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Zheng J, Peng X, Li X, Chen Y, Li X, Fu L, Li A, Lu Z. Occult urothelial carcinoma with mediastinal metastasis: A case report. Oncol Lett 2024; 27:148. [PMID: 38385116 PMCID: PMC10879954 DOI: 10.3892/ol.2024.14281] [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: 06/18/2023] [Accepted: 01/25/2024] [Indexed: 02/23/2024] Open
Abstract
Occult urothelial carcinoma (UC), particularly with mediastinal metastases, is an uncommon clinical occurrence. The present study describes the unusual case of a 70-year-old male patient who developed mediastinal metastases from an occult UC. Histological evaluations and immunohistochemical features of the mediastinal tumor were indicative of UC; however, extensive imaging failed to identify the primary urological lesion. The findings suggest that mediastinal metastases from UCs, despite their rarity, should be considered in cases where patients with mediastinal tumors exhibit chest-related symptoms. Prompt pathological examinations are crucial for ascertaining the nature and origin of the tumor. Moreover, individualized treatment should be performed in strict accordance with the established oncology guidelines.
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Affiliation(s)
- Jingfan Zheng
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong 261041, P.R. China
| | - Xintong Peng
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong 261041, P.R. China
| | - Xiaoqing Li
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong 261041, P.R. China
| | - Yuyu Chen
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong 261041, P.R. China
| | - Xinyi Li
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong 261041, P.R. China
| | - Ling Fu
- Department of Oncology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261041, P.R. China
| | - Ao Li
- Department of Oncology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261041, P.R. China
| | - Zhong Lu
- Department of Oncology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261041, P.R. China
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Ballas L, Singh P, Lerner SP. Targeting barriers to wider use of trimodality therapy in localized muscle invasive bladder cancer. Urol Oncol 2023; 41:35-38. [PMID: 33153882 DOI: 10.1016/j.urolonc.2020.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/28/2020] [Accepted: 10/07/2020] [Indexed: 11/18/2022]
Abstract
Radical cystectomy with bilateral pelvic lymphadenectomy and trimodality bladder-sparing therapy or TMT, are both curative options for patients with nonmetastatic muscle invasive bladder cancer. Patients should be afforded the opportunity for a multidisciplinary evaluation with equipoise in discussing these options for eligible patients. We discuss the barriers to broader acceptance and utilization of TMT and encourage support of clinical trials of TMT.
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Affiliation(s)
- Leslie Ballas
- Department of Radiation Oncology University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Parminder Singh
- Division of Hematology and Oncology Mayo Clinic College of Medicine, Scottsdale, AZ
| | - Seth P Lerner
- Baylor College of Medicine, Dan L Duncan Cancer Center, Houston, TX.
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Kim KS, Kim SH, Cho HJ, Sur HJ, Choi YS. Holmium laser-assisted laparoscopic partial cystectomy for bladder cancer: a single-institutional pilot study with technical feasibility and short-term oncological outcome. BMC Cancer 2022; 22:195. [PMID: 35189855 PMCID: PMC8862280 DOI: 10.1186/s12885-022-09308-7] [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: 08/17/2021] [Accepted: 02/16/2022] [Indexed: 11/30/2022] Open
Abstract
Background In selected patients with bladder cancer, partial cystectomy is an alternative treatment for bladder preservation with fair oncologic result. During partial cystectomy, tumor margin demarcation is difficult. Various methods were adopted, however, there is no standard for tumor margin demarcation. We aimed to introduce and provide our experience with holmium laser-assisted method with ten patients. Methods From March 2016 and February 2019, patients who want partial cystectomy for bladder cancer were enrolled in this study. Inclusion criteria were stage T2 or T3 disease and tumor location restricted within the dome, and lateral, posterior side of the bladder were included. Transurethral holmium laser-assisted mucosal incision was made and deepened until perivesical fat. Minimal Safety margin for 5-10 mm were spared, and tumor removal was done laparoscopically. Results Ten patients underwent holmium laser-assisted laparoscopic partial cystectomy. All procedures were done without complication. The tumor locations were laterally in seven patients, dome in two patients, and posterior wall in one patient. Pathologic examination of surgical margin showed no cancer cell involvement in all cases. There were no recurrences or metastases for 12 months follow up. Conclusions Holmium laser-assisted laparoscopic partial cystectomy is effective and safe technique in carefully selected patients. To achieve precise and appropriate surgical margin during the laparoscopic partial cystectomy, holmium laser resection provides feasible and safe method that assists in bladder incision with minimal ureteral orifice involvement. Trial registration Retrospectively registered.
