Reference Citation Analysis: Find an Article, Find a Category, Find a Journal, Find a Scholar

For: Miyake M, Matsuyama H, Teramukai S, Kinoshita F, Yokota I, Matsumoto H, Shimada K, Kinjyo M, Shimokama T, Okumura K, Yomenori M, Enokida H, Nakagawa M, Nakai Y, Fujimoto K; Nishinihon Uro-oncology Extensive Collaboration group. A new risk stratification model for intravesical recurrence, disease progression, and cancer-specific death in patients with non-muscle invasive bladder cancer: the J-NICE risk tables. Int J Clin Oncol 2020;25:1364-76. [PMID: 32232691 DOI: 10.1007/s10147-020-01654-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 03/04/2020] [Indexed: 10/24/2022]

For:	Miyake M, Matsuyama H, Teramukai S, Kinoshita F, Yokota I, Matsumoto H, Shimada K, Kinjyo M, Shimokama T, Okumura K, Yomenori M, Enokida H, Nakagawa M, Nakai Y, Fujimoto K; Nishinihon Uro-oncology Extensive Collaboration group. A new risk stratification model for intravesical recurrence, disease progression, and cancer-specific death in patients with non-muscle invasive bladder cancer: the J-NICE risk tables. Int J Clin Oncol 2020;25:1364-76. [PMID: 32232691 DOI: 10.1007/s10147-020-01654-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 03/04/2020] [Indexed: 10/24/2022]

Number

Cited by Other Article(s)

Miyake M, Kitamura H, Nishimura N, Miyamoto T, Nakahama T, Fujii T, Matsumoto H, Matsuyama H, Yonemori M, Enokida H, Taoka R, Kobayashi T, Kojima T, Matsui Y, Nishiyama N, Nishiyama H, Fujimoto K. Validation of non-muscle-invasive bladder cancer risk stratification updated in the 2021 European Association of Urology guidelines. BJUI COMPASS 2024;5:269-280. [PMID: 38371197 PMCID: PMC10869660 DOI: 10.1002/bco2.305] [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: 07/22/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 02/20/2024] Open

Abstract

Objective

The objective of this study is to validate the predictive ability of the 2021 European Association of Urology (EAU) risk model compared to that of existing risk models, including the 2019 EAU model and risk scoring tables of the European Organization for Research and Treatment of Cancer, Club Urologico Espanol de Tratamiento Oncologico, and Japanese Nishinihon Uro-oncology Extensive Collaboration Group.

Patients and methods

This retrospective multi-institutional database study included two cohorts-3024 patients receiving intravesical bacillus Calmette-Guerin (BCG) treatment (BCG cohort) and 789 patients not receiving BCG treatment (non-BCG cohort). The Kaplan-Meier estimate and log-rank test were used to visualize and compare oncological survival outcomes after transurethral surgery among the risk groups. Harrell's concordance index (C-index) was used to evaluate the predictive ability of the models.

Results

We observed a risk shift from the 2019 EAU risk grouping to the 2021 EAU risk grouping in a substantial number of patients. For progression, the C-index of the 2021 EAU model was significantly higher than that of the 2019 EAU model in both the BCG (0.617 vs. 0.572; P = 0.011) and non-BCG (0.718 vs. 0.560; P < 0.001) cohorts. According to the 2021 EAU model, 731 (24%) and 130 (16%) patients in the BCG and non-BCG cohorts, respectively, were considered to have a very high risk. Survival analysis showed no significant differences among the five very high-risk subgroups in both cohorts. A major limitation was potential selection bias owing to the retrospective nature of this study.

Conclusions

The updated 2021 EAU model showed better stratification than the three existing risk models, especially for progression, in both cohorts, determining the most appropriate postoperative treatment and identifying patients requiring intensified surveillance or early cystectomy.

