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Huang Y, Xie C, Li Q, Huang X, Huang W, Yin D. Prognostic factors and nomogram for the overall survival of bladder cancer bone metastasis: A SEER-based study. Medicine (Baltimore) 2023; 102:e33275. [PMID: 36930117 PMCID: PMC10019198 DOI: 10.1097/md.0000000000033275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/23/2023] [Indexed: 03/18/2023] Open
Abstract
Bone metastasis has a poor prognosis in patients with bladder cancer (BC). This study aimed to construct a prognostic nomogram for predicting the overall survival of patients with bone-metastatic BC (BMBC). The Surveillance, Epidemiology, and End Results database was used to recruit patients with BMBC between 2010 and 2018. Univariate and multivariate analyses were performed to screen for prognostic factors and construct a nomogram. Harrell concordance index, receiver operating characteristic curve, and calibration curve were used to verify the prognostic nomograms. All statistical analyses and chart formation were performed using SPSS 23.0 and R software 4.1.2. A total of 1361 patients diagnosed with BMBC were identified in the Surveillance, Epidemiology, and End Results database. Six independent prognostic factors, including marital status, histological type, T stage, other metastases, surgery, and chemotherapy, were identified and included in the nomogram construction. Among them, chemotherapy contributed the most to the prognosis in the nomogram. The concordance index of the nomogram was 0.745 and 0.753 in the training and validation groups, respectively, and all values of the area under the curve were >0.77. The calibration curves showed perfect consistency between the observed and predicted survival rates. The prognostic nomogram developed in this study is expected to become an accurate and individualized tool for predicting overall survival in patients with BMBC and providing guidance for appropriate treatment or care.
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Affiliation(s)
- Yu Huang
- Jinan University, Guangzhou, PR China
- Department of Orthopedics, The People’s Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, China
| | - Chengxin Xie
- Department of Orthopedics, The People’s Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, China
| | - Qinglong Li
- Department of Orthopedics, The People’s Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, China
| | - Xiao Huang
- Department of Orthopedics, The People’s Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, China
| | - Wenwen Huang
- Department of Orthopedics, The People’s Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, China
| | - Dong Yin
- Department of Orthopedics, The People’s Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, China
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Hu W, Zhang Y, Ning J, Li M, Tang Y, Li L, Cheng F, Yu W. Anti-tumor effect of AZD8055 against bladder cancer and bladder cancer-associated macrophages. Heliyon 2023; 9:e14272. [PMID: 36938467 PMCID: PMC10020012 DOI: 10.1016/j.heliyon.2023.e14272] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 02/22/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
The increased activity of the mTOR pathway in bladder cancer has been extensively studied, but no satisfactory mTOR inhibitor has been found in bladder cancer. The role of AZD8055, a second-generation mTOR inhibitor, has not been reported in bladder cancer. Herein, we investigated the effects of AZD8055 on bladder cells and their interaction with macrophages in vivo and in vitro. In four bladder cancer cell lines, the phosphorylation of mTOR, AKT and S6K1 was suppressed by AZD8055. AZD8055 inhibited proliferation and induced G1 cell-cycle arrest and apoptosis of bladder cancer cells in a concentration-dependent manner. AZD8055 also inhibits the migration and invasion of bladder cancer cells by blocking EMT and MMP9. In addition, AZD8055 inhibited chemotaxis and M2 phenotype of macrophage after co-culture with bladder cancer cells. These anti-tumor effects of AZD8055 were verified in vivo. Our findings collectively demonstrated that low-dose AZD8055 induces cytotoxicity and apoptosis, and inhibits the Akt/mTOR activation, invasion and migration of bladder cancer. These findings also demonstrate that AZD8055 partially blocked the interactions of bladder cancer cells and macrophages. In conclusion, AZD8055 is a promising mTOR inhibitor for bladder cancer.
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Yu EM, Belay S, Li W, Aragon-Ching JB. Non-urothelial and urothelial variants of bladder cancer. Cancer Treat Res Commun 2022; 33:100661. [PMID: 36442362 DOI: 10.1016/j.ctarc.2022.100661] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/14/2022] [Accepted: 11/16/2022] [Indexed: 11/21/2022]
Abstract
Non-urothelial bladder cancers make up a rare minority of all genitourinary (GU) tract histologic cancers since urothelial cancer (UC) makes up the most common histologic subtype. Bladder cancer variant histology (BCVH) or urothelial variants also occur rarely though distinction is important given aggressive presentation and natural history. While methods for diagnosis and treatment of typical urothelial cancers (UC) are well-established, there are no clear guidelines with regard to the diagnosis of non-urothelial bladder cancers, which often results in misdiagnosis and treatment delay. This review will focus on the clinicopathologic characteristics of the most common non-urothelial bladder cancers, to be distinguished from bladder cancer variant histology containing a UC component. The role of genomics in non-urothelial bladder cancers is evolving and the use of biomarkers to guide the diagnosis and treatment of these tumors remains a key area of unmet need. Treatment of these cancers will be discussed in a companion review.
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Affiliation(s)
- Eun-Mi Yu
- GU Medical Oncology, Inova Schar Cancer Institute, USA
| | - Sarah Belay
- University of Virginia School of Medicine, USA
| | - Wenping Li
- Department of Pathology, Inova Fairfax Hospital, USA
| | - Jeanny B Aragon-Ching
- GU Medical Oncology, Inova Schar Cancer Institute, USA; Associate Professor of Medical Education, University of Virginia, USA.
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4
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Lew M. An Approach to Nonurothelial Malignancies of the Urinary Bladder in Urine Cytology. Adv Anat Pathol 2022; 29:412-422. [PMID: 35687328 DOI: 10.1097/pap.0000000000000352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Urine cytology is an economical and convenient method of triaging patients who present with urinary symptoms as well as surveying those who have previously been diagnosed with urothelial carcinoma for recurrent or persistent disease. While the vast majority of malignancies diagnosed in urine cytology are urothelial carcinomas, it is important to recognize nonurothelial elements to inform patient prognosis and raise the possibility of involvement by a urothelial carcinoma variant, nonurothelial malignancy of the bladder, or a nonbladder primary, which may alter patient management pathways. As such, becoming familiar with morphologic features of nonurothelial malignancies in urine cytology as well as their related clinical risk factors, radiologic and cystoscopic features, differential diagnostic considerations, and the utility and pitfalls of ancillary tests can facilitate optimal patient care.
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Affiliation(s)
- Madelyn Lew
- Department of Pathology, University of Michigan Hospital and Health System, Ann Arbor, MI
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Mittal S, Malik K, Raja A. Nonbilharzial Squamous Cell Bladder Cancer: An Indian Experience. South Asian J Cancer 2022; 11:322-325. [PMID: 36756093 PMCID: PMC9902085 DOI: 10.1055/s-0042-1754338] [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] [Indexed: 10/15/2022] Open
Abstract
Anand RajaBackground Squamous cell carcinoma represents the second most common histological type of bladder cancer. Nonbilharzial squamous cell carcinomas of bladder are rare histological variant with limited experience. Objective We aimed to review our experience to determine various treatment patterns and survival outcomes for this malignancy. Methods Data from patients treated at our center from 1995 to 2016 was collected from patient records and analyzed. Clinicopathological variables, treatment patterns, and follow-up data were extracted. Results A total of 32 patients were included in the study with a median age of 55.5 years. Hematuria was the most common presentation. Overall, 16 patients underwent radical cystectomy, 8 underwent definitive radiotherapy (RT), 4 received palliative RT, and 4 patients defaulted for any treatment. Surgery conferred better survival rates as compared with RT (31.9 vs. 7.45 months). In the surgical group, only pathological TNM staging was a significant prognostic factor. Conclusion In localized nonbilharzial squamous cell bladder cancer, radical cystectomy with bilateral pelvic node dissection appears to be treatment modality of choice. Larger series are needed to validate the role of other perioperative modalities.
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Affiliation(s)
- Saket Mittal
- Department of Surgical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India
| | - Kanuj Malik
- Department of Surgical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India
| | - Anand Raja
- Department of Surgical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India,Address for correspondence Anand Raja, MCh Department of Surgical Oncology, Cancer Institute (WIA)Street Name & Number: No. 38 Sardar Patel Marg, Adyar, Chennai, Tamil Nadu, 600036India
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Dursun F, Elshabrawy A, Wang H, Wu S, Liss MA, Kaushik D, Grosser D, Svatek RS, Mansour AM. Histological variants of non–muscle invasive bladder cancer: Survival outcomes of radical cystectomy vs. bladder preservation therapy. Urol Oncol 2022; 40:275.e1-275.e10. [DOI: 10.1016/j.urolonc.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 01/27/2022] [Accepted: 02/06/2022] [Indexed: 10/18/2022]
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Rapidly Progressive Bladder Cancer Diagnosed because of Spontaneous Bladder Rupture. Case Rep Urol 2022; 2022:4586199. [PMID: 35585958 PMCID: PMC9110233 DOI: 10.1155/2022/4586199] [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] [Received: 01/11/2022] [Revised: 03/26/2022] [Accepted: 04/15/2022] [Indexed: 11/25/2022] Open
Abstract
Background Spontaneous bladder rupture (SBR) is very rare and can be associated with advanced bladder cancer. Because of its rarity, the optimal management of bladder cancer with SBR has not been established. Herein, we report a case of SBR due to locally advanced bladder cancer, which rapidly invaded the ileum and caused peritoneal dissemination. Case Presentation. An 86-year-old man presented with sudden-onset lower abdominal pain and distension. The patient was diagnosed with bladder perforation and bladder tumor on contrast-enhanced computed tomography (CECT). Transurethral resection of the bladder tumor revealed an invasive urothelial carcinoma with squamous differentiation. Although radical cystectomy with lymph node dissection was planned, preoperative CECT and magnetic resonance imaging revealed enlargement of the bilateral iliac regional lymph nodes, multiple peritoneal nodules, and invasion of the bladder tumor to the ileocecum. Therefore, cystectomy and resection of ileocecum with palliative intent and bilateral cutaneous ureterostomy were performed. However, the patient's general condition rapidly worsened after surgery, and he died 74 days after the initial diagnosis. Conclusions We encountered a case of SBR accompanied by bladder cancer with extremely rapid progression, which suggested the importance of short-interval repeat imaging examinations. Emergency surgery should be considered when bladder cancer is suspected in patients with SBR so as not to miss the window period of a possible cure.
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Hurst CD, Cheng G, Platt FM, Alder O, Black EV, Burns JE, Brown J, Jain S, Roulson JA, Knowles MA. Molecular profile of pure squamous cell carcinoma of the bladder identifies major roles for OSMR and YAP signalling. JOURNAL OF PATHOLOGY CLINICAL RESEARCH 2022; 8:279-293. [PMID: 35289095 PMCID: PMC8977277 DOI: 10.1002/cjp2.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 11/20/2022]
Abstract
Pure squamous cell carcinoma (SCC) is the most common pure variant form of bladder cancer, found in 2–5% of cases. It often presents late and is unresponsive to cisplatin‐based chemotherapy. The molecular features of these tumours have not been elucidated in detail. We carried out whole‐exome sequencing (WES), copy number, and transcriptome analysis of bladder SCC. Muscle‐invasive bladder cancer (MIBC) samples with no evidence of squamous differentiation (non‐SD) were used for comparison. To assess commonality of features with urothelial carcinoma with SD, we examined data from SD samples in The Cancer Genome Atlas (TCGA) study of MIBC. TP53 was the most commonly mutated gene in SCC (64%) followed by FAT1 (45%). Copy number analysis revealed complex changes in SCC, many differing from those in samples with SD. Gain of 5p and 7p was the most common feature, and focal regions on 5p included OSMR and RICTOR. In addition to 9p deletions, we found some samples with focal gain of 9p24 containing CD274 (PD‐L1). Loss of 4q35 containing FAT1 was found in many samples such that all but one sample analysed by WES had FAT1 mutation or deletion. Expression features included upregulation of oncostatin M receptor (OSMR), metalloproteinases, metallothioneins, keratinisation genes, extracellular matrix components, inflammatory response genes, stem cell markers, and immune response modulators. Exploration of differentially expressed transcription factors identified BNC1 and TFAP2A, a gene repressed by PPARG, as the most upregulated factors. Known urothelial differentiation factors were downregulated along with 72 Kruppel‐associated (KRAB) domain‐containing zinc finger family protein (KZFP) genes. Novel therapies are urgently needed for these tumours. In addition to upregulated expression of EGFR, which has been suggested as a therapeutic target in basal/squamous bladder cancer, we identified expression signatures that indicate upregulated OSMR and YAP/TAZ signalling. Preclinical evaluation of the effects of inhibition of these pathways alone or in combination is merited.
