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Apolo AB, Michaels-Igbokwe C, Simon NI, Benjamin DJ, Farrar M, Hepp Z, Mucha L, Heidenreich S, Cutts K, Krucien N, Ramachandran N, Gore JL. Patient Preferences for First-Line Treatment of Locally Advanced or Metastatic Urothelial Carcinoma: An Application of Multidimensional Thresholding. THE PATIENT 2024:10.1007/s40271-024-00709-3. [PMID: 39198374 DOI: 10.1007/s40271-024-00709-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/25/2024] [Indexed: 09/01/2024]
Abstract
OBJECTIVES Patient preferences have the potential to influence the development of new treatments for locally advanced/metastatic urothelial carcinoma (la/mUC), and therefore we explored how patients with la/mUC value different attributes of first-line treatments. METHODS An online preference survey and multidimensional thresholding (MDT) exercise were developed following a targeted literature review and qualitative interviews with physicians, patients with la/mUC, and their caregivers. Treatment attributes included two benefits (overall response rate [ORR], pain related to bladder cancer [scored 0-100; 100 being the worst pain possible]) and four treatment-related risks (peripheral neuropathy, severe side effects, mild to moderate nausea, mild to moderate skin reactions). A Dirichlet regression was used to estimate average preference weights. Marginal utility and the reduction in ORR that patients would accept in exchange for a 10-point decrease or a 10% decrease in other attributes were calculated. RESULTS A total of 100 patients were recruited and self-completed the survey and MDT. Mean patient age was 64.9 years (standard deviation, 7.6), 54% were female, and 38% identified as white. All included treatment attributes had a statistically significant impact on preferences. Changes in ORR had the largest impact, followed by cancer-related pain and treatment-related risks. Patients were willing to accept an 8.4% decrease in ORR to reduce their pain level by 10 points or a 7.8% decrease in ORR to reduce the risk of peripheral neuropathy by 10%. For a 10% decrease in severe side effects, mild to moderate nausea, or skin reaction, patients would accept decreases in ORR of 5.5%, 3.7%, or 3.4%, respectively. CONCLUSIONS Of the attributes tested, changes in ORR were most important to patients. Patients made tradeoffs between treatment attributes indicating that a lower ORR may be acceptable for an improvement in other attributes such as reduced cancer-related pain or the risk of treatment-related adverse events.
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Affiliation(s)
- Andrea B Apolo
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Nicholas I Simon
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | - Lisa Mucha
- Astellas Pharma, Inc, Northbrook, IL, USA
| | | | | | | | | | - John L Gore
- Department of Urology, University of Washington, Seattle, WA, USA
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Beeren I, Klerks NE, Aben KK, Oddens JR, Witjes JA, Kiemeney LA, Vrieling A. Health-related Quality of Life During the First 4 Years After Non-Muscle-invasive Bladder Cancer Diagnosis: Results of a Large Multicentre Prospective Cohort. Eur Urol Oncol 2024; 7:829-837. [PMID: 37996278 DOI: 10.1016/j.euo.2023.11.007] [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] [Received: 07/12/2023] [Revised: 10/18/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND The health-related quality of life (HRQoL) of patients with non-muscle-invasive bladder cancer (NMIBC) may be impaired due to the chronic and burdensome disease course, but longitudinal data are limited. OBJECTIVE To evaluate HRQoL outcomes during the first 4 yr after NMIBC diagnosis, and to compare HRQoL across patient characteristics and with a normative population. DESIGN, SETTING, AND PARTICIPANTS Patients with NMIBC (n = 1019) were included from the multicentre prospective cohort UroLife. Data were collected at 6 wk (baseline), and 3, 15, and 51 mo after diagnosis. Longitudinal reference data were obtained from an age- and sex-matched normative population (n = 490). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Cancer- and NMIBC-specific HRQoL outcomes (range 0-100) were evaluated by the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and EORTC QLQ-NMIBC24 questionnaires, respectively. Linear mixed modelling was used to analyse within-group changes and between-group differences. RESULTS AND LIMITATIONS The majority of HRQoL outcomes remained stable over time. Observed changes were only of small clinical relevance. Improvements were noted in insomnia, social functioning, and three NMIBC-specific symptoms, while minor deteriorations in appetite and diarrhoea lasted until 51 mo. HRQoL in some domains was worse for high-grade NMIBC, high European Association of Urology (EAU) risk group, initial Bacillus Calmette-Guérin (BCG) treatment, being female, and being younger (<65 yr); yet differences were few, small, and temporary. No differences were observed across recurrence status. Compared with a normative population, clinically relevant worse scores were observed for six of 15 outcomes, which mostly recovered at 51 mo, except for minor symptoms of appetite loss and diarrhoea. CONCLUSIONS No remarkable changes in HRQoL were observed during the first 4 yr after NMIBC diagnosis. Grade, EAU risk group, initial treatment, recurrence, sex, and age did not importantly affect HRQoL. HRQoL was largely comparable with that of the general population, especially after 4 yr. PATIENT SUMMARY Quality of life is not largely affected during the first 4 yr after non-muscle-invasive bladder cancer diagnosis.
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Affiliation(s)
- Ivy Beeren
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nena E Klerks
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Katja K Aben
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
| | - Jorg R Oddens
- Department of Urology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - J Alfred Witjes
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lambertus A Kiemeney
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alina Vrieling
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
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Kim C, Oh S, Im H, Gim J. Unveiling Bladder Cancer Prognostic Insights by Integrating Patient-Matched Sample and CpG Methylation Analysis. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1175. [PMID: 39064604 PMCID: PMC11279046 DOI: 10.3390/medicina60071175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 07/07/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024]
Abstract
Bladder cancer prognosis remains a pressing clinical challenge, necessitating the identification of novel biomarkers for precise survival prediction and improved quality of life outcomes. This study proposes a comprehensive strategy to uncover key prognostic biomarkers in bladder cancer using DNA methylation analysis and extreme survival pattern observations in matched pairs of cancer and adjacent normal cells. Unlike traditional approaches that overlook cancer heterogeneity by analyzing entire samples, our methodology leverages patient-matched samples to account for this variability. Specifically, DNA methylation profiles from adjacent normal bladder tissue and bladder cancer tissue collected from the same individuals were analyzed to pinpoint critical methylation changes specific to cancer cells while mitigating confounding effects from individual genetic differences. Utilizing differential threshold settings for methylation levels within cancer-associated pathways enabled the identification of biomarkers that significantly impact patient survival. Our analysis identified distinct survival patterns associated with specific CpG sites, underscoring these sites' pivotal roles in bladder cancer outcomes. By hypothesizing and testing the influence of methylation levels on survival, we pinpointed CpG biomarkers that profoundly affect the prognosis. Notably, CpG markers, such as cg16269144 (PRKCZ), cg16624272 (PTK2), cg11304234, and cg26534425 (IL18), exhibited critical methylation thresholds that correlate with patient mortality. This study emphasizes the importance of tailored approaches to enhancing prognostic accuracy and refining therapeutic strategies for bladder cancer patients. The identified biomarkers pave the way for personalized prognostication and targeted interventions, promising advancements in bladder cancer management and patient care.
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Affiliation(s)
- Chanbyeol Kim
- Department of Biomedical Science, Chosun University, Gwangju 61452, Republic of Korea; (C.K.); (S.O.); (H.I.)
- AI Convergence College, Chosun University, Gwangju 61452, Republic of Korea
| | - Sangwon Oh
- Department of Biomedical Science, Chosun University, Gwangju 61452, Republic of Korea; (C.K.); (S.O.); (H.I.)
- AI Convergence College, Chosun University, Gwangju 61452, Republic of Korea
| | - Hamin Im
- Department of Biomedical Science, Chosun University, Gwangju 61452, Republic of Korea; (C.K.); (S.O.); (H.I.)