Collapse

Scheipner L, Zurl H, Altziebler JV, Pichler GP, Schöpfer-Schwab S, Jasarevic S, Gaisl M, Pohl KC, Pemberger K, Andlar S, Hutterer GC, Bele U, Leitsmann C, Leitsmann M, Augustin H, Zigeuner R, Ahyai S, Mischinger J. Charlson-Deyo Comorbidity Index as a Novel Predictor for Recurrence in Non-Muscle-Invasive Bladder Cancer. Cancers (Basel) 2023;15:5770. [PMID: 38136315 PMCID: PMC10742244 DOI: 10.3390/cancers15245770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 11/19/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open

Affiliation(s)

Lukas Scheipner Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Hanna Zurl Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Julia V. Altziebler Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Georg P. Pichler Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Stephanie Schöpfer-Schwab Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Samra Jasarevic Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Michael Gaisl Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Klara C. Pohl Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Karl Pemberger Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Stefan Andlar Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Georg C. Hutterer Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Uros Bele Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Conrad Leitsmann Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Marianne Leitsmann Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.) Institute for Applied Quality Improvement and Research in Health Care, 37073 Goettingen, Germany
Herbert Augustin Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Richard Zigeuner Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Sascha Ahyai Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Johannes Mischinger Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)

Collapse

Miyake M, Nishimura N, Fujii T, Fujimoto K. Recent advancements in the diagnosis and treatment of non-muscle invasive bladder cancer: Evidence update of surgical concept, risk stratification, and BCG-treated disease. Int J Urol 2023;30:944-957. [PMID: 37522629 DOI: 10.1111/iju.15263] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023]

Abstract

In the management of non-muscle invasive bladder cancer (NMIBC), disease progression and long-term control are determined by the intensity of delivered treatment and surveillance and the cancer cells' biological nature. This requires risk stratification-based postoperative management, such as intravesical instillation of chemotherapy drugs, Bacillus Calmette-Guérin (BCG), and radical cystectomy. Advancements in mechanical engineering, molecular biology, and surgical skills have evolved the clinical management of NMIBC. In this review, we describe the updated evidence and perspectives regarding the following aspects: (1) advancements in surgical concepts, techniques, and devices for transurethral resection of the bladder tumor; (2) advancements in risk stratification tools for NMIBC; and (3) advancements in treatment strategies for BCG-treated NMIBC. Repeat transurethral resection, en-bloc transurethral resection, and enhanced tumor visualization, including photodynamic diagnosis and narrow-band imaging, help reduce residual cancer cells, provide accurate diagnosis and staging, and sensitive detection, which are the first essential steps for cancer cure. Risk stratification should always be updated and improved because the treatment strategy changes over time. The BCG-treated disease concept has recently diversified to include BCG failure, resistance, refractory, unresponsiveness, exposure, and intolerance. A BCG-unresponsive disease is an extremely aggressive subset unlikely to respond to a rechallenge with BCG. Numerous ongoing clinical trials aim to develop a future bladder-sparing approach for very high-risk BCG-naïve NMIBC and BCG-unresponsive NMIBC. The key to improving the quality of patient care lies in the continuous efforts to overcome the clinical limitations of bedside management.

Collapse

Preoperative CT features to predict risk stratification of non-muscle invasive bladder cancer. Abdom Radiol (NY) 2023;48:659-668. [PMID: 36454277 DOI: 10.1007/s00261-022-03730-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 12/02/2022]

Hald OC, Phan YC, Carter CJM, Klatte T. Bladder tumour resection weight as a prognostic factor for recurrence and progression in patients with high-risk non-muscle invasive bladder treated with BCG. Clin Genitourin Cancer 2022;21:e70-e77. [PMID: 36180340 DOI: 10.1016/j.clgc.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/18/2022] [Accepted: 08/21/2022] [Indexed: 11/18/2022]

Miyake M, Iida K, Nishimura N, Inoue T, Matsumoto H, Matsuyama H, Fujiwara Y, Komura K, Inamoto T, Azuma H, Yasumoto H, Shiina H, Yonemori M, Enokida H, Nakagawa M, Fukuhara H, Inoue K, Yoshida T, Kinoshita H, Matsuda T, Fujii T, Fujimoto K. Site-specific Risk Stratification Models for Postoperative Recurrence and Survival Prediction in Patients with Upper Tract Urothelial Carcinoma Undergoing Radical Nephroureterectomy: Better Stratification for Adjuvant Therapy. EUR UROL SUPPL 2022;41:95-104. [PMID: 35813249 PMCID: PMC9257658 DOI: 10.1016/j.euros.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2022] [Indexed: 11/29/2022] Open

Abstract

Background

Site-specific postoperative risk models for localized upper tract urothelial carcinoma (UTUC) are unavailable.

Objective

To create specific risk models for renal pelvic urothelial carcinoma (RPUC) and ureteral urothelial carcinoma (UUC), and to compare the predictive accuracy with the overall UTUC risk model.