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Affiliation(s)
- Kang Sup Kim
- Department of Urology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Sang Hoon Kim
- Department of Urology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Korea
| | - Hyuk Jin Cho
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hong Jin Sur
- Department of Urology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Yong Sun Choi
- Department of Urology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Korea.
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Fan J, Wu K, Zhang P, He D. Green-laser assisted laparoscopic partial cystectomy for selective muscle-invasive bladder cancer: technique and initial outcome. World J Urol 2019; 37:2671-2675. [PMID: 30843089 DOI: 10.1007/s00345-019-02712-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 02/27/2019] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To describe a green-laser marking technique to assist partial cystectomy, which allows accurate identification of tumour margins, and provide our initial experience with ten patients. METHODS Between January 2014 and February 2018, ten patients suspected with muscle-invasive bladder cancer and request of bladder-preserving treatment were selected. In each case, bilateral pelvic lymphadenectomy was performed before green-laser assisted laparoscopic partial cystectomy. Under the direct view of cystoscope, the front-firing green-laser incision was performed 0.5-1 cm away from the exterior margin of lesion with adequate depth into the fat tissue. Tumours were then en bloc removed via laparoscope under the tracing of laser beam. RESULTS The location of 12 tumours in 10 patients was superior wall in 7 cases, lateral wall in 3 cases, anterior wall in 1 case, and posterior wall in 1 case. All procedures were completed without serious complications. The median operating time was 270 (210-360) min with a median haemoglobin decrease of 11 (3-38) g/L. Nine patients were high-grade transitional cell carcinoma and one patient was urachal carcinoma, and the clinical stage was pT1 in 1 case, pT2 in 4 cases, and pT3 in 5 cases. The pathological evaluation of tumour margins was negative in 10 patients. During the follow-up, no recurrence or metastasis were detected in 8 patients, but 2 patients presented regional recurrence. CONCLUSION The use of green-laser marking technique during laparoscopic partial cystectomy is a feasible manoeuvre in assisting the accurate incision and minimizing injury to the remaining bladder.
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Affiliation(s)
- Jinhai Fan
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, #277 Yanta West Road, Xi'an, 710061, Shaanxi Province, People's Republic of China
| | - Kaijie Wu
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, #277 Yanta West Road, Xi'an, 710061, Shaanxi Province, People's Republic of China
| | - Pu Zhang
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, #277 Yanta West Road, Xi'an, 710061, Shaanxi Province, People's Republic of China
| | - Dalin He
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, #277 Yanta West Road, Xi'an, 710061, Shaanxi Province, People's Republic of China.