- AI Convergence College, Chosun University, Gwangju 61452, Republic of Korea
| | - Jungsoo Gim
- Department of Biomedical Science, Chosun University, Gwangju 61452, Republic of Korea; (C.K.); (S.O.); (H.I.)
- AI Convergence College, Chosun University, Gwangju 61452, Republic of Korea
- BK FOUR Department of Integrative Biological Science, Chosun University, Gwangju 61452, Republic of Korea
- Well-Ageing Medicare Institute, Chosun University, Gwangju 61452, Republic of Korea
- Asian Dementia Research Initiative, Chosun University, Gwangju 61452, Republic of Korea
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Dos Reis PF, Martucci RB. Factors influencing health-related quality of life in patients with bladder or kidney cancer: a prospective cohort study of the impact of nutritional status and frailty phenotype. J Cancer Surviv 2024:10.1007/s11764-024-01637-9. [PMID: 38954250 DOI: 10.1007/s11764-024-01637-9] [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: 03/15/2023] [Accepted: 07/21/2023] [Indexed: 07/04/2024]
Abstract
PURPOSE This study aimed to investigate the impact of nutritional status and frailty phenotype and the predictors of temporal changes on health-related quality of life (HRQoL) of patients with bladder or kidney cancer. METHODS Frailty phenotype, Patient-Generated Subjective Global Assessment, and Quality-of-life questionnaire Core-30 were applied twice to patients diagnosed with bladder or kidney cancer. Patients also completed a sociodemographic questionnaire, and clinical data were collected from records. RESULTS Sixty-two individuals completed the study, mostly male, with a mean age of 62.5 (± 11.4) years. The median time of follow-up was 14.5 months. Role functioning, emotional functioning, and fatigue improved over time (p < 0.05). The factors that negatively affected the long-term quality of life summary score were being female, malnourished, pre-frail and frail, cancer treatment, performance status, and lower income. Using the multivariate model, being malnourished (β = - 7.25; 95% CI, - 10.78 to - 3.71; p < 0.001), frail (β = - 7.25; 95% CI, - 13.39 to - 1.11; p = 0.021), and each one-point increase in performance status (β = - 6.9; 95% CI, - 9.54 to - 4.26; p < 0.001), were the ones that most negatively impacted the HRQoL between the two assessments. CONCLUSION This study confirmed that frailty, nutritional status, and performance status are the main predictors of HRQoL of patients with bladder or kidney cancer over time. IMPLICATIONS FOR CANCER SURVIVORS These findings may be the first step towards highlighting the importance of preventing malnutrition and frailty, in favor of a better long-term QoL for cancer patients.
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Affiliation(s)
- Patrícia Fonseca Dos Reis
- Education and Technical-Scientific Information Service, National Cancer Institute, Marquês de Pombal, 125, 3º andar, Centro, Rio de Janeiro, RJ, 20230-240, Brazil.
- Post-graduation Program in Medical Science, Rio de Janeiro State University, Rio de Janeiro, Brazil.