Design, setting, and participants

A multi-institutional database retrospective study of 1917 UTUC patients who underwent radical nephroureterectomy (RNU) between 2000 and 2018 was conducted.

Outcome measurements and statistical analysis

A multivariate hazard model was used to identify the prognostic factors for extraurinary tract recurrence (EUTR), cancer-specific death (CSD), and intravesical recurrence (IVR) after RNU. Patients were stratified into low-, intermediate-, high-, and highest-risk groups. External validation was performed to estimate a concordance index of the created risk models. We investigated whether our risk models could aid decision-making regarding adjuvant chemotherapy (AC) after RNU.

Results and limitations

The UTUC risk models could stratify the risk of cumulative incidence of three endpoints. The RPUC- and UUC-specific risk models showed better stratification than the overall UTUC risk model for all the three endpoints, EUTR, CSD, and IVR (RPUC: concordance index, 0.719 vs 0.770, 0.714 vs 0.794, and 0.538 vs 0.569, respectively; UUC: 0.716 vs 0.767, 0.766 vs 0.809, and 0.553 vs 0.594, respectively). The UUC-specific risk model can identify the high- and highest-risk patients likely to benefit from AC after RNU. A major limitation was the potential selection bias owing to the retrospective nature of this study.

Conclusions

We recommend using site-specific risk models instead of the overall UTUC risk model for better risk stratification and decision-making for AC after RNU.

Patient summary

Upper tract urothelial carcinoma comprises renal pelvic and ureteral carcinomas. We recommend using site-specific risk models instead of the overall upper tract urothelial carcinoma risk model in risk prediction and decision-making for adjuvant therapy after radical surgery.

Collapse

Affiliation(s)

Makito Miyake Department of Urology, Nara Medical University, Kashihara, Nara, Japan Corresponding author. Department of Urology, Nara Medical University, 840 Shijo-cho, Nara 634-8522, Japan. Tel. +81 744 22 3051 (ext 2338); Fax: +81 744 22 9282.
Kota Iida Department of Urology, Nara Medical University, Kashihara, Nara, Japan
Nobutaka Nishimura Department of Urology, Nara Medical University, Kashihara, Nara, Japan
Takashi Inoue Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Nara, Japan
Hiroaki Matsumoto Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
Hideyasu Matsuyama Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
Yuya Fujiwara Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
Kazumasa Komura Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
Teruo Inamoto Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
Haruhito Azuma Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
Hiroaki Yasumoto Department of Urology, Shimane University School of Medicine, Izumo, Shimane, Japan
Hiroaki Shiina Department of Urology, Shimane University School of Medicine, Izumo, Shimane, Japan
Masaya Yonemori Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, Japan
Hideki Enokida Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, Japan
Masayuki Nakagawa Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, Japan
Hideo Fukuhara Department of Urology, Kochi Medical School, Kohasu, Oko-cho, Nankoku-shi, Kochi, Japan
Keiji Inoue Department of Urology, Kochi Medical School, Kohasu, Oko-cho, Nankoku-shi, Kochi, Japan
Takashi Yoshida Department of Urology and Andrology, Kansai Medical University, Osaka, Japan
Hidefumi Kinoshita Department of Urology and Andrology, Kansai Medical University, Osaka, Japan
Tadashi Matsuda Department of Urology and Andrology, Kansai Medical University, Osaka, Japan
Tomomi Fujii Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara, Japan
Kiyohide Fujimoto Department of Urology, Nara Medical University, Kashihara, Nara, Japan
Nishinihon Uro-oncology Extensive Collaboration Group

Collapse

Marquardt A, Richterstetter M, Taubert H, Hartmann A, Wullich B, Lieb V, Bellut L, Wach S, Apel H. Reduced Recurrence Rates Are Associated with Photodynamic Diagnostics Compared to White Light after Extended Transurethral Resection of Bladder Tumors. Life (Basel) 2022;12:life12050641. [PMID: 35629309 PMCID: PMC9143752 DOI: 10.3390/life12050641] [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: 04/01/2022] [Revised: 04/19/2022] [Accepted: 04/24/2022] [Indexed: 11/16/2022] Open

