Monica, CA; Department of Health Services, University of California Los Angeles, School of Public Health, Los Angeles, CA
| | - Christopher S Saigal
- Health Services Research Group, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA; RAND Corporation, Santa Monica, CA
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Cost-effectiveness of neoadjuvant chemotherapy before radical cystectomy for muscle-invasive bladder cancer. Urol Oncol 2014; 32:1172-7. [DOI: 10.1016/j.urolonc.2014.05.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 04/30/2014] [Accepted: 05/03/2014] [Indexed: 11/21/2022]
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Mnatsakanyan E, Tung WC, Caine B, Smith-Gagen J. Cancer of unknown primary: time trends in incidence, United States. Cancer Causes Control 2014; 25:747-57. [DOI: 10.1007/s10552-014-0378-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 03/26/2014] [Indexed: 11/28/2022]
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Nazeri N. Incidental Sonographic Detection of Non–Muscle-Invasive Papillary Urothelial Carcinoma in a Low-Risk Patient. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2014. [DOI: 10.1177/8756479313515331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This case presentation describes the early diagnosis of an invasive urinary bladder cancer in a woman in her late 60s with no history of cancer, hematuria, dysuria, smoking, or hormone replacement therapy. This was confirmed on histopathology after tumor resection. The case report demonstrates the importance of including scanning the urinary bladder in all pelvic sonography examinations, even in the low-risk population. The following study also discusses the prevalence, etiology, diagnostic tools, prognosis, and treatment of bladder cancer. Different types of bladder tumors, staging, and grading criteria are also described.
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Affiliation(s)
- Nikta Nazeri
- Obstetrics and Gynecology Medical Group of Verdugo Hills, Glendale, CA, USA
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18
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General adherence to guideline recommendations on initial diagnosis of bladder cancer in the United States and influencing factors. Clin Genitourin Cancer 2013; 12:270-7. [PMID: 24332507 DOI: 10.1016/j.clgc.2013.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 09/30/2013] [Accepted: 11/08/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Because international guidelines recommend best practices regarding staging of incident bladder cancer, we determined the adherence to such recommendations in the United States, performing a large retrospective database analysis. PATIENTS AND METHODS Patients with the diagnosis of urothelial cancer were identified in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database between 1992 and 2007. Staging procedures were identified and analyzed. As reference for published recommendations, we used the American Urological Association (AUA), European Association of Urology (EAU), and National Comprehensive Cancer Network (NCCN) guidelines. Based on these sources, recommended initial staging of bladder cancer was analyzed. Of all 56,130 patients, 6148 (10.9%) had a cytologic examination, 29,677 (52.9%) had a standard urinalysis, 2882 (5.1%) underwent intravenous pyelography (IVP), 6950 (12.4%) underwent retrograde pyelography (RPG), and 8145 (14.5%) had computed tomography/magnetic resonance imaging (CT/MRI). RESULTS There was a significant trend over the years to a higher use of cytologic analysis, standard urinalysis, and CT/MRI. We observed a significant trend toward a lower rate of IVP and a stable use of RPG. The limitation of our study is that claims data are designed for payment processing, not quality measurement. CONCLUSION Despite published recommendations on the initial diagnosis of bladder cancer, our data show that less than half of the included patients received all the elements thought to be required for an initial diagnosis of bladder cancer as recommended by guidelines. Greater adherence to recommendations may ensure optimal treatment strategies. Appropriate treatment is critical to patient outcomes, because evidence-based therapeutic management can be practiced only if an accurate assessment of the disease takes place at the time of initial diagnosis.
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Chamie K, Litwin MS, Bassett JC, Daskivich TJ, Lai J, Hanley JM, Konety BR, Saigal CS. Recurrence of high-risk bladder cancer: a population-based analysis. Cancer 2013; 119:3219-27. [PMID: 23737352 DOI: 10.1002/cncr.28147] [Citation(s) in RCA: 234] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 03/12/2013] [Accepted: 04/08/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND Patients with bladder cancer are apt to develop multiple recurrences that require intervention. The recurrence, progression, and bladder cancer-related mortality rates were examined in a cohort of individuals with high-grade non-muscle-invasive bladder cancer. METHODS Using linked Surveillance, Epidemiology, and End Results (SEER)-Medicare data, subjects were identified who had a diagnosis of high-grade, non-muscle-invasive disease in 1992 to 2002 and who were followed until 2007. Multivariate competing-risks regression analyses were then used to examine recurrence, progression, and bladder cancer-related mortality rates. RESULTS Of 7410 subjects, 2897 (39.1%) experienced a recurrence without progression, 2449 (33.0%) experienced disease progression, of whom 981 succumbed to bladder cancer. Using competing-risks regression analysis, the 10-year recurrence, progression, and bladder cancer-related mortality rates were found to be 74.3%, 33.3%, and 12.3%, respectively. Stage T1 was the only variable associated with a higher rate of recurrence. Women, black race, undifferentiated grade, and stage Tis and T1 were associated with a higher risk of progression and mortality. Advanced age (≥ 70) was associated with a higher risk of bladder cancer-related mortality. CONCLUSIONS Nearly three-fourths of patients diagnosed with high-risk bladder cancer will recur, progress, or die within 10 years of their diagnosis. Even though most patients do not die of bladder cancer, the vast majority endures the morbidity of recurrence and progression of their cancer. Increasing efforts should be made to offer patients intravesical therapy with the goal of minimizing the incidence of recurrences. Furthermore, the high recurrence rate seen during the first 2 years of diagnosis warrants an intense surveillance schedule.