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Affiliation(s)
- Carolyn D Hurst
- Division of Molecular Medicine, Leeds Institute of Medical Research at St James's, St James's University Hospital, Leeds, UK
| | - Guo Cheng
- Division of Molecular Medicine, Leeds Institute of Medical Research at St James's, St James's University Hospital, Leeds, UK
| | - Fiona M Platt
- Division of Molecular Medicine, Leeds Institute of Medical Research at St James's, St James's University Hospital, Leeds, UK
| | - Olivia Alder
- Division of Molecular Medicine, Leeds Institute of Medical Research at St James's, St James's University Hospital, Leeds, UK
| | - Emma Vi Black
- Division of Molecular Medicine, Leeds Institute of Medical Research at St James's, St James's University Hospital, Leeds, UK
| | - Julie E Burns
- Division of Molecular Medicine, Leeds Institute of Medical Research at St James's, St James's University Hospital, Leeds, UK
| | - Joanne Brown
- Division of Molecular Medicine, Leeds Institute of Medical Research at St James's, St James's University Hospital, Leeds, UK
| | - Sunjay Jain
- Pyrah Department of Urology, St James's University Hospital, Leeds, UK
| | - Jo-An Roulson
- Department of Histopathology, St James's University Hospital, Leeds, UK
| | - Margaret A Knowles
- Division of Molecular Medicine, Leeds Institute of Medical Research at St James's, St James's University Hospital, Leeds, UK
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Böthig R, Schöps W, Zellner M, Fiebag K, Kowald B, Kurze I, Böhme H, Kadhum T, Golka K. [Urinary Bladder Cancer as a Long-term Sequela of Spinal Cord Injury - Relevance to Practice]. Aktuelle Urol 2022; 53:137-147. [PMID: 34933348 DOI: 10.1055/a-1684-9870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Urinary bladder cancer is the second most common tumour disease after lung cancer leading to death in people with a spinal cord injury. This paper provides a comprehensive overview of the differences relevant to urologists between urinary bladder tumours in this population compared with urinary bladder tumours in the general population.People with a spinal cord injury are 1 to 2 decades younger on average at the time of tumour diagnosis than patients without a spinal cord injury. Histopathologic findings at the initial diagnosis of urinary bladder cancer in people with a spinal cord injury are much less favourable than for urinary bladder cancers in the general population. Muscle-invasive tumours and tumours with poor differentiation are much more common, and the proportion of squamous cell carcinomas is significantly higher. The incidence rises after more than 10 years of paralysis. Urinary bladder cancer mortality is significantly elevated and increases with the duration of paralysis. In diagnostic procedures and, in particular, in radical cystectomy, clinically important features have to be considered. For example, urodynamic examinations or cystoscopy may trigger autonomic dysreflexia with hypertensive crises and the risk of life-threatening bradycardia.In the case of radical cystectomy, frequent adhesions and callosities of the urinary bladder, among other things, must be taken into account intraoperatively. Severe paralysis, prolonged intestinal atony and other conditions are frequently observed after the surgical procedure due to neurogenic bowel dysfunction. Correct positioning of the patient immediately after surgery to avoid decubitus and to support breathing, as well as bowel management specific to spinal cord injury, must be strictly observed.Other special features of paraplegic patients with urinary bladder cancer that should also be considered in clinical practice, as well as considerations for screening for urinary bladder tumors, are presented in the article.
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Affiliation(s)
- Ralf Böthig
- Neuro-Urologie, BG Klinikum Hamburg, Hamburg, Germany
| | | | - Michael Zellner
- Abteilung Urologie und Neurourologie, Johannesbad Fachklinik Bad Füssing, Bad Füssing, Germany
| | - Kai Fiebag
- Neuro-Urologie, BG Klinikum Hamburg, Hamburg, Germany
| | | | - Ines Kurze
- Klinik für Paraplegiologie und Neuro-Urologie, Zentralklinik Bad Berka GmbH, Bad Berka, Germany
| | - Holger Böhme
- Klinik für Urologie, Asklepios Klinik Barmbek, Hamburg, Germany
| | - Thura Kadhum
- Abt. Psychosomatische Medizin, Mittelrhein-Klinik Fachklinik für psychosomatische Rehabilitation, Boppard - Bad Salzig, Germany
| | - Klaus Golka
- Klinische Arbeitsmedizin, Leibniz-Institut für Arbeitsforschung an der TU Dortmund, Dortmund, Germany
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Laymon M, Mosbah A, Hashem A, Mahmoud O, Harraz AM, Elsawy AA, Abol-Enein H. Oncologic Outcomes of Squamous Cell Carcinoma Versus Urothelial Carcinoma With Squamous Differentiation After Radical Cystectomy for Bladder Carcinoma. Clin Genitourin Cancer 2021; 20:148-154. [PMID: 34998698 DOI: 10.1016/j.clgc.2021.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 12/06/2021] [Accepted: 12/12/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION In this study we aim to compare clinicopathological characteristics and cancer specific survival between patients treated with radical cystectomy for pure squamous cell carcinoma (SCC) and urothelial carcinoma with squamous differentiation (SqD). PATIENTS AND METHODS We reviewed data of 1737 consecutive patients treated with radical cystectomy and urinary diversion between January 2004 and February 2014. Only patients with pure SCC or SqD were included in the analysis. Squamous differentiation was defined as intercellular bridges or keratinization in the tumor. Clinicopathological data and recurrence free survival (RFS) were compared between patients diagnosed with SCC and SqD. RESULTS SCC and SqD were found in 318 and 223 patients, respectively. Mean age was 57 ± 8.3 years in SCC and 58.8 ± 7.8 in SqD (P = .008). A higher proportion of female patients was observed in SCC group compared to SqD (31.8% vs. 22% P < .0001). Patients with SqD were more likely to have extravesical (58.3% vs. 46.2%: P = .006) and nodal positive disease (34.5% vs. 14.5%: P < .0001) than pure SCC patients. Bilharzial eggs were found in 61% of SCC vs. 46% of SqD (P = .001).; The median (IQR) follow up period for SCC and SqD was 63 (12-112) months and 23 months (9-74.7), respectively. The 5-year RFS for SCC and SqD were 77% and 59.8 %, respectively (P < .0001).; Multivariate cox regression analysis identified advanced pT stage (OR: 1.9, 95% CI: 1.3-2.86, P = .0001), nodal positive disease (OR: 1.6, 95% CI: 1.1-2.48, P = .01) and SqD histology (OR: 1.6, 95% CI: 1.14-2.31, P = .007 as independent predictors of 5-year RFS. CONCLUSION Patient with SCC had significantly higher 5-year RFS in comparison to SqD. The higher rate of extravesical disease and lymph node metastasis in SqD patients is indicative of aggressive behavior of this histologic type.
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Affiliation(s)
- Mahmoud Laymon
- Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
| | - Ahmed Mosbah
- Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Abdelwahab Hashem
- Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Osama Mahmoud
- Urology Department, Qena Faculty of Medicine, South Valley University, Qena, Egypt
| | - Ahmed M Harraz
- Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Amr A Elsawy
- Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Hassan Abol-Enein
- Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
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Evaluation of Therapeutic Targets in Histological Subtypes of Bladder Cancer. Int J Mol Sci 2021; 22:ijms222111547. [PMID: 34768978 PMCID: PMC8583926 DOI: 10.3390/ijms222111547] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 12/29/2022] Open
Abstract
Histologically, bladder cancer is a heterogeneous group comprising urothelial carcinoma (UC), squamous cell carcinoma, adenocarcinomas (ACs), urachal carcinomas (UrCs), and small cell neuroendocrine carcinomas (SCCs). However, all bladder cancers have been treated so far uniformly, and targeted therapy options are still limited. Thus, we aimed to determine the protein expression/molecular status of commonly used cancer targets (programmed cell death 1 ligand 1 (PD-L1), mismatch repair (MMR), androgen and estrogen receptors (AR/ER), Nectin-4, tumor-associated calcium signal transducer 2 (Tacstd2, Trop-2), epidermal growth factor receptor (EGFR), human epidermal growth factor receptor 2 (HER2), and fibroblast growth factor receptor 3 (FGFR3)) to give first insights into whether patients with SCC, AC/UrCs, and squamous-differentiated carcinomas (Sq-BLCA) of the bladder could be eligible for targeted therapies. In addition, for MMR-deficient tumors, microsatellite instability was analyzed. We completed our own data with molecular data from The Cancer Genome Atlas (TCGA). We present ratios for each drug and cumulative ratios for multiple therapeutic options for each nonurothelial subtype. For example, 58.9% of SCC patients, 33.5% of AC/UrCs patients, and 79.3% of Sq-BLCA patients would be eligible for at least one of the analyzed targets. In conclusion, our findings hold promise for targeted therapeutic approaches in selected patients in the future, as various drugs could be applied according to the biomarker status.
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12
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Böthig R, Tiburtius C, Schöps W, Zellner M, Balzer O, Kowald B, Hirschfeld S, Thietje R, Pietsch A, Kurze I, Forchert M, Kadhum T, Golka K. Urinary bladder cancer as a late sequela of traumatic spinal cord injury. Mil Med Res 2021; 8:29. [PMID: 33910625 PMCID: PMC8082770 DOI: 10.1186/s40779-021-00322-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 04/16/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Traumatic spinal cord injury (SCI) is also a combat-related injury that is increasing in modern warfare. The aim of this work is to inform medical experts regarding the different course of bladder cancer in able-bodied patients compared with SCI patients based on the latest medical scientific knowledge, and to present decision-making aids for the assessment of bladder cancer as a late sequela of traumatic SCI. METHODS A study conducted between January 1998 and December 2019 in the BG Trauma Hospital Hamburg formed the basis for the decision-making aids. Urinary bladder cancer was diagnosed in 40 out of 7396 treated outpatient and inpatient SCI patients. General patient information, latency period, age at initial diagnosis, type of bladder management and survival of SCI patients with bladder cancer were collected and analysed. T category, grading and tumour entity in these patients were compared with those in the general population. Relevant bladder cancer risk factors in SCI patients were analysed. Furthermore, relevant published literature was taken into consideration. RESULTS Initial diagnosis of urinary bladder cancer in SCI patients occurs at a mean age of 56.4 years (SD ± 10.7 years), i.e., approximately 20 years earlier as compared with the general population. These bladder cancers are significantly more frequently muscle invasive (i.e., T category ≥ T2) and present a higher grade at initial diagnosis. Furthermore, SCI patients show a significantly higher proportion of the more aggressive squamous cell carcinoma than that of the general population in areas not endemic for the tropical disease schistosomiasis. Consequently, the survival time is extremely unfavourable. A very important finding, for practical reasons is that, in the Hamburg study as well as in the literature, urinary bladder cancer is more frequently observed after 10 years or more of SCI. Based on these findings, a matrix was compiled where the various influencing factors, either for or against the recognition of an association between SCI and urinary bladder cancer, were weighted according to their relevance. CONCLUSIONS The results showed that urinary bladder cancer in SCI patients differs considerably from that in able-bodied patients. The presented algorithm is an important aid in everyday clinical practice for assessing the correlation between SCI and bladder cancer.