Abstract

One pillar in treating non-muscle-invasive bladder cancer (NMIBC) is the complete and high-quality transurethral resection of the primary tumor (TURBT). However, even after a high-quality primary resection, the residual tumor risk is considerable, thus requiring a re-TURBT. Resections performed with the aid of a photodynamic diagnostics report improved recurrence-free survival rates and increased detection rates of carcinoma in situ (CIS). This monocentric retrospective study reports on patients treated with an extended TURBT procedure using conventional white-light cystoscopy or photodynamic diagnostics (PDD). Only patients undergoing a TURBT resection for their primary tumor were included in the statistical analysis. Recurrence-free survival and overall survival were the clinical endpoints. Mann−Whitney U tests and chi-squared tests were used for descriptive intergroup comparisons. The associations with overall survival and recurrence-free survival were determined by univariate and multivariate analyses. The test results were considered significant when p was < 0.05. In comparison to conventional white-light cystoscopy, PDD increased the detection rates of CIS (p = 0.004) and tumor multifocality (p = 0.005) and led to reduced residual tumor incidence at the primary resection site (p < 0.001). Likewise, tumor recurrence rates were reduced in the PDD cohort (p < 0.001). Patient age and the presence of residual tumor at the primary resection site were identified as independent predictors of overall survival. For recurrence-free survival, only the PDD resection method was an independent predictor (HR = 0.43; p < 0.001). In summary, we demonstrated that the utilization of PDD techniques was associated with improved detection rates of CIS and multifocal tumors and with reduced recurrence rates. The extended resection protocol allowed us to determine that PDD resections lead to a reduced residual tumor rate at the initial resection site. This residual tumor state at the resection site, determined by extended TURBT, became an independent predictor of long-term survival. On the other hand, the PDD technique was confirmed as the only independent predictor of recurrence-free survival.

Collapse

Affiliation(s)

Alexander Marquardt Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany; (A.M.); (M.R.); (H.T.); (B.W.); (V.L.); (L.B.); (H.A.)
Mario Richterstetter Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany; (A.M.); (M.R.); (H.T.); (B.W.); (V.L.); (L.B.); (H.A.)
Helge Taubert Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany; (A.M.); (M.R.); (H.T.); (B.W.); (V.L.); (L.B.); (H.A.) Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany;
Arndt Hartmann Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany; Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen, Krankenhausstrasse 8-10, 91054 Erlangen, Germany
Bernd Wullich Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany; (A.M.); (M.R.); (H.T.); (B.W.); (V.L.); (L.B.); (H.A.) Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany;
Verena Lieb Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany; (A.M.); (M.R.); (H.T.); (B.W.); (V.L.); (L.B.); (H.A.) Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany;
Laura Bellut Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany; (A.M.); (M.R.); (H.T.); (B.W.); (V.L.); (L.B.); (H.A.) Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany;
Sven Wach Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany; (A.M.); (M.R.); (H.T.); (B.W.); (V.L.); (L.B.); (H.A.) Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany; Correspondence: ; Tel.: +49-9131-8542658; Fax: +49-9131-8523374
Hendrik Apel Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany; (A.M.); (M.R.); (H.T.); (B.W.); (V.L.); (L.B.); (H.A.) Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany;

Collapse

Kang Y, Zhu X, Wang X, Liao S, Jin M, Zhang L, Wu X, Zhao T, Zhang J, Lv J, Zhu D. Identification and Validation of the Prognostic Stemness Biomarkers in Bladder Cancer Bone Metastasis. Front Oncol 2021;11:641184. [PMID: 33816287 PMCID: PMC8017322 DOI: 10.3389/fonc.2021.641184] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 01/29/2021] [Indexed: 12/22/2022] Open

Abstract

Background

Bladder urothelial carcinoma (BLCA) is one of the most common urinary system malignancies with a high metastasis rate. Cancer stem cells (CSCs) play an important role in the occurrence and progression of BLCA, however, its roles in bone metastasis and the prognostic stemness biomarkers have not been identified in BLCA.

Method

In order to identify the roles of CSC in the tumorigenesis, bone metastasis and prognosis of BLCA, the RNA sequencing data of patients with BLCA were retrieved from The Cancer Genome Atlas (TCGA) databases. The mRNA expression-based stemness index (mRNAsi) and the differential expressed genes (DEGs) were evaluated and identified. The associations between mRNAsi and the tumorigenesis, bone metastasis, clinical stage and overall survival (OS) were also established. The key prognostic stemness-related genes (PSRGs) were screened by Lasso regression, and based on them, the predict model was constructed. Its accuracy was tested by the area under the curve (AUC) of the receiver operator characteristic (ROC) curve and the risk score. Additionally, in order to explore the key regulatory network, the relationship among differentially expressing TFs, PSRGs, and absolute quantification of 50 hallmarks of cancer were also identified by Pearson correlation analysis. To verify the identified key TFs and PSRGs, their expression levels were identified by our clinical samples via immunohistochemistry (IHC).