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Affiliation(s)
- Karim Chamie
- Department of Urology, Health Services Research Group, David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, California; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, California
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Schulman KL, Berenson K, Tina Shih YC, Foley KA, Ganguli A, de Souza J, Yaghmour NA, Shteynshlyuger A. A checklist for ascertaining study cohorts in oncology health services research using secondary data: report of the ISPOR oncology good outcomes research practices working group. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2013; 16:655-669. [PMID: 23796301 DOI: 10.1016/j.jval.2013.02.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES The ISPOR Oncology Special Interest Group formed a working group at the end of 2010 to develop standards for conducting oncology health services research using secondary data. The first mission of the group was to develop a checklist focused on issues specific to selection of a sample of oncology patients using a secondary data source. METHODS A systematic review of the published literature from 2006 to 2010 was conducted to characterize the use of secondary data sources in oncology and inform the leadership of the working group prior to the construction of the checklist. A draft checklist was subsequently presented to the ISPOR membership in 2011 with subsequent feedback from the larger Oncology Special Interest Group also incorporated into the final checklist. RESULTS The checklist includes six elements: identification of the cancer to be studied, selection of an appropriate data source, evaluation of the applicability of published algorithms, development of custom algorithms (if needed), validation of the custom algorithm, and reporting and discussions of the ascertainment criteria. The checklist was intended to be applicable to various types of secondary data sources, including cancer registries, claims databases, electronic medical records, and others. CONCLUSIONS This checklist makes two important contributions to oncology health services research. First, it can assist decision makers and reviewers in evaluating the quality of studies using secondary data. Second, it highlights methodological issues to be considered when researchers are constructing a study cohort from a secondary data source.
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Sivalingam S, Drachenberg D. The incidence of prostate cancer and urothelial cancer in the prostate in cystoprostatectomy specimens in a tertiary care Canadian centre. Can Urol Assoc J 2013; 7:35-8. [PMID: 23671490 DOI: 10.5489/cuaj.212] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Radical cystoprostatectomy remains the gold standard treatment for muscle invasive bladder cancer. However, given the treatment related complications of compromised potency and continence with this procedure, prostate/sexuality sparing cystectomy in orthotopic neobladder candidates has emerged in an effort to minimize these quality of life concerns. Recent evidence suggests only a marginal functional benefit from these technical refinements. We sought to determine the incidence of occult prostate cancer and urothelial cancer of the prostate in cystoprostatectomy specimens conducted for muscle invasive bladder cancer. METHODS We retrospectively reviewed 83 male patients who underwent radical cystoprostatectomy for muscle invasive bladder cancer between April 2004 and March 2007. The median age of our study group was 71 years. Pathologic findings of prostate/urothelial cancer in the prostate were identified. Clinically significant prostate cancer was defined as Gleason score >6, tumour volume >0.5cc, extracapsular extension or perineural invasion. RESULTS Our review yielded a 30% (±10%, 0.95 CI) rate of prostate cancer, with 19% (± 8.5%, 0.95 CI) of total specimens being positive for clinically significant prostate cancer. Urothelial cancer in the prostate was identified in 16% (±8.5%, 0.95 CI) of patients, with an overlap with prostate cancer in 2 patients. The overall rate of an underlying cancer within the prostate of our cystoprostatectomy specimens was about 46% (±10.7%, 0.95 CI). CONCLUSION These findings suggest that the oncological risk of leaving behind residual cancer may not justify the practice of prostate-sparing cystectomies.