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Bennett N, Incrocci L, Baldwin D, Hackett G, El-Zawahry A, Graziottin A, Lukasiewicz M, McVary K, Sato Y, Krychman M. Cancer, Benign Gynecology, and Sexual Function—Issues and Answers. J Sex Med 2016; 13:519-37. [DOI: 10.1016/j.jsxm.2016.01.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 01/10/2016] [Accepted: 01/12/2016] [Indexed: 12/20/2022]
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Mai HX, Liu JLE, Pei SJ, Zhao LI, Qu N, Dong JK, Chen B, Wang YL, Huang C, Chen LJ. Comparison of the short-term efficacy of sequential treatment with intravesical single-port laparoscopic partial cystectomy with bladder preservation or open partial cystectomy in combination with cisplatin plus gemcitabine chemotherapy. Exp Ther Med 2015; 10:74-80. [PMID: 26170915 DOI: 10.3892/etm.2015.2448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 03/18/2015] [Indexed: 11/06/2022] Open
Abstract
This study aimed to assess the short-term efficacy of sequential therapy for T2/T3a bladder cancer with intravesical single-port laparoscopic partial cystectomy or open partial cystectomy combined with cisplatin plus gemcitabine (GC) chemotherapy in a prospective randomized controlled study. Thirty patients with bladder cancer who underwent open partial cystectomy (group A) or single-port laparoscopic partial cystectomy (group B) and received standard GC chemotherapy were analyzed. Perioperative functional indicators and tumor recurrence during a 1-year postoperative follow-up were compared between the two groups. The baseline characteristics were comparable between the two groups. The mean operative time, amount of blood loss and duration of hospital stay were 90.3 min, 182.0 ml and 7.3 days, respectively, for group A, and 105.3 min, 49.3 ml and 5.8 days, respectively, for group B. No secondary postoperative bleeding, urine leakage, wound infection or other complications were observed in the two groups. Postoperative scarring was not evident in group B. The overall incidence of surgical complications, tumor recurrence rate and complications during chemotherapy in the postoperative follow-up period of 12 months were similar between the two groups. Single-port laparoscopic partial cystectomy surgery is an idea surgical method for the treatment of invasive bladder cancer, with good surgical effect, minimal invasiveness, rapid recovery and short hospital stay. The data from 1-year postoperative follow-up showed that laparoscopic surgery was superior with regard to perioperative bleeding, postoperative recovery and duration of indwelling urinary catheter use. However, regarding the tumor recurrence rate, long-term comparative details are required to determine the effect of laparoscopic surgery.
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Affiliation(s)
- Hai-Xing Mai
- Chinese People's Liberation Army General Hospital & Medical School of Chinese People's Liberation Army, Beijing 100853, P.R. China ; Department of Urology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, P.R. China
| | - Jun-LE Liu
- Department of Urology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, P.R. China
| | - Shu-Jun Pei
- Department of Urology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, P.R. China
| | - L I Zhao
- Chinese People's Liberation Army General Hospital & Medical School of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Nan Qu
- Chinese People's Liberation Army General Hospital & Medical School of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Jin-Kai Dong
- Chinese People's Liberation Army General Hospital & Medical School of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Biao Chen
- Chinese People's Liberation Army General Hospital & Medical School of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Ya-Lin Wang
- Chinese People's Liberation Army General Hospital & Medical School of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Cheng Huang
- Chinese People's Liberation Army General Hospital & Medical School of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Li-Jun Chen
- Department of Urology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, P.R. China
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Kramer MW, Heinisch A, Wegener G, Abbas M, von Klot C, Peters I, Tezval H, Herrmann TR, Kuczyk MA, Merseburger AS. [C-reactive protein prior to radical cystectomy: preoperative determination of CRP]. Urologe A 2014; 53:222-7. [PMID: 23955283 DOI: 10.1007/s00120-013-3299-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Numerous studies have shown a positive correlation between elevated C-reactive protein (CRP) and systemic spread of malignancies. The goal of the current study was to assess the predictive significance of preoperative CRP in patients undergoing radical cystectomy (RC). MATERIAL AND METHODS Preoperative CRP values were measured in 194 patients undergoing RC because of urothelial carcinoma between 1996 and 2005. Elevated CRP level was defined as ≥ 5 mg/l. RESULTS Preoperative increased CRP values were detected in 89 (45.9%) patients and these patients were more likely to have advanced tumor stages (pT3-4), positive resection margins and positive lymph nodes. Advanced urinary diversions were more common in patients with normal CRP values. In multivariate analysis, CRP was identified as an independent prognostic indicator for poor cancer-specific survival. CONCLUSION The results confirm previous reports that showed a prognostic significance of preoperative CRP elevation.