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Affiliation(s)
- Ralf Böthig
- Department of Neuro-Urology, Centre for Spinal Cord Injuries, BG Klinikum Hamburg, 21033, Hamburg, Germany.
| | - Christian Tiburtius
- Department of Neuro-Urology, Centre for Spinal Cord Injuries, BG Klinikum Hamburg, 21033, Hamburg, Germany
| | | | - Michael Zellner
- Department of Urology and Neuro-Urology, Johannesbad Fachklinik, 94072, Bad Füssing, Germany
| | - Oliver Balzer
- Department of Neuro-Urology, Centre for Spinal Cord Injuries, BG Klinikum Hamburg, 21033, Hamburg, Germany
| | - Birgitt Kowald
- Biomechanical Laboratory, Centre for Spinal Cord Injuries, BG Klinikum Hamburg, 21033, Hamburg, Germany
| | - Sven Hirschfeld
- Centre for Spinal Cord Injuries, BG Klinikum Hamburg, 21033, Hamburg, Germany
| | - Roland Thietje
- Centre for Spinal Cord Injuries, BG Klinikum Hamburg, 21033, Hamburg, Germany
| | - Aki Pietsch
- Department of Sports and Rehabilitation Medicine, BG Klinikum Hamburg, 21033, Hamburg, Germany
| | - Ines Kurze
- Department of Paraplegiology and Neuro-Urology, Centre for Spinal Cord Injuries, Zentralklinik Bad Berka, 99437, Bad Berka, Germany
| | - Martin Forchert
- Staff Position Accident Insurance Law, Statutory Accident Insurance for Wood and Metal (BGHM), 33602, Bielefeld, Germany
| | - Thura Kadhum
- Department of Psychosomatic Rehabilitation, Mittelrheinklinik Fachklinik, 56154, Boppard-Bad Salzig, Germany
| | - Klaus Golka
- Clinical Occupational Medicine, Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), 44139, Dortmund, Germany
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13
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Sanguedolce F, Calò B, Mancini V, Zanelli M, Palicelli A, Zizzo M, Ascani S, Carrieri G, Cormio L. Non-Muscle Invasive Bladder Cancer with Variant Histology: Biological Features and Clinical Implications. Oncology 2021; 99:345-358. [PMID: 33735905 DOI: 10.1159/000514759] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 12/30/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The most common bladder cancer (BC) histotype is pure urothelial carcinoma (UC), which may undergo divergent differentiation in some cases. Variant histology (VH) presents along variable morphologies, either single or combined between them or with pure UC. From a clinical standpoint, the vast majority of BC is diagnosed at non-invasive or minimally invasive stages, namely as non-muscle invasive BC (NMIBC). There is a wide range of therapeutic options for patients with NMIBC, according to their clinical and pathological features. However, current risk stratification models do not show optimal effectiveness. Evidence from the literature suggests that VH has peculiar biological features, and may be associated with poorer survival outcomes compared to pure UC. SUMMARY In order to describe the biological features and prognostic/predictive role of VH in NMIBC, and to discuss current treatment options, we performed a systematic literature search through multiple databases (PubMed/Medline, Google Scholar) for relevant articles according to the following terms, single and/or in combination: "non-muscle invasive bladder cancer," "variant histology," "micropapillary variant," "glandular differentiation," "squamous differentiation," "nested variant," "plasmacytoid variant," and "sarcomatoid variant." We extracted 99 studies including original articles, reviews, and systematic reviews, and subsequently analyzed data from 16 studies reporting on the outcome of NMIBC with VH. We found that the relative rarity of these forms as well as the heterogeneity in study populations and therapeutic protocols results in conflicting findings overall. Key Messages: The presence of VH should be taken into account when counseling a patient with NMIBC, since it may upgrade the disease to high-risk tumor and thus warrant a more aggressive treatment.
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Affiliation(s)
| | - Beppe Calò
- Urology Unit, University of Foggia, Bonomo Teaching Hospital, Foggia, Italy
| | - Vito Mancini
- Urology and Renal Transplantation Unit, University of Foggia, Foggia, Italy
| | - Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, Terni, Italy
| | - Giuseppe Carrieri
- Urology and Renal Transplantation Unit, University of Foggia, Foggia, Italy
| | - Luigi Cormio
- Urology Unit, University of Foggia, Bonomo Teaching Hospital, Foggia, Italy
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14
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Achenbach F, Rose M, Ortiz-Brüchle N, Seillier L, Knüchel R, Weyerer V, Hartmann A, Morsch R, Maurer A, Ecke TH, Garczyk S, Gaisa NT. SWI/SNF Alterations in Squamous Bladder Cancers. Genes (Basel) 2020; 11:genes11111368. [PMID: 33227989 PMCID: PMC7699259 DOI: 10.3390/genes11111368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/10/2020] [Accepted: 11/17/2020] [Indexed: 12/24/2022] Open
Abstract
Dysfunction of the SWI/SNF complex has been observed in various cancers including urothelial carcinomas. However, the clinical impact of the SWI/SNF complex in squamous-differentiated bladder cancers (sq-BLCA) remains unclear. Therefore, we aimed to analyze potential expression loss and genetic alterations of (putative) key components of the SWI/SNF complex considering the co-occurrence of genetic driver mutations and PD-L1 expression as indicators for therapeutic implications. Assessment of ARID1A, SMARCA2, SMARCA4, SMARCB1/INI1, SMARCC1, SMARCC2 and PBRM1 mutations in a TCGA data set of sq-BLCA (n = 45) revealed that ARID1A was the most frequently altered SWI/SNF gene (15%) while being associated with protein downregulation. Genetic alterations and loss of ARID1A were confirmed by Targeted Next Generation Sequencing (NGS) (3/6) and immunohistochemistry (6/116). Correlation with further mutational data and PD-L1 expression revealed co-occurrence of ARID1A loss and TP53 mutations, while positive correlations with other driver mutations such as PIK3CA were not observed. Finally, a rare number of sq-BLCA samples were characterized by both ARID1A protein loss and strong PD-L1 expression suggesting a putative benefit upon immune checkpoint inhibitor therapy. Hence, for the first time, our data revealed expression loss of SWI/SNF subunits in sq-BLCA, highlighting ARID1A as a putative target of a small subgroup of patients eligible for novel therapeutic strategies.
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Affiliation(s)
- Fabian Achenbach
- Institute of Pathology, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; (F.A.); (M.R.); (N.O.-B.); (L.S.); (R.K.); (A.M.); (S.G.)
| | - Michael Rose
- Institute of Pathology, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; (F.A.); (M.R.); (N.O.-B.); (L.S.); (R.K.); (A.M.); (S.G.)
| | - Nadina Ortiz-Brüchle
- Institute of Pathology, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; (F.A.); (M.R.); (N.O.-B.); (L.S.); (R.K.); (A.M.); (S.G.)
| | - Lancelot Seillier
- Institute of Pathology, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; (F.A.); (M.R.); (N.O.-B.); (L.S.); (R.K.); (A.M.); (S.G.)
| | - Ruth Knüchel
- Institute of Pathology, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; (F.A.); (M.R.); (N.O.-B.); (L.S.); (R.K.); (A.M.); (S.G.)
| | - Veronika Weyerer
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (V.W.); (A.H.)
| | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (V.W.); (A.H.)
| | - Ronja Morsch
- Department of Urology, RWTH Aachen University, 52074 Aachen, Germany;
| | - Angela Maurer
- Institute of Pathology, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; (F.A.); (M.R.); (N.O.-B.); (L.S.); (R.K.); (A.M.); (S.G.)
| | - Thorsten H. Ecke
- Department of Urology, Helios Clinic, 15526 Bad Saarow, Germany;
| | - Stefan Garczyk
- Institute of Pathology, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; (F.A.); (M.R.); (N.O.-B.); (L.S.); (R.K.); (A.M.); (S.G.)
| | - Nadine T. Gaisa
- Institute of Pathology, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; (F.A.); (M.R.); (N.O.-B.); (L.S.); (R.K.); (A.M.); (S.G.)
- Correspondence: ; Tel.: +49-241-8036118; Fax: +49-241-8082439
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15
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Prognostic value of pretreatment inflammatory markers in variant histologies of the bladder: is inflammation linked to survival after radical cystectomy? World J Urol 2020; 39:2537-2543. [PMID: 33084922 DOI: 10.1007/s00345-020-03482-8] [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] [Received: 06/27/2020] [Accepted: 10/03/2020] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To investigate differences in standard preoperative inflammatory markers in patients with urothelial carcinoma (UC) and variant histologies undergoing radical cystectomy (RC) and determine its impact on survival. METHODS Patients undergoing RC at an academic high-volume center were retrospectively analyzed. Preoperatively taken CRP, leukocytes, hemoglobin (Hb), and thrombocytes were analyzed as routine inflammatory biomarkers. Log-rank tests and Kruskal-Wallis analysis were used to calculate for differences in survival and in blood levels of biomarkers. RESULTS 886 patients with complete follow-up and UC or variant histology underwent RC at our institution between 2004 and 2019. Although variant histology presents with significantly higher t stage than UC, cancer-specific survival (CSS) of UC (1-year-CSS: 93%) is not significantly different to variant histology of UC with squamous differentiation (UCSD, 1-year-CSS: 81%), squamous cell carcinoma (SCC, 1-year-CSS: 82%), and adenocarcinoma (AC, 1-year-CSS: 81%). In UC, alterations in all biomarkers except leukocytes beyond routine cut-off values were associated with poor survival (p < 0.01), whereas Hb beyond cut-off values are associated with poor prognosis in SCC (p < 0.05). CRP levels are significantly elevated in UCSD and SCC at time of surgery compared to UC (p < 0.05). CONCLUSION Inflammatory biomarkers reveal distinctive patterns across UC and variant histologies of bladder cancer. As inflammation might play an important role in cancer progression, further research is warranted to understand those molecular mechanisms and their potential therapeutic impact in variant histology of bladder cancer.
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16
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Fan Z, Huang Z, Hu C, Tong Y, Zhao C. Risk factors and nomogram for newly diagnosis of bone metastasis in bladder cancer: A SEER-based study. Medicine (Baltimore) 2020; 99:e22675. [PMID: 33080711 PMCID: PMC7571943 DOI: 10.1097/md.0000000000022675] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Bladder cancer (BC) is the second most common urogenital malignant tumor. Bone metastasis (BM) is not common in BC patients, and there are only few studies on it. However, it was found in a clinical study that BM was related to the occurrence of bone complications and the decrease in survival rate. Early diagnosis of BC with BM is important for timely intervention and prevention of pathological fracture, which is of great significance for improving the quality of life of BC patients. This study aimed to identify the risk factors of BM and establish a predictive nomogram for the early diagnosis of BM in BC.The medical records of the newly diagnosed BC patients were extracted from the database of Surveillance, Epidemiology, and End Results (SEER) during 2010 to 2016. The risk factors of BC with BM were evaluated using multivariate logistic regression analysis. Then a nomogram was established to predict the risk of BC with BM.This study included 35,506 patients identified in the SEER database as diagnosed with BC, 796 of whom had BM. Grade, T stage, N stage, liver metastasis, race, brain metastasis, lung metastasis, histologic type, primary site, and age were risk predictors of BC with BM. Using Harrell's concordance index, calibration curve, and decision curve analyses, we found that the nomogram for predicting the risk of BC metastasis performed well internally.The nomogram developed in this study is expected to become an accurate and personalized tool for predicting risks of BC with BM in patients. It may be of great significance for clinicians to formulate more reasonable and effective treatment strategies. As the first study, we established a predictive nomogram for BC with BM based on the retrospective analysis of data of BC patients from the SEER database.