Results

A total of 8,647 DEGs were identified between 411 primary BLCAs and 19 normal solid tissue samples. According to the clinical stage, mRNAsi and bone metastasis of BLCA, 2,383 stage-related DEGs, 3,680 stemness-related DEGs and 716 bone metastasis-associated DEGs were uncovered, respectively. Additionally, compared with normal tissue, mRNAsi was significantly upregulated in the primary BLCA and also associated with the prognosis (P = 0.016), bone metastasis (P < 0.001) and AJCC clinical stage (P < 0.001) of BLCA patients. A total of 20 PSRGs were further screened by Lasso regression, and based on them, we constructed the predict model with a relatively high accuracy (AUC: 0.699). Moreover, we found two key TFs (EPO, ARID3A), four key PRSGs (CACNA1E, LINC01356, CGA and SSX3) and five key hallmarks of cancer gene sets (DNA repair, myc targets, E2F targets, mTORC1 signaling and unfolded protein response) in the regulatory network. The tissue microarray of BLCA and BLCA bone metastasis also revealed high expression of the key TFs (EPO, ARID3A) and PRSGs (SSX3) in BLCA.

Conclusion

Our study identifies mRNAsi as a reliable index in predicting the tumorigenesis, bone metastasis and prognosis of patients with BLCA and provides a well-applied model for predicting the OS for patients with BLCA based on 20 PSRGs. Besides, we also identified the regulatory network between key PSRGs and cancer gene sets in mediating the BLCA bone metastasis.

Collapse

Affiliation(s)

Yao Kang Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.,Department of Orthopedics, Hangzhou Medical College People's Hospital, Hangzhou, China
Xiaojun Zhu Department of Musculoskeletal Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China, Guangzhou, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
Xijun Wang State Key Laboratory of Oncology in South China, Guangzhou, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, China
Shiyao Liao Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.,Department of Orthopedics, Hangzhou Medical College People's Hospital, Hangzhou, China
Mengran Jin Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.,Department of Orthopedics, Hangzhou Medical College People's Hospital, Hangzhou, China
Li Zhang Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.,Department of Orthopedics, Hangzhou Medical College People's Hospital, Hangzhou, China
Xiangyang Wu Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.,Department of Orthopedics, Hangzhou Medical College People's Hospital, Hangzhou, China
Tingxiao Zhao Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.,Department of Orthopedics, Hangzhou Medical College People's Hospital, Hangzhou, China
Jun Zhang Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.,Department of Orthopedics, Hangzhou Medical College People's Hospital, Hangzhou, China
Jun Lv Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.,Department of Orthopedics, Hangzhou Medical College People's Hospital, Hangzhou, China
Danjie Zhu Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China.,Department of Orthopedics, Hangzhou Medical College People's Hospital, Hangzhou, China

Collapse

Miyake M, Nishimura N, Inoue T, Suzuki S, Fujii T, Owari T, Hori S, Nakai Y, Toritsuka M, Nakagawa H, Tsukamoto S, Anai S, Torimoto K, Yoneda T, Tanaka N, Fujimoto K. Fluorescent cystoscopy-assisted en bloc transurethral resection versus conventional transurethral resection in patients with non-muscle invasive bladder cancer: study protocol of a prospective, open-label, randomized control trial (the FLEBER study). Trials 2021;22:136. [PMID: 33579327 PMCID: PMC7881486 DOI: 10.1186/s13063-021-05094-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 02/02/2021] [Indexed: 11/26/2022] Open

Abstract

Background

Transurethral resection of bladder tumor (TURBT) is an essential procedure both for the treatment and staging of bladder cancer, particularly non-muscle invasive bladder cancer (NMIBC). The dissemination of cancer cells during resection and the consequent seeding into the bladder mucosa is the main cause of post-TURBT intravesical recurrence. Although the tumor dissemination is inevitable during conventional TURBT (cTURBT), this drawback can be overcome by tumor resection in one piece with intact surrounding normal tissues, referred to as en bloc resection. We previously described the photodynamic diagnosis (PDD)-assisted en bloc TURBT (EBTUR) technique and its favorable outcomes. Based on our preliminary studies, this randomized controlled trial was designed to evaluate the superiority of PDD-EBTUR to PDD-cTURBT.