| | - Renata Brum Martucci
- Post-graduation Program in Medical Science, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Rezaee ME, Mahon KM, Trock BJ, Nguyen THE, Smith AK, Hahn NM, Patel SH, Kates M. ERAS for Ambulatory TURBT: Enhancing Bladder Cancer Care (EMBRACE) randomised controlled trial protocol. BMJ Open 2024; 14:e076763. [PMID: 38858157 PMCID: PMC11168167 DOI: 10.1136/bmjopen-2023-076763] [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: 06/16/2023] [Accepted: 03/12/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION Transurethral resection of bladder tumour (TURBT) is one of the more common procedures performed by urologists. It is often described as an 'incision-free' and 'well-tolerated' operation. However, many patients experience distress and discomfort with the procedure. Substantial opportunity exists to improve the TURBT experience. An enhanced recovery after surgery (ERAS) protocol designed by patients with bladder cancer and their providers has been developed. METHODS AND ANALYSIS This is a single-centre, randomised controlled trial to investigate the effectiveness of an ERAS protocol compared with usual care in patients with bladder cancer undergoing ambulatory TURBT. The ERAS protocol is composed of preoperative, intraoperative and postoperative components designed to optimise each phase of perioperative care. 100 patients with suspected or known bladder cancer aged ≥18 years undergoing initial or repeat ambulatory TURBT will be enrolled. The change in Quality of Recovery 15 score, a measure of the quality of recovery, between the day of surgery and postoperative day 1 will be compared between the ERAS and control groups. ETHICS AND DISSEMINATION The trial has been approved by the Johns Hopkins Institutional Review Board #00392063. Participants will provide informed consent to participate before taking part in the study. Results will be reported in a separate publication. TRIAL REGISTRATION NUMBER NCT05905276.
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Affiliation(s)
- Michael E Rezaee
- The Brady Urological Institute, Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Katherine M Mahon
- The Brady Urological Institute, Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Bruce J Trock
- The Brady Urological Institute, Johns Hopkins Medicine, Baltimore, Maryland, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - The-Hung Edward Nguyen
- Department of Anesthesia and Critical Care Medicine, Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Armine K Smith
- The Brady Urological Institute, Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Noah M Hahn
- The Brady Urological Institute, Johns Hopkins Medicine, Baltimore, Maryland, USA
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sunil H Patel
- The Brady Urological Institute, Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Max Kates
- The Brady Urological Institute, Johns Hopkins Medicine, Baltimore, Maryland, USA
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Cho HJ, Chung HS, Hwang EC, Jung SI, Kwon D, Park K, Patel DP, Hsieh TC. Music from Noise-Canceling Headphones Is Beneficial against Anxiety in Male Bladder Cancer Patients Undergoing Follow-Up Cystoscopy: A Prospective Randomized Trial. Urol Int 2024:1-7. [PMID: 38735280 DOI: 10.1159/000539312] [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: 01/25/2024] [Accepted: 04/13/2024] [Indexed: 05/14/2024]
Abstract
INTRODUCTION Bladder cancer, with a greater incidence in males than in females, requires frequent cystoscopies. We aimed to evaluate the effect of music played through noise-canceling headphones on male bladder cancer patients during follow-up cystoscopy. METHODS A total of 160 male bladder cancer patients undergoing follow-up flexible cystoscopy were randomly divided into the noise-canceling headphones without music group and the noise-canceling headphones with music group (groups 1 and 2, respectively; n = 80 per group). The patients' clinical characteristics were examined, and objective and subjective measurements were compared before and after cystoscopy. The primary outcomes that were evaluated included the visual analog scale (VAS, 0-10) and the state-trait anxiety inventory (STAI, 20-80). Other outcomes, including vital signs and scores for assessing satisfaction and the willingness to repeat the procedure, were also examined. RESULTS The characteristics of the patients in groups 1 and 2, and their pre-cystoscopy status, did not differ significantly. Although post-cystoscopy vital signs for the objective parameters and VAS pain scores were similar between the groups, subjective parameters were not. When compared with group 1, post-cystoscopy STAI-state scores were significantly lower in group 2, whereas patients' satisfaction scores and the willingness to repeat the procedure were significantly higher in group 2 (p = 0.002, 0.001, and 0.001, respectively). Additionally, in group 2, STAI-state scores changed significantly after the procedure when compared with before the procedure (p = 0.002). CONCLUSION Providing music to male bladder cancer patients through noise-canceling headphones was found to reduce anxiety during cystoscopy and to improve patient satisfaction and willingness to undergo repeat cystoscopy.