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Affiliation(s)
- Zhiyi Fan
- Department of Minimally Invasive Spine Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province
| | - Zhangheng Huang
- Department of Minimally Invasive Spine Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province
| | - Chuan Hu
- Department of Minimally Invasive Spine Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province
- Qingdao university medical college, Qingdao, Shandong, China
| | - Yuexin Tong
- Department of Minimally Invasive Spine Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province
| | - Chengliang Zhao
- Department of Minimally Invasive Spine Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province
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17
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Andersson N, Ohlsson J, Wahlin S, Nodin B, Boman K, Lundgren S, Jirström K. Lymphocyte antigen 6 superfamily member D is a marker of urothelial and squamous differentiation: implications for risk stratification of bladder cancer. Biomark Res 2020; 8:51. [PMID: 33042546 PMCID: PMC7539380 DOI: 10.1186/s40364-020-00232-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/30/2020] [Indexed: 12/24/2022] Open
Abstract
Background Screening across a multitude of normal and malignant tissues revealed an enhanced expression of lymphocyte antigen 6 superfamily member D (LY6D) in squamous epithelium and urothelium, as well as in malignancies derived therefrom. The aim of this study was to further delineate the protein expression of LY6D in urothelial bladder cancer, with particular attention to its relationship with clinicopathological characteristics and patient outcome. Methods Immunohistochemical expression of LY6D was assessed in tissue microarrays with urothelial bladder cancer tumours from three independent patient cohorts; one with transurethral resection of the bladder (TURB) specimens of mixed tumour stages from 110 consecutive cases, one with tumours of mixed stages from 260 incident cases in a population-based cohort, and one with paired TURB specimens, resected tumours and a subset of lymph node metastases from 145 patients with muscle-invasive bladder cancer (MIBC). Chi-square and non-parametric tests were applied to examine associations of LY6D expression with clinicopathological characteristics. Kaplan-Meier and Cox regression analyses were applied to examine 5-year overall survival (OS) and recurrence free survival (RFS) in relation to LY6D expression. Results In the two cohorts with mixed stages, positive LY6D expression was denoted in 63 and 64% of the cases, respectively, and found to be significantly higher in low-grade and less invasive tumours. Negative LY6D expression was significantly associated with a reduced 5-year OS, although not independently of established prognostic factors. In the population-based cohort, LY6D expression was higher in tumours with squamous differentiation and lower in other variant histologies compared to pure urothelial tumours, and the association of LY6D expression with survival was somewhat enhanced after exclusion of the former. LY6D expression was generally lower in the MIBC cohort, and even more reduced in resected tumours compared to TURB specimens in patients who had not received neoadjuvant chemotherapy. There were no significant associations between LY6D expression and RFS, neither allover nor in relation to neoadjuvant chemotherapy. Conclusion LY6D is a marker of urothelial and squamous differentiation that may add useful diagnostic and prognostic information to better guide the clinical management of bladder cancer, given that the presence of variant histology is taken into account.
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Affiliation(s)
- Nina Andersson
- Division of Oncology and Therapeutic Pathology, Department of Clinical Sciences, Lund, Lund University, SE-221 85 Lund, Sweden
| | - Johan Ohlsson
- Division of Oncology and Therapeutic Pathology, Department of Clinical Sciences, Lund, Lund University, SE-221 85 Lund, Sweden
| | - Sara Wahlin
- Division of Oncology and Therapeutic Pathology, Department of Clinical Sciences, Lund, Lund University, SE-221 85 Lund, Sweden
| | - Björn Nodin
- Division of Oncology and Therapeutic Pathology, Department of Clinical Sciences, Lund, Lund University, SE-221 85 Lund, Sweden
| | - Karolina Boman
- Division of Oncology and Therapeutic Pathology, Department of Clinical Sciences, Lund, Lund University, SE-221 85 Lund, Sweden
| | - Sebastian Lundgren
- Division of Oncology and Therapeutic Pathology, Department of Clinical Sciences, Lund, Lund University, SE-221 85 Lund, Sweden
| | - Karin Jirström
- Division of Oncology and Therapeutic Pathology, Department of Clinical Sciences, Lund, Lund University, SE-221 85 Lund, Sweden
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18
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Adnan S, Khalil MAI, Fiaz S, Abu Bakar M, Ali A, Ahmad Cheema Z, Mir K. Oncological Outcomes of Non-Urothelial Bladder Cancers in a Specialized Cancer Hospital of a Developing Country. Cureus 2020; 12:e9957. [PMID: 32983661 PMCID: PMC7510515 DOI: 10.7759/cureus.9957] [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] [Indexed: 11/05/2022] Open
Abstract
Background Non-urothelial bladder cancers (NUBCs) constitute only 5% of all bladder cancers. Because of the scarcity of data, no standardized treatment can be offered to these patients. Surgical treatment can be offered to patients with localized disease; however, generally, the prognosis is unfavorable. Methodology Patients with histology-proven NUBC presenting to the Department of Uro-oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan, from January 2002 to July 2017 were identified and assessed retrospectively. Results A total of 20 patients with a median presenting age of 52 years (range: 34-87 years) were identified. Clinically, T3 was the commonest stage of presentation, i.e., in 11 (55%), whereas 1 (7.1%) patient had metastatic disease. Four types of NUBCs were identified: adenocarcinoma, squamous cell carcinoma, small cell carcinoma, and inflammatory myofibroblastic tumor. Most of the patients with adenocarcinoma were offered surgical treatment in the form of either partial (64.3%) or radical (28.6%) cystectomy. Two patients with small cell carcinoma and two of the three patients with SCC could only be offered palliative chemotherapy. During a median follow-up of 40 months, 14 (70%) patients developed disease progression or recurrence. All these patients succumbed to their disease during a median period of 37.5 months (range: 5-84 months). Furthermore, three- and five-year disease-free survival was 60% and 51%, respectively, and overall survival was 65% and 31%, respectively. Conclusions NUBC is a rare but aggressive disease that presents at an advanced stage in many cases. Treatment protocols are not uniform; therefore, further collaborative research is needed to improve survival outcomes.
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Affiliation(s)
- Siddique Adnan
- Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.,Urology, Institute of Kidney Diseases, Peshawar, PAK
| | | | - Shaukat Fiaz
- Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Muhammad Abu Bakar
- Biostatistics and Epidemiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Azfar Ali
- Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Zubair Ahmad Cheema
- Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Khurram Mir
- Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
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19
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Lobo N, Shariat SF, Guo CC, Fernandez MI, Kassouf W, Choudhury A, Gao J, Williams SB, Galsky MD, Taylor JA, Roupret M, Kamat AM. What Is the Significance of Variant Histology in Urothelial Carcinoma? Eur Urol Focus 2020; 6:653-663. [DOI: 10.1016/j.euf.2019.09.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 08/25/2019] [Accepted: 09/03/2019] [Indexed: 01/16/2023]
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20
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Kadouri Y, Hachem F, Lakssir J, Sayegh H, Benslimane L, Nouini Y. [Primitive adenocarcinoma of the bladder: about 6 cases]. Pan Afr Med J 2020; 36:61. [PMID: 32733631 PMCID: PMC7371441 DOI: 10.11604/pamj.2020.36.61.20176] [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: 08/27/2019] [Accepted: 09/09/2019] [Indexed: 11/11/2022] Open
Abstract
L´adénocarcinome primitif de la vessie est une variété rare de tumeurs vésicales qui représente moins de 2% des cancers de la vessie. Il semble atteindre préférentiellement le sexe masculin avec un sexe ratio de 3/1 et un âge moyen de survenu entre 60 ans et 70 ans. Sa présentation clinique est non spécifique et dominée par l´hématurie. La résection endoscopique de la vessie avec un examen anathomopathologique permet de poser le diagnostic. Le traitement de l´adénocarcinome primitif de la vessie reste sujet à de nombreuses controverses du fait de la rareté des cas rapportés dans la littérature. Cependant, le traitement de choix semble être une cystectomie totale avec curage ganglionnaire étendu. Nous rapportons une série de 6 cas d´adénocarcinome qui ont été traités et suivis au sein de notre formation. Notre analyse est basée sur l´évaluation des caractéristiques épidémiologiques, cliniques, anatomo-pathologiques, et thérapeutiques de l´adénocarcinome de la vessie, ainsi que sur l´étude des aspects évolutifs et des facteurs pronostiques.
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Affiliation(s)
- Youssef Kadouri
- Université Mohamed V, Faculté de Médecine et de Pharmacie de Rabat Maroc, Hôpital Ibn Sina, Service d´Urologie A, Rabat, Maroc
| | - Farouk Hachem
- Université Mohamed V, Faculté de Médecine et de Pharmacie de Rabat Maroc, Hôpital Ibn Sina, Service d´Urologie A, Rabat, Maroc
| | - Jihad Lakssir
- Université Mohamed V, Faculté de Médecine et de Pharmacie de Rabat Maroc, Hôpital Ibn Sina, Service d´Urologie A, Rabat, Maroc
| | - Hachem Sayegh
- Université Mohamed V, Faculté de Médecine et de Pharmacie de Rabat Maroc, Hôpital Ibn Sina, Service d´Urologie A, Rabat, Maroc
| | - Lounis Benslimane
- Université Mohamed V, Faculté de Médecine et de Pharmacie de Rabat Maroc, Hôpital Ibn Sina, Service d´Urologie A, Rabat, Maroc
| | - Yassine Nouini
- Université Mohamed V, Faculté de Médecine et de Pharmacie de Rabat Maroc, Hôpital Ibn Sina, Service d´Urologie A, Rabat, Maroc
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21
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Mukai S, Yamasaki K, Fujii M, Nagai T, Terada N, Kataoka H, Kamoto T. Dysregulation of Type II Transmembrane Serine Proteases and Ligand-Dependent Activation of MET in Urological Cancers. Int J Mol Sci 2020; 21:ijms21082663. [PMID: 32290402 PMCID: PMC7215454 DOI: 10.3390/ijms21082663] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/07/2020] [Accepted: 04/07/2020] [Indexed: 01/09/2023] Open
Abstract
Unlike in normal epithelium, dysregulated overactivation of various proteases have been reported in cancers. Degradation of pericancerous extracellular matrix leading to cancer cell invasion by matrix metalloproteases is well known evidence. On the other hand, several cell-surface proteases, including type II transmembrane serine proteases (TTSPs), also induce progression through activation of growth factors, protease activating receptors and other proteases. Hepatocyte growth factor (HGF) known as a multifunctional growth factor that upregulates cancer cell motility, invasiveness, proliferative, and anti-apoptotic activities through phosphorylation of MET (a specific receptor of HGF). HGF secreted as inactive zymogen (pro-HGF) from cancer associated stromal fibroblasts, and the proteolytic activation by several TTSPs including matriptase and hepsin is required. The activation is strictly regulated by HGF activator inhibitors (HAIs) in physiological condition. However, downregulation is frequently observed in cancers. Indeed, overactivation of MET by upregulation of matriptase and hepsin accompanied by the downregulation of HAIs in urological cancers (prostate cancer, renal cell carcinoma, and bladder cancer) are also reported, a phenomenon observed in cancer cells with malignant phenotype, and correlated with poor prognosis. In this review, we summarized current reports focusing on TTSPs, HAIs, and MET signaling axis in urological cancers.
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Affiliation(s)
- Shoichiro Mukai
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan; (K.Y.); (M.F.); (T.N.); (N.T.); (T.K.)
- Correspondence: ; Tel.: +81-985-85-2968
| | - Koji Yamasaki
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan; (K.Y.); (M.F.); (T.N.); (N.T.); (T.K.)
| | - Masato Fujii
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan; (K.Y.); (M.F.); (T.N.); (N.T.); (T.K.)
| | - Takahiro Nagai
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan; (K.Y.); (M.F.); (T.N.); (N.T.); (T.K.)
| | - Naoki Terada
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan; (K.Y.); (M.F.); (T.N.); (N.T.); (T.K.)
| | - Hiroaki Kataoka
- Oncopathology and Regenerative Biology Section, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan;
| | - Toshiyuki Kamoto
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan; (K.Y.); (M.F.); (T.N.); (N.T.); (T.K.)