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Affiliation(s)
- Sri Sivalingam
- Department of Urology, University of Manitoba, Winnipeg, MB
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Gakis G, Efstathiou J, Lerner SP, Cookson MS, Keegan KA, Guru KA, Shipley WU, Heidenreich A, Schoenberg MP, Sagaloswky AI, Soloway MS, Stenzl A. ICUD-EAU International Consultation on Bladder Cancer 2012: Radical cystectomy and bladder preservation for muscle-invasive urothelial carcinoma of the bladder. Eur Urol 2012; 63:45-57. [PMID: 22917985 DOI: 10.1016/j.eururo.2012.08.009] [Citation(s) in RCA: 293] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Accepted: 08/06/2012] [Indexed: 11/16/2022]
Abstract
CONTEXT New guidelines of the International Consultation on Urological Diseases for the treatment of muscle-invasive bladder cancer (MIBC) have recently been published. OBJECTIVE To provide a comprehensive overview of the current role of radical cystectomy (RC) in MIBC. EVIDENCE ACQUISITION A detailed Medline analysis was performed for original articles addressing the role of RC with regard to indication, timing, surgical extent, perioperative morbidity, oncologic outcome, and follow-up. The analysis also included radiation-based bladder-preserving strategies. EVIDENCE SYNTHESIS The major findings are presented in an evidence-based fashion and are based on large retrospective unicenter and multicenter series with some prospective data. CONCLUSIONS Open RC is the standard treatment for locoregional control of MIBC. Delay of RC is associated with reduced cancer-specific survival. In males, standard RC includes the removal of the bladder, prostate, seminal vesicles, and distal ureters; in females, RC includes an anterior pelvic exenteration including the bladder, entire urethra and adjacent vagina, uterus, and distal ureters. A procedure sparing the urethra and the urethra-supplying autonomous nerves can be performed in case of a planned orthotopic neobladder. Further technical variations (ie, seminal-sparing or vaginal-sparing techniques) aimed at improving functional outcomes must be weighed against the risk of a positive margin. Laparoscopic surgery is promising, but long-term data are required prior to accepting it as an option equivalent to the open procedure. Lymphadenectomy should remove all lymphatic tissue around the common iliac, external iliac, internal iliac, and obturator region bilaterally. Complications after RC should be reported according to the modified Clavien grading system. In selected patients with MIBC, bladder-preserving therapy with cystectomy reserved for tumor recurrence represents a safe and effective alternative to immediate RC.
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Affiliation(s)
- Georgios Gakis
- Department of Urology, University Hospital Tuebingen, Germany.
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Verma S, Rajesh A, Prasad SR, Gaitonde K, Lall CG, Mouraviev V, Aeron G, Bracken RB, Sandrasegaran K. Urinary Bladder Cancer: Role of MR Imaging. Radiographics 2012; 32:371-87. [DOI: 10.1148/rg.322115125] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Bladder cancer: improvements in clinical staging of muscle-invasive bladder cancer. Nat Rev Urol 2011; 8:360-1. [PMID: 21606973 DOI: 10.1038/nrurol.2011.69] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Montgomery JS, Weizer AZ, Montie JE. Editorial comment. Perioperative mortality is significantly greater in septuagenarian and octogenarian patients treated with radical cystectomy for urothelial carcinoma of the bladder. Urology 2011; 77:667-8. [PMID: 21377013 DOI: 10.1016/j.urology.2010.08.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 08/06/2010] [Accepted: 08/21/2010] [Indexed: 11/25/2022]
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Resnick MJ, Bergey M, Magerfleisch L, Tomaszewski JE, Malkowicz SB, Guzzo TJ. Longitudinal evaluation of the concordance and prognostic value of lymphovascular invasion in transurethral resection and radical cystectomy specimens. BJU Int 2010; 107:46-52. [DOI: 10.1111/j.1464-410x.2010.09635.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Whitson JM, Berry AB, Carroll PR, Konety BR. Urovysion™ testing can lead to early identification of intravesical therapy failure in patients with high risk non-muscle invasive bladder cancer. Int Braz J Urol 2009; 35:664-70; discussion 671-2. [DOI: 10.1590/s1677-55382009000600005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2009] [Indexed: 11/21/2022] Open
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Multiple Adverse Histological Features Increase the Odds of Under Staging T1 Bladder Cancer. J Urol 2009; 182:59-65; discussion 65. [DOI: 10.1016/j.juro.2009.02.116] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Indexed: 11/21/2022]
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Inequalities in bladder cancer survival. Nat Rev Urol 2009. [DOI: 10.1038/nrurol.2009.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Konety BR. Reducing bladder cancer deaths: the preemptive cystectomy approach. Cancer 2009; 115:914-7. [PMID: 19152439 DOI: 10.1002/cncr.24137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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