Methods

The FLEBER study is a single-center randomized controlled trial in NMIBC patients who require TURBT. The longest diameter of the tumor must be between 6 and 30 mm. A total of 160 eligible patients will be enrolled after screening and randomly allocated to the PDD-EBTUR (experimental) and PDD-cTURBT (control) groups in a 1:1 ratio (80 cases to 80 cases). All patients will be treated using a single, immediate postoperative intravesical chemotherapy with epirubicin. The primary endpoint of this trial is the 2-year recurrence-free survival after surgery in pathologically proven low- or intermediate-risk NMIBC. All patients will be monitored by cystoscopy and urine cytology every 3 months for 2 years. Patient data including adverse events and complications, and data from frequency volume charts, pain scales, and health-related QOL questionnaires will be collected before and after the TURBT at indicated visits.

Discussion

The goal of this trial is to determine the potential benefits of PDD-cTURBT and PDD-EBTUR followed by a single immediate postoperative intravesical chemotherapy in patients with low- or intermediate-risk NMIBC who undergo TURBT. Ultimately, our findings will lead to the development of better interventions and potentially change the standard of care.

Trial registration

This clinical trial was prospectively registered with the UMIN Clinical Trials Registry on 1 August 2020. The reference number is UMIN000041273, and the Ethics Committee of Nara Medical University Approval ID is 2702.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-021-05094-y.

Collapse

Affiliation(s)

Makito Miyake Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
Nobutaka Nishimura Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
Takashi Inoue Institute for Clinical and Translational Science, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
Shota Suzuki Institute for Clinical and Translational Science, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
Tomomi Fujii Department of Diagnostic Pathology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
Takuya Owari Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
Shunta Hori Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
Yasushi Nakai Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
Michihiro Toritsuka Department of Psychiatry, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
Hitoshi Nakagawa Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
Shinji Tsukamoto Department of Orthopedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
Satoshi Anai Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
Kazumasa Torimoto Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
Tatsuo Yoneda Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
Nobumichi Tanaka Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.,Department of Prostate Brachytherapy, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
Kiyohide Fujimoto Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan

Collapse

Miyake M, Nishimura N, Nakai Y, Fujii T, Owari T, Hori S, Morizawa Y, Gotoh D, Anai S, Torimoto K, Tanaka N, Hirao Y, Fujimoto K. Photodynamic Diagnosis-Assisted Transurethral Resection Using Oral 5-Aminolevulinic Acid Decreases the Risk of Repeated Recurrence in Non-Muscle-Invasive Bladder Cancer: A Cumulative Incidence Analysis by the Person-Time Method. Diagnostics (Basel) 2021;11:diagnostics11020185. [PMID: 33525423 PMCID: PMC7911613 DOI: 10.3390/diagnostics11020185] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 11/21/2022] Open

Affiliation(s)