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22
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Morsch R, Rose M, Maurer A, Cassataro MA, Braunschweig T, Knüchel R, Vögeli TA, Ecke T, Eckstein M, Weyerer V, Esposito I, Ackermann M, Niegisch G, Gaisa NT. Therapeutic implications of PD-L1 expression in bladder cancer with squamous differentiation. BMC Cancer 2020; 20:230. [PMID: 32188412 PMCID: PMC7079494 DOI: 10.1186/s12885-020-06727-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 03/09/2020] [Indexed: 12/13/2022] Open
Abstract
Background Immune checkpoint inhibitors (ICI) are an integral part of bladder cancer therapy, however, the relevance of ICI treatment for mixed and pure squamous cell carcinoma of the bladder remains poorly studied. Therefore, we analysed the expression of programmed death-ligand 1 (PD-L1) in urothelial carcinomas with squamous differentiation (UC/SCC) and pure squamous cell carcinoma (SCC) of the bladder and studied a UC/SCC patient with ICI therapy. Methods Tissue microarrays of 45 UC/SCC and 63 SCC samples were immunohistochemically stained with four anti-PD-L1 antibodies (28–8, 22C3, SP142 and SP263). PD-L1 expression was determined for tumour cells (TP-Score), immune cells (IC-Score) and combined (CPS, combined positive score). In addition, we present clinical and histological data of an UC/SCC patient with nivolumab therapy. Results Overall, positive PD-L1 staining ranged between 4.8 and 61.9% for IC and 0 and 51.2% for TC depending on the used antibody. There were no significant differences between UC/SCC and SCC. According to current FDA guidelines for example for first line therapy of urothelial cancer with pembrolizumab (CPS ≥ 10), a subset of SCC patients up to 20% would be eligible. Finally, our UC/SCC index patient revealed excellent therapy response regarding his lung metastasis. Conclusions Our data reveal a PD-L1 expression in squamous differentiated carcinomas comparable with current data shown for urothelial tumours. In accordance with the encouraging clinical data of the index patient we suggest ICI treatment also for mixed and pure SCC of the urinary bladder.
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Affiliation(s)
- Ronja Morsch
- Department of Urology, University Hospital RWTH Aachen University, Aachen, Germany.,Institute of Pathology, University Hospital RWTH Aachen University, Aachen, Germany
| | - Michael Rose
- Institute of Pathology, University Hospital RWTH Aachen University, Aachen, Germany
| | - Angela Maurer
- Institute of Pathology, University Hospital RWTH Aachen University, Aachen, Germany
| | | | - Till Braunschweig
- Institute of Pathology, University Hospital RWTH Aachen University, Aachen, Germany
| | - Ruth Knüchel
- Institute of Pathology, University Hospital RWTH Aachen University, Aachen, Germany
| | | | - Thorsten Ecke
- Department of Urology, HELIOS Hospital, Bad Saarow, Germany
| | - Markus Eckstein
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Veronika Weyerer
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Irene Esposito
- Institute of Pathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Maximilian Ackermann
- Institute of Pathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Günter Niegisch
- Department of Urology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Nadine T Gaisa
- Institute of Pathology, University Hospital RWTH Aachen University, Aachen, Germany.
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Nomograms to predict individual prognosis of patients with squamous cell carcinoma of the urinary bladder. BMC Cancer 2019; 19:1200. [PMID: 31818271 PMCID: PMC6902456 DOI: 10.1186/s12885-019-6430-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 12/03/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND On the basis of some significant clinical parameters, we had an intent to establish nomograms for estimating the prognosis of patients with squamous cell carcinoma of the urinary bladder (SCCB), including overall survival (OS) and cancer-specific survival (CSS). METHODS The data of 1210 patients diagnosed with SCCB between 2004 and 2014,were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. The Cox proportional hazards regression model was applied to evaluate the association between variables and survival. Nomograms were constructed to predict the OS and CSS of an individual patient based on the Cox model. In the end, the performance of nomograms was internally validated by using calibration curves, concordance index (C-index), and k-fold cross-validation. RESULTS Several common indicators were taken into the two nomograms (OS and CSS), including age at diagnosis, marital status, sex, TNM stage, surgical approach, tumor size, and lymph node ratio while the OS nomogram additionally contained race, grade, and chemotherapy. They had an excellent predictive accuracy on 1- and 3- year OS and CSS with C-index of 0.733 (95% confidence interval [CI], 0.717-0.749) for OS and 0.724 (95% CI, 0.707-0.741) for CSS. All calibration curves showed great consistency between actual survival and predictive survival. CONCLUSIONS The nomograms with improved accuracy and applicability on predicting the survival outcome of patients with SCCB would provide a reliable tool to help clinicians to evaluate the risk of patients and make individual treatment strategies.
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Kaczynski RE, Fegely D, Nier M, Valentin-Capeles N, Battista J. Primary non-urothelial squamous cell carcinoma masquerading as a perforated gastric ulcer: a case report. J Surg Case Rep 2019; 2019:rjz216. [PMID: 31360437 PMCID: PMC6649734 DOI: 10.1093/jscr/rjz216] [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] [Received: 04/24/2019] [Revised: 06/17/2019] [Accepted: 06/28/2019] [Indexed: 11/14/2022] Open
Abstract
We present an 84-year-old female patient with a very rare form of primary non-urothelial squamous cell carcinoma of the bladder, found incidentally during emergency exploratory laparotomy for a perforated pre-pyloric gastric ulcer. The bladder tumor was positive for CK5/6, CK903, and thrombomodulin biomarkers, as well as for high-risk HPV (16, 18, and 31). Based on a literature review of non-urothelial bladder cancers, specifically non-bilharzial squamous cell carcinoma, we believe our patient had a very rare form of primary non-urothelial squamous cell carcinoma of the bladder. The presence of these tumor markers and the lack of clinical evidence to suggest another primary origin, such as anus, rectum, cervix, or uterus, support this conclusion. This case provides an interesting example of a very rare incidental finding during an emergent procedure.
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Affiliation(s)
- Rachel E Kaczynski
- Department of Surgery, St. John's Episcopal Hospital, Far Rockaway, New York, NY, USA
| | - Daniel Fegely
- Department of Surgery, St. John's Episcopal Hospital, Far Rockaway, New York, NY, USA
| | - Matthew Nier
- Department of Medical Education, Midwestern University, Glendale, AZ, USA
| | - Neysa Valentin-Capeles
- FACOS, Department of Surgery, St. John's Episcopal Hospital, Far Rockaway, New York, NY, USA
| | - Jackie Battista
- FACOS, Department of Surgery, St. John's Episcopal Hospital, Far Rockaway, New York, NY, USA
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Tsuboi I, Maruyama Y, Sadahira T, Wada K, Ando N, Mitsui Y, Nishiyama Y, Arata R, Araki M, Nasu Y, Ono N. Inflammatory myofibroblastic bladder tumor with divergent behavior in a patient with spinal cord injury. IJU Case Rep 2019; 2:212-214. [PMID: 32743416 PMCID: PMC7292174 DOI: 10.1002/iju5.12085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/08/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION An inflammatory myofibroblastic tumor of the bladder is rare. Some urothelial carcinoma with sarcomatoid changes may mimic an inflammatory myofibroblastic tumor. CASE PRESENTATION A 76-year-old man with indwelling urinary catheters because of a spinal cord injury presented with gross hematuria. Transurethral electrocoagulation and a resection were performed. A T2-weighted magnetic resonance imaging showed a tumor and hematoma in the bladder diverticulum that pathologically resembled an inflammatory myofibroblastic tumor. This lesion was then removed en bloc by partial cystectomy. Histology showed a squamous cell carcinoma with sarcomatoid changes. After 4 months, a computed tomography showed the lesion had expanded outside the skin adjacent to the bladder. CONCLUSION Some cases of inflammatory myofibroblastic tumors have a malignant course. Urologists therefore need to be aware of the possibility of rare cases of malignant bladder myofibroblasts.
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Affiliation(s)
- Ichiro Tsuboi
- Department of UrologyOkayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesKita‐kuOkayamaJapan
- Department of UrologyKochi Health Sciences CenterKochi CityKochiJapan
- Okayama Urological Research Group (OURG)Kita‐kuOkayamaJapan
| | - Yuki Maruyama
- Department of UrologyOkayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesKita‐kuOkayamaJapan
- Okayama Urological Research Group (OURG)Kita‐kuOkayamaJapan
| | - Takuya Sadahira
- Department of UrologyOkayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesKita‐kuOkayamaJapan
- Okayama Urological Research Group (OURG)Kita‐kuOkayamaJapan
| | - Koichiro Wada
- Department of UrologyOkayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesKita‐kuOkayamaJapan
- Okayama Urological Research Group (OURG)Kita‐kuOkayamaJapan
| | - Nobuyoshi Ando
- Department of UrologyKochi Health Sciences CenterKochi CityKochiJapan
- Okayama Urological Research Group (OURG)Kita‐kuOkayamaJapan
| | - Yosuke Mitsui
- Department of UrologyOkayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesKita‐kuOkayamaJapan
- Okayama Urological Research Group (OURG)Kita‐kuOkayamaJapan
| | - Yasuhiro Nishiyama
- Department of UrologyKochi Health Sciences CenterKochi CityKochiJapan
- Okayama Urological Research Group (OURG)Kita‐kuOkayamaJapan
| | - Ryoji Arata
- Department of UrologyKochi Health Sciences CenterKochi CityKochiJapan
- Okayama Urological Research Group (OURG)Kita‐kuOkayamaJapan
| | - Motoo Araki
- Department of UrologyOkayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesKita‐kuOkayamaJapan
- Okayama Urological Research Group (OURG)Kita‐kuOkayamaJapan
| | - Yasutomo Nasu
- Department of UrologyOkayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesKita‐kuOkayamaJapan
- Okayama Urological Research Group (OURG)Kita‐kuOkayamaJapan
| | - Noriaki Ono
- Department of UrologyKochi Health Sciences CenterKochi CityKochiJapan
- Okayama Urological Research Group (OURG)Kita‐kuOkayamaJapan
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Self D, Ranasinghe W, Edirisinghe A, Ruthven S. Primary squamous cell carcinoma of the bladder presenting with colovesical and vesicocutaneous fistulae in a 29-year-old. ANZ J Surg 2019; 90:E34-E37. [PMID: 31033176 DOI: 10.1111/ans.15112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/16/2019] [Accepted: 01/22/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Duncan Self
- Gosford Hospital, Gosford, New South Wales, Australia
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27
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Baumeister P, Zamboni S, Mattei A, Antonelli A, Simeone C, Mordasini L, DiBona C, Moschini M. Histological variants in non-muscle invasive bladder cancer. Transl Androl Urol 2019; 8:34-38. [PMID: 30976566 PMCID: PMC6414352 DOI: 10.21037/tau.2019.01.09] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Several studies evaluated the role of histological variants on oncological outcomes after radical cystectomy (RC) and they were found significantly associated with worse recurrence and survival. Sparse data exists regarding the role variant histology in non-muscle invasive diseases: assessing their relationship with recurrence and progression is important to understand the most effective treatment and follow-up schedule. For these reasons, the aim of the present non-systematic review was to assess the literature on variant histology in non-muscle invasive bladder cancer (BCa). The diagnosis of presence variant histology at transurethral resection (TUR) specimens challenging for pathologists and several studies published in literature evaluated concordance between TUR and RC specimen with discordant results. These differences are probably related to diversity in collection of samples and pathological evaluation and underline the necessity to have good tissue-sample and a pathologic evaluation performed by expert and dedicated uropathologists. Treatment of BCa with variant histology shall include immediate RC in case of plasmacitoid, pure squamous, micropapillary and sarcomatoid variants. The neuroendocrine differentiation, therefore, showed chemosensitiveness, and RC preceded by neoadjuvant chemotherapy should be proposed. Intravesical instillations with Bacillus Calmette Guerin (BCG) can be suggested in very selected cases of nested and glandular variants.