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Affiliation(s)
- Hyun-Jin Cho
- Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ho Seok Chung
- Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
- Department of Urology, University of California San Diego, La Jolla, California, USA
| | - Eu Chang Hwang
- Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seung Il Jung
- Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Dongdeuk Kwon
- Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Kwangsung Park
- Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Darshan P Patel
- Department of Urology, University of California San Diego, La Jolla, California, USA
| | - Tung-Chin Hsieh
- Department of Urology, University of California San Diego, La Jolla, California, USA
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Ceasar RC, Ladi-Seyedian SS, Escobar D, Han J, Koh K, Porten S, Chu C, Gould EE, Bhanvadia S. "I think my vagina is still there?": Women's perspectives on sexual function and dysfunction following radical cystectomy for bladder cancer, a qualitative study. J Sex Med 2024; 21:464-470. [PMID: 38491395 DOI: 10.1093/jsxmed/qdae025] [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: 07/27/2023] [Revised: 01/22/2024] [Accepted: 01/28/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Women's sexual health after radical cystectomy is an important but poorly understood aspect of bladder cancer survivorship. Dedicated investigation is needed to elucidate patient perceptions on sexual function and dysfunction in this setting. AIMS In this study we sought to qualitatively examine women's perceptions and experiences of sexual health following radical cystectomy for bladder cancer. METHODS We conducted one-on-one qualitative telephone interviews with 40 women who underwent radical cystectomy in the past 6 months to 5 years and signed a research consent form to be contacted for future studies. We examined women's experiences of engaging in sexual activity after surgery and their attitudes toward sex and body image. We audio recorded, transcribed, and coded the interviews using ATLAS.ti software and applied grounded theory methods for analysis. OUTCOMES For data that emerged during the qualitative interviews that was related to lack of knowledge about how physical and psychological sexual health would be affected after surgery, we reviewed and discussed transcripts that enabled coding of the data into emerging topic areas. RESULTS Our analysis yielded 4 main themes. (1) Women reported receiving little to no information from providers about female sexual dysfunction prior to or after radical cystectomy. Women wished they had been provided more information about female sexual dysfunction from their clinicians, including strategies for postoperative self-pleasure and nonintercourse methods of sexual pleasure with partners. (2) Women shared that they were not sexually active following surgery due to physical and mental barriers. (3) When women did try to engage in sex, they described feeling disappointed that it did not feel the same as prior to surgery. (4) Some women found that physical therapy helped them to physically and mentally recover their strength to engage in sexual activity again. CLINICAL IMPLICATIONS Clinicians must directly address sexual health concerns with patients who undergo radical cystectomy. STRENGTHS AND LIMITATIONS This study has several key strengths. Investigation into women's sexual function and dysfunction addresses a gap in understanding of this component of women's health-related quality of life after radical cystectomy, which represents an unmet need. The large number of interviews conducted as well as the in-depth information obtained through one-on-one interviews are additional strengths. This study also has limitations, including possible shortcomings of telephone interviews compared with in-person interviews. However, telephone interviews were beneficial because the interviews took place during the COVID-19 pandemic and spared patients from extra visits or from having to travel long distances to the respective medical centers. Other possible limitations were that patients may have been reluctant to share all of their experiences and that patients who underwent urostomies, also termed ileal conduits, were overrepresented in this study compared with women who underwent continent urine diversions, which allow greater control over urine output. CONCLUSION Broadening the understanding of sexual health beyond sexual intercourse to encompass sexuality and self-pleasure can provide clinicians, patients, and their families with more effective preparation and strategies to care for an essential aspect of their wellbeing.