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Affiliation(s)
- M W Kramer
- Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland
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Li A, Fang W, Zhang F, Li W, Lu H, Liu S, Wang H, Zhang B. Transurethral resection and degeneration of bladder tumour. Can Urol Assoc J 2014; 7:E812-6. [PMID: 24475002 DOI: 10.5489/cuaj.363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We evaluate the efficacy and safety of transurethral resection and degeneration of bladder tumour (TURD-Bt). METHODS In total, 56 patients with bladder tumour were treated by TURD-Bt. The results in these patients were compared with 32 patients treated by current transurethral resection of bladder tumour (TUR-Bt). Patients with or without disease progressive factors were respectively compared between the 2 groups. The factors included recurrent tumour, multiple tumours, tumour ≥3 cm in diameter, clinical stage T2, histological grade 3, adenocarcinoma, and ureteral obstruction or hydronephrosis. RESULTS Follow-up time was 48.55 ± 23.74 months in TURD-Bt group and 56.28 ± 17.61 months in the TUR-Bt group (p > 0.05). In patients without progressive factors, no tumour recurrence was found and overall survival was 14 (100%) in the TURD-Bt group; 3 (37.50%) patients had recurrence and overall survival was 5 (62.5%) in the TUR-Bt group. In patients with progressive factors, 8 (19.05%) patients had tumour recurrence, overall survival was 32 (76.19%) and cancer death was 3 (7.14%) in TURD-Bt group; 18 (75.00%) patients had tumour recurrence (p < 0.05), overall survival was 12 (50.00%) (p < 0.01) and cancer death was 8 (33.33%) (p < 0.05) in TUR-Bt group. No significant complication was found in TURD-Bt group. CONCLUSION This study suggests that complete resection and degeneration of bladder tumour can be expected by TURD-Bt. The surgical procedure is safe and efficacious, and could be predictable and controllable before and during surgery. We would conclude that for bladder cancers without lymph node metastasis and distal metastasis, TURD-Bt could be performed to replace radical TUR-Bt and preserve the bladder.
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Affiliation(s)
- Aihua Li
- Department of Urology, Yangpu Hospital, School of Medicine, Tongji University Shanghai, China
| | - Wei Fang
- Department of Urology, Yangpu Hospital, School of Medicine, Tongji University Shanghai, China
| | - Feng Zhang
- Department of Urology, Yangpu Hospital, School of Medicine, Tongji University Shanghai, China
| | - Weiwu Li
- Department of Urology, Yangpu Hospital, School of Medicine, Tongji University Shanghai, China
| | - Honghai Lu
- Department of Urology, Yangpu Hospital, School of Medicine, Tongji University Shanghai, China
| | - Sikuan Liu
- Department of Urology, Yangpu Hospital, School of Medicine, Tongji University Shanghai, China
| | - Hui Wang
- Department of Urology, Yangpu Hospital, School of Medicine, Tongji University Shanghai, China
| | - Binghui Zhang
- Department of Urology, Yangpu Hospital, School of Medicine, Tongji University Shanghai, China
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Incrocci L, Jensen PT. Pelvic Radiotherapy and Sexual Function in Men and Women. J Sex Med 2013; 10 Suppl 1:53-64. [DOI: 10.1111/jsm.12010] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Trimodality treatment in the conservative management of infiltrating bladder cancer: a critical review of the literature. Crit Rev Oncol Hematol 2012; 86:176-90. [PMID: 23088957 DOI: 10.1016/j.critrevonc.2012.09.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Revised: 08/21/2012] [Accepted: 09/26/2012] [Indexed: 11/23/2022] Open
Abstract
Although radical cystectomy is still the treatment of choice for patients with infiltrating bladder cancer, there is growing evidence of the effectiveness of a conservative approach. Developed as a treatment of need for elderly or unfit patients unable to undergo radical cystectomy, conservative therapy is becoming a true alternative to surgery for highly selected patients. Although transurethral bladder resection, external radiotherapy and systemic chemotherapy can control the disease as single treatments, the best results have been observed when they are combined. Moreover, new irradiation techniques and new-generation drugs are now being tested in an attempt to improve disease control further. Conservative management requires the multidisciplinary involvement of different specialties in order to give patients a real alternative to surgical treatment.