Makito Miyake Department of Urology, Nara Medical University, Kashihara, Nara 634-8522, Japan; (N.N.); (Y.N.); (T.O.); (S.H.); (Y.M.); (D.G.); (S.A.); (K.T.) Correspondence: (M.M.); (K.F.); Tel.: +81-744-22-3051 (M.M.)
Nobutaka Nishimura Department of Urology, Nara Medical University, Kashihara, Nara 634-8522, Japan; (N.N.); (Y.N.); (T.O.); (S.H.); (Y.M.); (D.G.); (S.A.); (K.T.)
Yasushi Nakai Department of Urology, Nara Medical University, Kashihara, Nara 634-8522, Japan; (N.N.); (Y.N.); (T.O.); (S.H.); (Y.M.); (D.G.); (S.A.); (K.T.)
Tomomi Fujii Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara 634-8522, Japan;
Takuya Owari Department of Urology, Nara Medical University, Kashihara, Nara 634-8522, Japan; (N.N.); (Y.N.); (T.O.); (S.H.); (Y.M.); (D.G.); (S.A.); (K.T.)
Shunta Hori Department of Urology, Nara Medical University, Kashihara, Nara 634-8522, Japan; (N.N.); (Y.N.); (T.O.); (S.H.); (Y.M.); (D.G.); (S.A.); (K.T.)
Yosuke Morizawa Department of Urology, Nara Medical University, Kashihara, Nara 634-8522, Japan; (N.N.); (Y.N.); (T.O.); (S.H.); (Y.M.); (D.G.); (S.A.); (K.T.)
Daisuke Gotoh Department of Urology, Nara Medical University, Kashihara, Nara 634-8522, Japan; (N.N.); (Y.N.); (T.O.); (S.H.); (Y.M.); (D.G.); (S.A.); (K.T.)
Satoshi Anai Department of Urology, Nara Medical University, Kashihara, Nara 634-8522, Japan; (N.N.); (Y.N.); (T.O.); (S.H.); (Y.M.); (D.G.); (S.A.); (K.T.)
Kazumasa Torimoto Department of Urology, Nara Medical University, Kashihara, Nara 634-8522, Japan; (N.N.); (Y.N.); (T.O.); (S.H.); (Y.M.); (D.G.); (S.A.); (K.T.)
Nobumichi Tanaka Department of Prostate Brachytherapy Nara Medical University, Kashihara, Nara 634-8522, Japan;
Yoshihiko Hirao Department of Urology, Osaka Gyoumeikan Hospital, Konohana-ku, Osaka 554-0012, Japan;
Kiyohide Fujimoto Department of Urology, Nara Medical University, Kashihara, Nara 634-8522, Japan; (N.N.); (Y.N.); (T.O.); (S.H.); (Y.M.); (D.G.); (S.A.); (K.T.) Correspondence: (M.M.); (K.F.); Tel.: +81-744-22-3051 (M.M.)

Collapse

Miyake M, Nishimura N, Fujii T, Miyamoto T, Iida K, Hori S, Morizawa Y, Gotoh D, Nakai Y, Anai S, Torimoto K, Tanaka N, Fujimoto K. Photodynamic Diagnosis-Assisted En Bloc Transurethral Resection of Bladder Tumor for Nonmuscle Invasive Bladder Cancer: Short-Term Oncologic and Functional Outcomes. J Endourol 2020;35:319-327. [PMID: 32940054 DOI: 10.1089/end.2020.0371] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open

Abstract

Background: We describe the oncologic and functional outcomes and the surgical technique of the photodynamic diagnosis (PDD)-assisted en bloc transurethral resection of bladder tumor (EBTUR) using a rectangular cutting loop. Methods: We reviewed 40 patients with carcinoma in situ-free nonmuscle invasive bladder cancer undergoing PDD-TURBT. Of 40 patients, 12 underwent photodynamic diagnosis-assisted en bloc transurethral resection of bladder tumor (PDD-EBTUR) and 28 underwent PDD-assisted conventional TURBT (cTURBT). Two groups were matched in terms of clinicopathologic background and did not include patients treated with intravesical Bacillus Calmette-Guerin. The assessment of postoperative quality of life (QoL) was based on patient-reported outcome measure, including the International Prostate Symptom Score, Functional Assessment of Cancer Therapy-Bladder (FACT-BL), and 8-item Short Form (SF-8^™) questionnaires before and 1 month after TUR. This study was approved by the Ethics commitee and all participants provided informed consent. Results: PDD guidance provided substantial help for circumferent demarcation around the bladder tumor, which precedes tumor dissection. One female patient (12%) treated by PDD-EBTUR had grade II bladder perforation requiring prolonged catheterization. Pathologic assessment of horizontal and vertical margins in resected specimens by PDD-EBTUR revealed that all specimens had muscularis propria, and the rate of en bloc resection was 100%. No patient had intravesical recurrence in the PDD-EBTUR group (median follow-up, 11 months), while two patients in the PDD-cTURBT group had T_a low-grade recurrent tumors (8 months). Postoperatively, scores of daytime frequency and nocturia were increased in both groups. QoL assessment using the FACT-BL and SF-8 revealed that postoperative deterioration of bladder-specific subscale and emotional/mental scores was found in the EBTUR group but not in the cTURBT group. Conclusions: Based on the initial experience on 12 patients, we considered that PDD-EBTUR is an acceptable surgical method. Further experience and research are mandatory to determine whether this technique yields better outcomes and has true clinical advantage.

Collapse