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Affiliation(s)
| | - Stefania Zamboni
- Klinik für Urologie, Luzerner Kantonsspital, Lucerne 6004, Switzerland.,Department of Urology, Spedali Civili di Brescia, Brescia 25123, Italy
| | - Agostino Mattei
- Klinik für Urologie, Luzerner Kantonsspital, Lucerne 6004, Switzerland
| | | | - Claudio Simeone
- Department of Urology, Spedali Civili di Brescia, Brescia 25123, Italy
| | - Livio Mordasini
- Klinik für Urologie, Luzerner Kantonsspital, Lucerne 6004, Switzerland
| | - Carlo DiBona
- Klinik für Urologie, Luzerner Kantonsspital, Lucerne 6004, Switzerland
| | - Marco Moschini
- Klinik für Urologie, Luzerner Kantonsspital, Lucerne 6004, Switzerland
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Maia MC, Hansen A, Alves C, Salah S. Biomarkers in Non-Schistosomiasis-related squamous cell carcinoma of the urinary bladder: A review. Crit Rev Oncol Hematol 2019; 135:76-84. [DOI: 10.1016/j.critrevonc.2019.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 10/04/2018] [Accepted: 01/17/2019] [Indexed: 01/23/2023] Open
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Bacinschi XE, Ilie SM, Trifanescu OG, Serbanescu GL, Botnariuc I, Curea F, Orlov C, Anghel RM. Rare Pelvic Malignant Tumors in Adults: Treatment Features and Clinical Outcome in Nonmetastatic Disease (Single Institution Experience). Cancer Biother Radiopharm 2018; 34:56-66. [PMID: 30484700 DOI: 10.1089/cbr.2018.2535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Nearly 200 cancers repertories are rare, and more than 20% are pelvic neoplasia. Diagnosis and treatment are challenging, even in reference centers, and survival is influenced by the aggressiveness of certain histologies and absence of a standard of care. PATIENTS AND METHODS The authors report the results of a retrospective analysis of patients that attended the Institute of Oncology, Bucharest, between 2004 and 2015, for nonmetastatic pelvic malignant tumor treatment and follow-up. The outcomes are compared between the rare and common histology groups. RESULTS Of the 60 cases analyzed, 17 patients (28.33%) bore a rare tumor, 33 (55%) were women, and the median age was 59 years. The majority was concerned by bladder (41.66%, 25 patients) and cervix (23.33%, 14 patients) neoplasms. For a median follow-up of 27.5 months, relapse was registered in 27 patients (45%), of whom 9 (33.33%) were from the rare group (53% of this subpopulation). The highest relapse rates were recorded in patients with rare bladder tumors (66.7%, 4 patients) compared with 42.1% (8 patients) in the common group (p = 0.294) and in prostate localization (66.7%, 2 patients) compared with 16.7% (1 patient) (p = 0.134). Estimated median relapse-free survival (RFS) was 60, 12 months in the rare group and 67 months for common tumors. CONCLUSIONS In nonmetastatic rare pelvic tumor patients, the outcome was found to be poorer than in those concerned by common histologies stratified by organ. A higher rate of relapse and the lowest median RFS were observed in bladder and prostatic cancers.
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Affiliation(s)
- Xenia E Bacinschi
- 1 Department of Oncology-Radiotherapy, Institute of Oncology "Prof. Dr. Alexandru Trestioreanu," Bucharest, Romania
- 2 University of Medicine and Pharmacy "Carol Davila," Bucharest, Romania
| | - Silvia M Ilie
- 1 Department of Oncology-Radiotherapy, Institute of Oncology "Prof. Dr. Alexandru Trestioreanu," Bucharest, Romania
| | - Oana G Trifanescu
- 1 Department of Oncology-Radiotherapy, Institute of Oncology "Prof. Dr. Alexandru Trestioreanu," Bucharest, Romania
- 2 University of Medicine and Pharmacy "Carol Davila," Bucharest, Romania
| | - Georgia-Luiza Serbanescu
- 1 Department of Oncology-Radiotherapy, Institute of Oncology "Prof. Dr. Alexandru Trestioreanu," Bucharest, Romania
- 2 University of Medicine and Pharmacy "Carol Davila," Bucharest, Romania
| | - Inga Botnariuc
- 2 University of Medicine and Pharmacy "Carol Davila," Bucharest, Romania
| | - Fabiana Curea
- 2 University of Medicine and Pharmacy "Carol Davila," Bucharest, Romania
| | - Cristina Orlov
- 2 University of Medicine and Pharmacy "Carol Davila," Bucharest, Romania
| | - Rodica M Anghel
- 1 Department of Oncology-Radiotherapy, Institute of Oncology "Prof. Dr. Alexandru Trestioreanu," Bucharest, Romania
- 2 University of Medicine and Pharmacy "Carol Davila," Bucharest, Romania
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Yamasaki K, Mukai S, Nagai T, Nakahara K, Fujii M, Terada N, Ohno A, Sato Y, Toda Y, Kataoka H, Kamoto T. Matriptase-Induced Phosphorylation of MET is Significantly Associated with Poor Prognosis in Invasive Bladder Cancer; an Immunohistochemical Analysis. Int J Mol Sci 2018; 19:ijms19123708. [PMID: 30469509 PMCID: PMC6321379 DOI: 10.3390/ijms19123708] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/13/2018] [Accepted: 11/20/2018] [Indexed: 12/14/2022] Open
Abstract
Hepatocyte growth factor (HGF) plays an important role in cancer progression via phosphorylation of MET (c-met proto-oncogene product, receptor of HGF). HGF-zymogen (pro-HGF) must be processed for activation by HGF activators including matriptase, which is a type II transmembrane serine protease and the most efficient activator. The enzymatic activity is tightly regulated by HGF activator inhibitors (HAIs). Dysregulated pro-HGF activation (with upregulated MET phosphorylation) is reported to promote cancer progression in various cancers. We retrospectively analyzed the expression of matriptase, phosphorylated-MET (phospho-MET) and HAI-1 in tumor specimens obtained from patients with invasive bladder cancer by immunohistochemistry. High expression of phospho-MET and increased expression of matriptase were significantly associated with poor prognosis, and high matriptase/low HAI-1 expression showed poorer prognosis. Furthermore, high expression of matriptase tended to correlate with phosphorylation of MET. Increased expression of matriptase may induce the ligand-dependent activation of MET, which leads to poor prognosis in patients with invasive bladder cancer.
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Affiliation(s)
- Koji Yamasaki
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.
| | - Shoichiro Mukai
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.
| | - Takahiro Nagai
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.
| | - Kozue Nakahara
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.
| | - Masato Fujii
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.
| | - Naoki Terada
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.
| | - Akinobu Ohno
- Section of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.
| | - Yuichiro Sato
- Section of Diagnostic Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.
| | - Yoshinobu Toda
- Department of Clinical Laboratory Science, Tenri Health Care University, Nara 632-0018, Japan.
| | - Hiroaki Kataoka
- Oncopathology and Regenerative Biology Section, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.
| | - Toshiyuki Kamoto
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.
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Al Edwan GM, Mansi HH, Atta ONM, Shaban MM. Squamous cell carcinoma of the bladder presented with spontaneous intraperitoneal bladder rupture: A case report. Int J Surg Case Rep 2018; 48:61-64. [PMID: 29852423 PMCID: PMC6026717 DOI: 10.1016/j.ijscr.2018.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/24/2018] [Accepted: 05/02/2018] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Spontaneous intraperitoneal bladder rupture can present with symptoms of acute abdomen. The associated high mortality rate is attributed to the delay in diagnosis, and the possibility of the presence of a bladder carcinoma contributes to high mortality as well. CASE PRESENTATION We present a case of spontaneous intraperitoneal bladder rupture associated with squamous cell carcinoma managed with partial cystectomy. DISCUSSION The incidence of this condition is (1:126,000) but with high mortality rate. It occurs more commonly in male [1]. It can be associated with carcinoma, chronic cystitis, chronic catheterization, bladder outflow obstruction and others. Standard management includes timely diagnosis of this condition, followed by bladder repair in the form of primary closure, partial cystectomy or radical cystectomy. However in the presence of carcinoma the prognosis is poor. CONCLUSION high index of clinical suspicion and the timely diagnosis can lead to a more favorable outcome.
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Affiliation(s)
- Ghazi M Al Edwan
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Jordan
| | - Hammam H Mansi
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Jordan.
| | - Omar Nabeeh M Atta
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Jordan
| | - Mazen M Shaban
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Jordan
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32
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Zahoor H, Elson P, Stephenson A, Haber GP, Kaouk J, Fergany A, Lee B, Koshkin V, Ornstein M, Gilligan T, Garcia JA, Rini B, Grivas P. Patient Characteristics, Treatment Patterns and Prognostic Factors in Squamous Cell Bladder Cancer. Clin Genitourin Cancer 2018; 16:e437-e442. [DOI: 10.1016/j.clgc.2017.10.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/27/2017] [Accepted: 10/09/2017] [Indexed: 12/01/2022]
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33
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Clinical characteristics and outcomes of nonurothelial cell carcinoma of the bladder: Results from the National Cancer Data Base. Urol Oncol 2018; 36:78.e1-78.e12. [DOI: 10.1016/j.urolonc.2017.10.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 10/02/2017] [Accepted: 10/13/2017] [Indexed: 11/21/2022]
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Characteristics and clinical significance of histological variants of bladder cancer. Nat Rev Urol 2017; 14:651-668. [DOI: 10.1038/nrurol.2017.125] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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35
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Railkar R, Krane LS, Li QQ, Sanford T, Siddiqui MR, Haines D, Vourganti S, Brancato SJ, Choyke PL, Kobayashi H, Agarwal PK. Epidermal Growth Factor Receptor (EGFR)-targeted Photoimmunotherapy (PIT) for the Treatment of EGFR-expressing Bladder Cancer. Mol Cancer Ther 2017; 16:2201-2214. [PMID: 28619755 DOI: 10.1158/1535-7163.mct-16-0924] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 05/05/2017] [Accepted: 06/09/2017] [Indexed: 12/12/2022]
Abstract
The use of light as a means of therapy for bladder cancer has a long history but has been hampered by a lack of tumor specificity and therefore, damage to the normal bladder mucosa. Here, we describe a targeted form of phototherapy called photoimmunotherapy (PIT), which targets EGFR-expressing bladder cancer. Anti-EGFR antibody panitumumab was labeled with the photoabsorber (PA), IRDye 700Dx (IR700), to create a panitumumab-IR700 antibody-PA conjugate that is activated by near-infrared radiation (NIR). Bladder cancer tissue microarray (TMA) and bladder cancer cell lines were analyzed for expression of EGFR. Mechanism of PIT-induced cell death was studied using proliferation assays, transmission electron microscopy (TEM), and production of reactive oxygen species. Finally, the in vivo effect was studied in xenografts. EGFR staining of TMAs showed that while most bladder cancers have expression of EGFR to a varying degree, squamous cell carcinomas (SCC) have the highest expression of EGFR. Panitumumab-IR700 activated by NIR light rapidly killed UMUC-5 cells, a bladder SCC line. Panitumumab alone, panitumumab-IR700 without NIR, or NIR alone had no effect on cells. TEM demonstrated that cell death is due to necrosis. Singlet oxygen species contributed toward cell death. NIR-PIT with panitumumab-IR700 reduced growth compared with only panitumumab-IR700-treated UMUC-5 xenograft tumors. PIT is a new targeted treatment for bladder cancer. Panitumumab-IR700-induced PIT selectively kills EGFR-expressing bladder cancer cells in vitro and in vivo and therefore warrants further therapeutic studies in orthotopic xenografts of bladder cancer and ultimately in patients. Mol Cancer Ther; 16(10); 2201-14. ©2017 AACR.
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Affiliation(s)
- Reema Railkar
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - L Spencer Krane
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Q Quentin Li
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Thomas Sanford
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Mohammad Rashid Siddiqui
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Diana Haines
- Pathology Section, Pathology/Histotechnology Laboratory, Leidos Biomedical Research, Inc. Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Srinivas Vourganti
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Sam J Brancato
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Peter L Choyke
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Hisataka Kobayashi
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Piyush K Agarwal
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland.
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Martin JW, Carballido EM, Ahmed A, Farhan B, Dutta R, Smith C, Youssef RF. Squamous cell carcinoma of the urinary bladder: Systematic review of clinical characteristics and therapeutic approaches. Arab J Urol 2016; 14:183-91. [PMID: 27547458 PMCID: PMC4983161 DOI: 10.1016/j.aju.2016.07.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/24/2016] [Accepted: 07/03/2016] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE To highlight the current understanding of the epidemiology, clinicopathological characteristics, and management of squamous cell carcinoma (SCC) of the bladder, as it accounts for 2-5% of bladder tumours, with a focus on non-bilharzial-associated SCC (NB-SCC). The standard treatment for bladder SCC remains radical cystectomy (RC). We present an updated clinical profile of bladder SCC and a review of NB-SCC therapeutic approaches, including RC, neoadjuvant and adjuvant treatments, radiotherapy, chemotherapy, and immunotherapy. METHODS Using search terms relating to SCC, urinary bladder, and treatment modalities, we performed a search of the PubMed and Embase databases to identify NB-SCC treatment approaches and outcomes. Peer-reviewed English language reports from 1975 to present assessing SCC management were included. Two authors independently screened and extracted the data. RESULTS Of the 806 articles screened, 10 met the pre-defined inclusion criteria. RC was performed in seven of the 10 studies. Although radiotherapy alone yielded poor outcomes, preoperative radiotherapy and RC were associated with improved survival. There is little evidence supporting the use of chemotherapy in NB-SCC, and its efficacy in relation to RC is not known. CONCLUSION Based on current literature, there is insufficient evidence to provide a treatment recommendation for NB-SCC. Whilst RC is the standard of care, the role of preoperative radiotherapy should be revisited and compared to RC alone. Additional studies incorporating multimodal approaches, contemporary radiation techniques, and systemic therapies are warranted. Immunotherapy as a treatment for bladder SCC has yet to be investigated.