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Affiliation(s)
- Rachel Carmen Ceasar
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, 1845 N Soto St, Los Angeles, CA 90032, United States
| | - Seyedeh-Sanam Ladi-Seyedian
- Department of Urology, Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Ave, Los Angeles, CA 90033, United States
| | - Domenique Escobar
- Department of Urology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA 94143, United States
| | - Jullet Han
- Department of Urology, Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Ave, Los Angeles, CA 90033, United States
| | - Kailyn Koh
- Department of Urology, Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Ave, Los Angeles, CA 90033, United States
| | - Sima Porten
- Department of Urology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA 94143, United States
| | - Carissa Chu
- Department of Urology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA 94143, United States
| | - Erin E Gould
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, 1845 N Soto St, Los Angeles, CA 90032, United States
| | - Sumeet Bhanvadia
- Department of Urology, Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Ave, Los Angeles, CA 90033, United States
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Milloy N, Kirker M, Unsworth M, Montgomery R, Kluth C, Kearney M, Chang J. Real-World Analysis of Treatment Patterns and Platinum-Based Treatment Eligibility of Patients With Metastatic Urothelial Cancer in 5 European Countries. Clin Genitourin Cancer 2024; 22:e136-e147.e1. [PMID: 37945404 DOI: 10.1016/j.clgc.2023.09.010] [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] [Received: 07/12/2023] [Revised: 09/25/2023] [Accepted: 09/28/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION The global treatment landscape for metastatic urothelial cancer (mUC) is evolving, with the recent approval of several new therapeutics. To enable informed treatment decisions, a need exists to understand both treatment patterns and how physicians determine platinum-based treatment eligibility status. This study investigated physicians' current approaches to first-line (1L) chemotherapy, treatment patterns, and assessment of platinum-based treatment eligibility of patients with mUC in real-world clinical practice. PATIENTS AND METHODS Data were derived from the Adelphi mUC Disease Specific Programme™, a large, independent, multinational, cross-sectional survey of physicians and their consulting patients with mUC presenting in a real-world clinical setting, conducted in France, Germany, Italy, Spain, and the United Kingdom between November 2020 and April 2021. Physicians completed record forms for their next 8 consecutively consulting patients (≤3 1L, ≤2 second-line, and ≤3 third-line) with a physician-confirmed diagnosis of mUC, reporting data on demographics, clinical characteristics, eligibility for platinum-based chemotherapy, and treatments received. RESULTS Overall, 232 physicians provided data for 1922 patients. Renal function impairment (72%), Eastern Cooperative Oncology Group performance status (59%), and age (38%) were the most commonly reported criteria physicians used to determine eligibility for platinum-based chemotherapy. At 1L, 82% of patients received platinum-based chemotherapy (cisplatin, 51%; carboplatin, 31%) and 10% received immune checkpoint inhibitor (ICI) therapy. At second-line, 12% received platinum-based chemotherapy, 63% ICI therapy, and 21% non-platinum-based chemotherapy. At third-line, 4% received platinum-based chemotherapy, 41% best supportive care only, and 36% other non-platinum-based chemotherapy. CONCLUSIONS The results of this real-world study indicate that in accordance with European guidelines, the majority of patients with mUC received standard-of-care 1L platinum-based chemotherapy and use of ICIs was limited. Future research should assess how physicians' perceptions toward determining platinum eligibility status evolve with newer guideline recommendations and the introduction of new therapy options for mUC.
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Affiliation(s)
- Neil Milloy
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Macclesfield, Cheshire, United Kingdom
| | | | - Mia Unsworth
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Macclesfield, Cheshire, United Kingdom.