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Autocrine CCL2 promotes cell migration and invasion via PKC activation and tyrosine phosphorylation of paxillin in bladder cancer cells. Cytokine 2012; 59:423-32. [PMID: 22617682 DOI: 10.1016/j.cyto.2012.04.017] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 03/27/2012] [Accepted: 04/11/2012] [Indexed: 12/20/2022]
Abstract
The amount of monocyte chemoattractant protein-1 (MCP-1/CCL2) produced by a transitional cell carcinoma is directly correlated with high recurrence and poor prognosis in bladder cancer. However, the mechanisms underlying the effects of CCL2 on tumor progression remain unexplored. To investigate the role played by CCL2, we examined cell migration in various bladder cancer cell lines. We found that high-grade cancer cells expressing high levels of CCL2 showed more migration activity than low-grade bladder cancer cells expressing low levels of the chemokine. Although the activation of CCL2/CCR2 signals did not appreciably affect cell growth, it mediated cell migration and invasion via the activation of protein kinase C and phosphorylation of tyrosine in paxillin. Blocking CCL2 and CCR2 with small hairpin RNA (shCCL2) or a specific inhibitor reduced CCL2/CCR2-mediated cell migration. The antagonist of CCR2 promoted the survival of mice bearing MBT2 bladder cancer cells, and CCL2-depleted cells showed low tumorigenicity compared with shGFP cells. In addition to observing high-levels of CCL2 in high-grade human bladder cancer cells, we showed that the CCL2/CCR2 signaling pathway mediated migratory and invasive activity, whereas blocking the pathway decreased migration and invasion. In conclusion, high levels of CCL2 expressed in bladder cancer mediates tumor invasion and is involved with advanced tumorigenesis. Our findings suggest that this CCL2/CCR2 pathway is a potential candidate for the attenuation of bladder cancer metastases.
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Hamasaki T, Suzuki Y, Tomita Y, Kimura G, Kondo Y. Efficacy of transurethral resection of the bladder tumor (TUR-BT) for huge bladder cancer. J NIPPON MED SCH 2010; 77:190-4. [PMID: 20818136 DOI: 10.1272/jnms.77.190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
There are no guidelines regarding whether to perform either a radical transurethral resection of the bladder tumor (TUR-BT) or a total cystectomy after TUR biopsy for huge bladder cancer, and this decision is entrusted to each institution. Of 439 patients in whom TUR-BT was performed from 2005 through 2009, the weight of the total resected volume was > 50 g in 6 patients, and among these 6 patients the following variables were compared: operating time, weight of resected volume, transfusion volume, presence or absence of hydronephrosis, preoperative urinary cytology, serum cytokeratin 19 fragment (CYFRA) level, intraoperative bladder compliance, and histopathological findings. The median age, operating time, weight of resected volume, transfusion volume, and length of follow-up were 72 years, 300 minutes, 88 g, 202 mL, 16 months, respectively. The serum CYFRA level in patients with muscle-invasive cancer (11.8 ng/mL) was higher than that in patients with non-muscle-invasive cancer (5.06 ng/mL). All patients with non-muscle-invasive bladder cancer survived without recurrence. Although the mean length of follow-up was only 16 months (5-59 months), the 1 patient who was followed up for 59 months had no recurrence. In cases of muscle-invasive bladder cancer, all patients, except for a relatively recent patient, have died. In cases without muscle invasion, lymph node metastasis, distal metastasis, or preoperative renal dysfunction accompanied by hydronephrosis, with favorable bladder compliance, we believe that radical TUR-BT should be actively performed to preserve the bladder. A second TUR-BT should be performed in cases of non-muscle-invasive cancer without G3 components to treat the huge bladder cancer.
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Affiliation(s)
- Tsutomu Hamasaki
- Department of Urologic Surgery, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan.
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