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Key Words
- B-SCC, bilharzial-associated SCC
- Bilharzial
- Bladder
- CISC, clean intermittent self-catheterisation
- COX-2, cyclooxygenase 2
- DFS, disease-free survival
- FGF-2, fibroblast growth factor 2
- HER-2, human epidermal growth factor receptor 2
- HPV, human papilloma virus
- LN, lymph node
- LVI, lymphovascular invasion
- NAC, neoadjuvant chemotherapy
- NB-SCC, non-bilharzial SCC
- OS, overall survival
- PD-1, programmed cell death 1
- PD-L1, programmed death-ligand 1
- RC, radical cystectomy
- Radical cystectomy
- Radiotherapy
- SCC, squamous cell carcinoma
- SCI, spinal cord injury
- SEER, Surveillance, Epidemiology, and End Results
- Squamous cell carcinoma (SCC)
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Affiliation(s)
- Jeremy W Martin
- Department of Urology, University of California - Irvine, Orange, CA, USA
| | - Estrella M Carballido
- Division of Hematology and Medical Oncology, Mayo Clinic Cancer Center, Scottsdale, AZ, USA
| | - Ahmed Ahmed
- Department of Urology, University of California - Irvine, Orange, CA, USA; Department of Urology, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Bilal Farhan
- Department of Urology, University of California - Irvine, Orange, CA, USA
| | - Rahul Dutta
- Department of Urology, University of California - Irvine, Orange, CA, USA
| | - Cody Smith
- Department of Urology, University of California - Irvine, Orange, CA, USA
| | - Ramy F Youssef
- Department of Urology, University of California - Irvine, Orange, CA, USA
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Moursy EES, Eldahshoursy MZ, Gamal WM, Badawy AA. Orthotopic genital sparing radical cystectomy in pre-menopausal women with muscle-invasive bladder carcinoma: A prospective study. Indian J Urol 2016; 32:65-70. [PMID: 26941498 PMCID: PMC4756555 DOI: 10.4103/0970-1591.173112] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Invasive cancer bladder is a life-threatening disease that is best treated with radical cystectomy and a suitable urinary diversion. The aim of this study was to evaluate the oncological outcome, voiding and sexual functions after genital sparing radical cystectomy with orthotopic bladder reconstruction in pre-menopausal women with bladder cancer. MATERIALS AND METHODS 18 pre-menopausal women who underwent radical cystectomy and orthotopic urinary diversion with preservation of genital organs were included for this study. The patients were followed-up clinically and radiologically to assess their oncological outcome in addition to their voiding and sexual function. RESULTS Mean age of the patients was 37.8 years, and the median follow-up after surgery was 70 months. One patient was lost to follow-up at 12 months post-operatively. The surgery was completed as planned in all patients, with a mean operative time of 290 min and an average blood loss of 750 mL. 14 patients were able to void satisfactorily, being continent day and night, while four patients needed clean intermittent catheterization. Sexual life remained unchanged in 15 cases, while three patients reported dysparunea. Till the last follow-up, there was no local recurrence while distant metastases were detected in three cases, two of whom died. CONCLUSIONS Genital sparing cystectomy is a valid option for managing carefully selected women with muscle-invasive bladder cancer with good functional and sexual outcomes.
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Affiliation(s)
| | | | - Wael M Gamal
- Department of Urology, Sohag University, Sohag, Egypt
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Urinary Bladder Adenocarcinoma Metastatic to the Abdominal Wall: Report of a Case with Cytohistologic Correlation. Case Rep Pathol 2016; 2016:8608412. [PMID: 27006847 PMCID: PMC4781945 DOI: 10.1155/2016/8608412] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 02/07/2016] [Indexed: 11/30/2022] Open
Abstract
We report a case of adenocarcinoma metastatic to the abdominal wall in a 71-year-old man with a history of primary bladder adenocarcinoma. CT-guided core biopsy was performed; imprints and histologic sections showed malignant glands lined by tumor cells with hyperchromatic nuclei and prominent nucleoli, infiltrating through skeletal muscle. Immunohistochemistry revealed positivity for CK7, membranous/cytoplasmic β-catenin, caudal-type homeobox transcription factor 2 (CDX2), and α-methylacyl coenzyme A racemase and negativity for CK20, p63, prostate-specific antigen (PSA), and prostate-specific acid phosphatase (PSAP). These findings were interpreted as metastatic adenocarcinoma, consistent with bladder primary. Primary bladder adenocarcinoma is a rare malignancy arising within glandular metaplasia and is associated with cystitis cystica and cystitis glandularis. Predisposing factors include bladder exstrophy, schistosomiasis, and other causes of chronic bladder irritation. This tumor is divided into intestinal, clear cell, and signet ring cell subtypes. Treatment involves radical cystectomy with pelvic lymph node dissection, and prognosis is unfavorable. Primary bladder adenocarcinoma should be differentiated from urachal adenocarcinoma, which arises from urachal remnants near the bladder dome, and secondary adenocarcinoma, or vesical involvement by adenocarcinoma from a different primary. CK7, CK20, CDX2, thrombomodulin, and β-catenin can help distinguish primary bladder adenocarcinoma from colonic adenocarcinoma; PSA and PSAP can help distinguish primary bladder adenocarcinoma from prostate adenocarcinoma.
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BAKRY RANIA, EL-SAYED MOHAMEDI, HAMZA HESHAMM, HASSAN KHALEDH. Pretreatment levels of serum osteoprotegerin and p53 protein and urine telomerase as prognostic factors affecting survival in Egyptian bladder cancer patients. Oncol Lett 2016; 11:823-830. [PMID: 26870291 PMCID: PMC4727083 DOI: 10.3892/ol.2015.3925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 08/27/2015] [Indexed: 12/18/2022] Open
Abstract
A non-invasive marker is required for the diagnosis and follow-up of patients with bladder cancer. The aim of the current study was to evaluate the potential prognostic significance of serum osteoprotegerin (OPG), p53 protein and urine telomerase in patients with bladder cancer. For all patients, serum levels of OPG and p53 protein were determined using enzyme-linked immunosorbent assay (ELISA), and urine telomerase was assessed using a polymerase chain reaction ELISA technique. Patients were assigned into group 1 (cystectomy and adjuvant radiotherapy) or group 2 (transurethral resection and chemoradiotherapy). The results revealed that serum OPG and p53, and urine telomerase levels were significantly higher in bladder cancer patients compared with in healthy individuals (P<0.0001). High serum OPG was associated with significantly lower overall survival and disease-free survival rates (both P=0.001), and was correlated with advanced tumor stages (P<0.0001), high tumor grades (P<0.0001) and the occurrence of disease relapse (P=0.001). Serum p53 and urine telomerase did not demonstrate prognostic significance. These findings indicate that serum OPG level may be used as a diagnostic tool and a prognostic variable for patients with muscle invasive bladder cancer. Future trials are required to elucidate its therapeutic role in such patients.
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Affiliation(s)
- RANIA BAKRY
- Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut 71111, Egypt
| | - MOHAMED I. EL-SAYED
- Department of Radiotherapy, South Egypt Cancer Institute, Assiut University, Assiut 71111, Egypt
| | - HESHAM M. HAMZA
- Department of Surgical Oncology, South Egypt Cancer Institute, Assiut University, Assiut 71111, Egypt
| | - KHALED H. HASSAN
- Department of Biochemistry, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo 11566, Egypt
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[A CASE OF UROTHELIAL CARCINOMA OF THE URINARY BLADDER WITH SQUAMOUS DIFFERENTIATION RESPONDING TO PACLITAXEL AND CARBOPLATIN NEOADJUVANT CHEMOTHERAPY]. Nihon Hinyokika Gakkai Zasshi 2015; 106:206-10. [PMID: 26419080 DOI: 10.5980/jpnjurol.106.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A 42-year-old man was referred to our hospital for macrohematuria. Computer tomography and magnetic resonance imaging revealed right hydronephrosis and a retroperitoneal mass, located next to right side of the bladder. Cystoscopy showed a protruded lesion covered with normal mucosa at the right lateral wall. The patient underwent transurethral resection of the bladder tumor and biopsies of the bladder wall. Histological examination showed squamous cell carcinoma. Neoadjuvant chemotherapy using paclitaxel and carboplatin (TC) was performed. A total cystectomy, right nephroureterectomy and construction of the ileal conduit were performed after one course of systemic chemotherapy. Histological examination showed urothelial carcinoma with squamous cell differentiation. Unexpectedly, a small amount of CIS was detected only in the vicinity of the TUR scar. The patient received 2 cycles of TC chemotherapy as adjuvant chemotherapy. Unfortunately, 11 months later, local recurrence and liver metastasis were detected. He died 17 months after the surgery.
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Yu B, Zhou J, Cai H, Xu T, Xu Z, Zou Q, Gu M. Neoadjuvant chemotherapy for primary adenocarcinomas of the urinary bladder: a single-site experience. BMC Urol 2015; 15:3. [PMID: 25631709 PMCID: PMC4328949 DOI: 10.1186/1471-2490-15-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 01/22/2015] [Indexed: 11/10/2022] Open
Abstract
Background Adenocarcinoma of the urinary bladder is a rare malignancy. Radical surgery is suggested as the best available treatment for early-stage disease, but there is currently no consensus on standard chemotherapy regimen for advanced stage. We assessed the feasibility and effect of neoadjuvant chemotherapy with gemcitabine and cisplatin (GC) plus S-1 for patients with locally advanced primary adenocarcinomas of the urinary bladder. Methods Six patients with locally advanced urachal or non-urachal (n = 3, each) primary adenocarcinoma of the bladder were treated from October 2010 to October 2013 at a single center. All the patients were treated with 3 cycles (21d, each) of GC plus S-1 (gemcitabine, 1000 mg/m2, days 1 and 8; cisplatin, 70 mg/m2, day 2; and S-1, 50 mg bid, day 1-14). After neoadjuvant chemotherapy, patients with urachal cancer were treated with en bloc radical cystectomy and umbilectomy; the remaining 3 patients were treated with cystectomy. Results All patients successfully completed the neoadjuvant chemotherapy without serious side effects. Two patients were assessed as complete response, 2 as partial response, 1 as stable disease and 1 as progressive disease. Conclusions Despite the limitations of a small study population, the GC plus S-1 regimen for locally advanced primary adenocarcinoma of the urinary bladder was effective, and facilitated the success of surgery to a certain extent. Short follow-up time was also a limitation of our study. More studies are needed to evaluate the results.
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Affiliation(s)
| | | | | | | | | | - Qing Zou
- Department of Urologic Surgery, Affiliated Cancer Hospital of Jiangsu Province of Nanjing Medical University, Nanjing, China.