| | - Rachel Montgomery
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Macclesfield, Cheshire, United Kingdom
| | - Caspian Kluth
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Macclesfield, Cheshire, United Kingdom
| | - Mairead Kearney
- The healthcare business of Merck Healthcare KGaA, Darmstadt, Germany
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Rafiei S, Kheradkhah G, Kotronoulas G, Doustmehraban M, Shafiei F, Masoumi M, Parnian E, Nosrati Sanjabad E, Ghashghaee A. Quality of life in bladder cancer: systematic review and meta-analysis. BMJ Support Palliat Care 2024; 13:e707-e714. [PMID: 37400163 DOI: 10.1136/spcare-2023-004185] [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] [Received: 01/26/2023] [Accepted: 05/23/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Worldwide, bladder cancer (BC) has been regarded as the tenth most common cancer with more than 573 000 new cases in 2020. This research presents a systematic review and meta-analysis of studies examining the quality of life (QOL) among patients with BC. METHODS The study was designed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 11 articles were extracted from a literature search conducted through electronic databases including PubMed, EMBASE, Scopus and Web of Science from the onset of January 2000 to June 2022. A random-effects model was applied to estimate the pooled QOL in patients with BC. RESULTS We included 11 primary studies in the final meta-analysis. Based on random effect analysis, total score of QOL was 53.92 (95% CI: 47.84 to 60) representing a moderate level of QOL among patients. Based on the analysis, it was found that physical items with a score of 49.82 (95% CI: 45.8 to 53.84) had a lower score in comparison with mental items at a score of 52 (95% CI: 49.54 to 54.47). In addition, the item of role limitations due to physical health with a score of 46.26 (95% CI: 20.11 to 72.41), and social functioning with a score of 46.25 (95% CI: 18.85 to 73.66), respectively, had the lowest QOL in patients with BC. CONCLUSION Generally, the QOL among patients with BC was in a moderate condition, which can be improved through determining the influencing factors on QOL as a crucial strategy to define future treatment procedures in an effective manner.
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Affiliation(s)
- Sima Rafiei
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran (the Islamic Republic of)
| | - Golnaz Kheradkhah
- The School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK
| | | | - Maryam Doustmehraban
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran (the Islamic Republic of)
| | - Farnoosh Shafiei
- Student Research Committee, Faculty of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Masoumi
- Clinical research and development center, Qom University of Medical Sciences, Qom, Iran
| | - Elaheh Parnian
- Student Research Committee, Faculty of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran
| | - Elmira Nosrati Sanjabad
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ghashghaee
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran (the Islamic Republic of)
- The School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK
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Grivas P, Grande E, Davis ID, Moon HH, Grimm MO, Gupta S, Barthélémy P, Thibault C, Guenther S, Hanson S, Sternberg CN. Avelumab first-line maintenance treatment for advanced urothelial carcinoma: review of evidence to guide clinical practice. ESMO Open 2023; 8:102050. [PMID: 37976999 PMCID: PMC10685024 DOI: 10.1016/j.esmoop.2023.102050] [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] [Received: 06/30/2023] [Revised: 08/03/2023] [Accepted: 09/23/2023] [Indexed: 11/19/2023] Open
Abstract
The JAVELIN Bladder 100 phase III trial led to the incorporation of avelumab first-line (1L) maintenance treatment into international guidelines as a standard of care for patients with advanced urothelial carcinoma (UC) without progression after 1L platinum-based chemotherapy. JAVELIN Bladder 100 showed that avelumab 1L maintenance significantly prolonged overall survival (OS) and progression-free survival in this population compared with a 'watch-and-wait' approach. The aim of this manuscript is to review clinical studies of avelumab 1L maintenance in patients with advanced UC, including long-term efficacy and safety data from JAVELIN Bladder 100, subgroup analyses in clinically relevant subpopulations, and 'real-world' data obtained outside of clinical trials, providing a comprehensive resource to support patient management. Extended follow-up from JAVELIN Bladder 100 has shown that avelumab provides a long-term efficacy benefit, with a median OS of 23.8 months measured from start of maintenance treatment, and 29.7 months measured from start of 1L chemotherapy. Longer OS was observed across subgroups, including patients who received 1L cisplatin + gemcitabine, patients who received four or six cycles of 1L chemotherapy, and patients with complete response, partial response, or stable disease as best response to 1L induction chemotherapy. No new safety signals were seen in patients who received ≥1 year of avelumab treatment, and toxicity was similar in those who had received cisplatin or carboplatin with gemcitabine. Other clinical datasets, including noninterventional studies conducted in Europe, USA, and Asia, have confirmed the efficacy of avelumab 1L maintenance. Potential subsequent treatment options after avelumab maintenance include antibody-drug conjugates (enfortumab vedotin or sacituzumab govitecan), erdafitinib in biomarker-selected patients, platinum rechallenge in suitable patients, nonplatinum chemotherapy, and clinical trial participation; however, evidence to determine optimal treatment sequences is needed. Ongoing trials of avelumab-based combination regimens as maintenance treatment have the potential to evolve the treatment landscape for patients with advanced UC.