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Role of fibroblast growth factor in squamous cell carcinoma of the bladder: prognostic biomarker and potential therapeutic target. Urol Oncol 2014; 33:111.e1-7. [PMID: 25477183 DOI: 10.1016/j.urolonc.2014.09.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 09/29/2014] [Accepted: 09/30/2014] [Indexed: 11/22/2022]
Abstract
BACKGROUND We evaluated the association of fibroblast growth factor (FGF2) expression with pathologic features and clinical outcomes of squamous cell carcinoma (SCC) of the urinary bladder. METHODS Immunohistochemistry of FGF2 was performed on radical cystectomy specimens with pure SCC from 1997 to 2003. The relationship between FGF2 and pathologic parameters and oncological outcome was assessed. RESULTS The study included 151 patients with SCC (98 men) with a median age of 52 years (range: 36-74 y). Schistosomal infection was found in 81% of patients. Pathologic category was T2 and T3 in 88% of patients and the grade was low in>50%. Lymph node invasion and lymphovascular invasion were found in 30.5% and 16%. Altered FGF2 was associated with tumor grade (P = 0.014), lymph node invasion, and lymphovascular invasion (P = 0.042). Altered FGF2 was associated with both disease recurrence and cancer-specific mortality (P≤0.001) in Kaplan-Meier analyses and was an independent predictor of cancer recurrence (hazard ratio = 2.561, P = 0. 009) and cancer-specific mortality (hazard ratio = 2.679, P = 0. 033) in multivariate Cox regression analyses. Adding FGF2 to a model including standard clinicopathologic prognostics (pathologic T category, lymph node status, and grade) showed a significant improvement (6%) in accuracy of prediction poor oncological outcome. CONCLUSIONS FGF2 overexpression is associated with aggressive pathologic features and worse outcomes after radical cystectomy for SCC, suggesting a good prognostic and possible therapeutic role.
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Dietrich D, Meller S, Uhl B, Ralla B, Stephan C, Jung K, Ellinger J, Kristiansen G. Nucleic acid-based tissue biomarkers of urologic malignancies. Crit Rev Clin Lab Sci 2014; 51:173-99. [DOI: 10.3109/10408363.2014.906130] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Rausch S, Gaisa N, Youssef RF, Lotan Y, Stenzl A, Kälble T. [Squamous cell lesions of the urinary bladder]. Urologe A 2014; 53:368, 370-4. [PMID: 24549798 DOI: 10.1007/s00120-013-3406-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Squamous cell carcinoma (SCC) and transitional carcinoma with squamous differentiation (SCC/TCC) are rare in western countries. Chronic inflammation and irritation of the urothelium are common risk factors for the development of SCC and TCC/SCC. Tumour biology of squamous cell cancer and precancerous squamous lesions is different from transitional cell cancer (TCC). Recent advances in molecular analysis of benign and malignant squamous cell lesions indicate that they are closely associated and might lead to improved bladder cancer subclassification in the future. AIM At present, the clinical management and therapy of SCC remains challenging, as scientific evidence based on prospective clinical trials is not available. We performed an analysis of available literature on natural history, treatment, and prognosis of SCC, SCC/TCC and metaplastic lesions. Furthermore, recent findings in molecular cancer biology are discussed with a focus on their relevance for SCC carcinogenesis.
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Affiliation(s)
- S Rausch
- Urologische Universitätsklinik Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland,
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Rausch S, Lotan Y, Youssef RF. Squamous cell carcinogenesis and squamous cell carcinoma of the urinary bladder: a contemporary review with focus on nonbilharzial squamous cell carcinoma. Urol Oncol 2013; 32:32.e11-6. [PMID: 23433891 DOI: 10.1016/j.urolonc.2012.11.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 11/20/2012] [Accepted: 11/27/2012] [Indexed: 11/17/2022]
Abstract
Bladder squamous cell carcinoma, squamous metaplasia, and transitional cell carcinoma with squamous differentiation are infrequent findings in Western countries. A common risk factor for their development consists of chronic bladder irritation and inflammation. The prognostic and clinical relevance and natural history of squamous cell lesions has been under investigation, revealing individual premalignant characteristics. Recent developments in molecular characterization of squamous alterations of the urinary tract indicate pathogenetic similarities and interrelations and might lead to more precise tumor classification and risk stratification in the future. Nevertheless, current clinical management of patients with premalignant and malignant bladder squamous cell lesions remains challenging, as high evidence level studies are not available and prognosis of invasive squamous carcinoma is poor. Our review summarizes the available data on clinical presentation, treatment, and outcome of bladder squamous cell carcinoma, metaplastic lesions, and transitional cell carcinoma with squamous differentiation and discusses implementable current advances in the understanding of bladder cancer tumorigenesis.
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Affiliation(s)
- Steffen Rausch
- Department of Urology, Klinikum Fulda gAG, Fulda, Germany.
| | - Yair Lotan
- Department of Urology, University of Texas, Southwestern Medical Center, Dallas, TX
| | - Ramy F Youssef
- Department of Urology, University of Texas, Southwestern Medical Center, Dallas, TX
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Gulmann C, Paner GP, Parakh RS, Hansel DE, Shen SS, Ro JY, Annaiah C, Lopez-Beltran A, Rao P, Arora K, Cho Y, Herrera-Hernandez L, Alsabeh R, Amin MB. Immunohistochemical profile to distinguish urothelial from squamous differentiation in carcinomas of urothelial tract. Hum Pathol 2012; 44:164-72. [PMID: 22995333 DOI: 10.1016/j.humpath.2012.05.018] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 05/11/2012] [Accepted: 05/16/2012] [Indexed: 01/19/2023]
Abstract
Urothelial neoplasms with squamous morphology raise the differential diagnosis between pure primary squamous cell carcinoma, urothelial carcinoma with squamous differentiation and secondary involvement by squamous cell carcinoma, for example, from uterine cervix. Accurate identification between these entities is critical due to differing prognosis and therapeutic strategies. We evaluated the utility of an immunohistochemical panel of 3 urothelial-associated antibodies (uroplakin III, S100P, and GATA3) and two squamous-associated antibodies (CK14 and desmoglein-3) in 50 primary urothelial neoplasms: 15 pure urothelial carcinomas, 12 pure squamous cell carcinomas and 23 urothelial carcinomas with squamous differentiation. Squamous differentiation was defined by intercellular bridges or evidence of keratinization. Pure squamous cell carcinomas were positive for CK14 (100%) and desmoglein-3 (75%), negative for GATA3 and uroplakin III; one case was S100P positive (9%). Pure urothelial carcinomas had an opposite pattern and were positive for S100P (93%), GATA3 (93%), and uroplakin III (67%) and were negative for desmoglein-3; CK 14 was positive in 27% of cases; 74% of urothelial carcinomas with squamous differentiation had expression of urothelial and squamous associated markers (S100P, 83%; GATA3, 35%; uroplakin III, 13%; CK14, 87%; and desmoglein-3, 70%), although reactivity for individual markers within some tumors did not always correspond with morphologic differentiation. Of the remaining 26%, 4 showed an overall "squamous" immunoprofile, whereas 2 cases showed a "urothelial" immunoprofile. Our study showed that a panel of five antibodies identifies squamous and urothelial differentiation in most instances suggesting potential diagnostic utility.
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Comparative outcomes of pure squamous cell carcinoma and urothelial carcinoma with squamous differentiation in patients treated with radical cystectomy. J Urol 2011; 187:74-9. [PMID: 22088332 DOI: 10.1016/j.juro.2011.09.056] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Indexed: 11/20/2022]
Abstract
PURPOSE We compared clinical outcomes, and identified predictors of cancer specific and overall survival after radical cystectomy in patients with urothelial carcinoma with squamous differentiation and those with pure squamous cell carcinoma. MATERIALS AND METHODS We reviewed data on 2,031 patients treated with radical cystectomy and pelvic lymph node dissection at a single high volume referral center. Of these patients 78 had squamous cell carcinoma and 67 had squamous differentiation. Survival estimates by histological subtype were described using Kaplan-Meier methods. Within histological subtypes pathological stage, nodal invasion, soft tissue margins, age and gender were evaluated as predictors of cancer specific survival and overall survival using univariate Cox regression. RESULTS Median followup was 44 months. Of 104 patient deaths 60 died of their disease. We did not find a statistically significant difference between survival curves of patients with squamous cell carcinoma and squamous differentiation (log rank overall survival p = 0.6, cancer specific survival p = 0.17). Positive soft tissue margins were associated with worse cancer specific survival (HR 6.92, 95% CI 2.98-16.10, p ≤0.0005) and overall survival (HR 3.68, 95% CI 1.84-7.35, p ≤0.0005) in patients with pure squamous cell carcinoma. Among patients with squamous differentiation, pelvic lymphadenopathy was associated with decreased overall survival (HR 2.52, 95% CI 1.33-4.77, p = 0.004) and cancer specific survival (HR 3.23, 95% CI 1.57-6.67, p = 0.002). CONCLUSIONS There appears to be no evidence of a difference in cancer specific survival or overall survival between patients with squamous cell carcinoma and those with squamous differentiation treated with radical cystectomy and pelvic lymph node dissection. Patients with squamous differentiation and tumor metastases to pelvic lymph nodes should be followed more closely, and adjuvant treatment should be considered to improve survival. Wide surgical resection is critical to achieve local tumor control and improve survival in patients with squamous cell carcinoma.
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Chalasani V, Chin JL, Izawa JI. Histologic variants of urothelial bladder cancer and nonurothelial histology in bladder cancer. Can Urol Assoc J 2011; 3:S193-8. [PMID: 20019984 DOI: 10.5489/cuaj.1195] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Bladder cancer can be classified histologically as urothelial or non-urothelial. Urothelial cancer has a propensity for divergent differentiation, which has increasingly been recognized in recent years due to heightened awareness and improved immunohistochemistry techniques. Furthermore, the recent World Health Organization classification of urothelial cancers improved clarity on this issue, with its listing of 13 histologic variants of urothelial cancer. The divergent differentiation patterns include, amongst others, squamous, glandular, micropapillary, nested, lymphepithelioma-like, plasmacytoid and sarcomatoid variants of urothelial cancer. Attempts to quantify the amount of divergent differentiation present, such as using the nonconventional differentiation number, have been made recently, which will improve the ability to compare publications from different centres. Genetic-based studies have indicated that the histologic variants of urothelial cancer arise from a common clonal precursor. Mostly, the current evidence suggests that urothelial cancer with divergent differentiation has a worse prognosis when compared with pure urothelial cancer. This article will review the current literature on variant histologies of urothelial cancer, and well as new developments in pure squamous cell carcinoma, small cell carcinoma and adenocarcinoma of the bladder.
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Affiliation(s)
- Venu Chalasani
- Departments of Surgery & Oncology, Divisions of Urology & Surgical Oncology, London Health Sciences Centre-Victoria Hospital, London, ON
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Kapur P, Lotan Y, King E, Kabbani W, Mitra AP, Mosbah A, Abol-Enein H, Ghoneim M, Youssef RF. Primary adenocarcinoma of the urinary bladder: value of cell cycle biomarkers. Am J Clin Pathol 2011; 135:822-30. [PMID: 21571954 DOI: 10.1309/ajcp76kuvotbkqry] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Primary adenocarcinomas of the urinary bladder are uncommon, and the molecular pathways are currently not well defined. In this study, we assessed the association between biologic markers and clinicopathologic characteristics in a cohort of 21 patients with primary urinary bladder adenocarcinoma. Immunohistochemical staining for cell cycle-specific markers, including p53, p21, p27, Ki-67, and cyclin E, were performed on sections of a tissue microarray construct. The tumors were high grade in 12 (57%) and pT2 or higher in 18 (86%); lymph nodes were involved in 6 cases (29%); and there was pathologic evidence of schistosomiasis in 14 (67%). The best prognostic combination of markers was combined alterations in p27 and Ki-67 and was associated with stage (P = .012), grade (P = .005), DNA ploidy (P = .005), and lymph node involvement (P = .04). Stage, lymph node involvement, combined alterations of p27 and Ki-67, and combined alterations of all 5 biomarkers were associated with increased probability of disease recurrence and cancer-specific mortality (P < .05).
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Hattori M, Nishimura Y, Toyonaga M, Kakinuma H, Matsumoto K, Ohbu M. Cytological significance of abnormal squamous cells in urinary cytology. Diagn Cytopathol 2011; 40:798-803. [PMID: 21309015 DOI: 10.1002/dc.21645] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Accepted: 12/09/2010] [Indexed: 11/08/2022]
Affiliation(s)
- Manabu Hattori
- Department of Clinical Cytology, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa, Japan.
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