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Affiliation(s)
- P Grivas
- Department of Medicine, Division of Hematology/Oncology, University of Washington School of Medicine, Seattle, USA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, USA.
| | - E Grande
- Department of Medical Oncology, MD Anderson Cancer Center Madrid, Madrid, Spain
| | - I D Davis
- Monash University Eastern Health Clinical School, Box Hill, Victoria, Australia
| | - H H Moon
- Department of Hematology/Oncology, Kaiser Permanente Southern California, Riverside Medical Center, Riverside, USA
| | - M-O Grimm
- Department of Urology, Jena University Hospital, Jena, Germany
| | - S Gupta
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, USA
| | - P Barthélémy
- Medical Oncology Unit, Institut de Cancérologie Strasbourg Europe, Strasbourg
| | - C Thibault
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP Centre, Paris, France
| | - S Guenther
- Merck Healthcare KGaA, Darmstadt, Germany
| | | | - C N Sternberg
- Englander Institute for Precision Medicine, Weill Cornell Medicine, Hematology/Oncology, Meyer Cancer Center, New York, USA
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11
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Matson M, Tien T, Yardy G, Allchorne P, Green JSA. The Use of Hospital Services by Patients With Muscle Invasive Bladder Cancer in the Last Year of Life: Identifying the Areas to Improve Care. Cureus 2023; 15:e49175. [PMID: 38130562 PMCID: PMC10734556 DOI: 10.7759/cureus.49175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION Muscle-invasive bladder cancer (MIBC) is associated with significant morbidity. However, patients' specific health needs have not been well defined. This study analyses the utilisation of hospital resources by MIBC patients in the 12 months before death, informing healthcare modelling and enabling service redesign to improve their quality of life. MATERIALS AND METHODS All patients who died after being diagnosed with MIBC at a single hospital in the United Kingdom within four years were included. Patients' electronic health records were reviewed to collect data on all interactions with hospital services in their last year of life. RESULTS A total of 41 patients were included, with survival times ranging from one to 88 months (with a median of nine months). In the last year of life, a patient from this cohort had an average of 5.2 outpatient appointments and 2.3 emergency admissions leading to 17.1 days of inpatient stay and 1.3 operations/procedures. The most common reasons for emergency admission were for the management of haematuria (23%), urinary tract infection (23%), or chest infection (12%). CONCLUSION Patients with MIBC demonstrate significant utilisation of healthcare resources in their last year of life. An awareness of this should inform honest discussions with patients, earlier provision of palliative care, and proactive management of haematuria and urinary tract infections to improve care in this important stage of life.
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Affiliation(s)
- Monty Matson
- Department of Urology, Barts Health NHS Trust, London, GBR
| | - Tony Tien
- Department of Urology, Barts Health NHS Trust, London, GBR
| | - George Yardy
- Department of Urology, East Suffolk and North Essex NHS Foundation Trust, Colchester, GBR
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12
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Li J, Liu X. Coptisine inhibits the malignancy of bladder carcinoma cells and regulates XPO1 expression. Chem Biol Drug Des 2023; 102:805-814. [PMID: 37442763 DOI: 10.1111/cbdd.14291] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/20/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023]
Abstract
This work is performed to investigate the effect of coptisine (COP) on the malignant biological behaviors of bladder carcinoma cells and its underlying mechanism. Bladder carcinoma cell lines were treated with different concentrations of COP in vitro. Cell counting kit-8 (CCK-8), scratch healing assay, Transwell assay, and flow cytometry were used to detect cell growth, migration, invasion, and cell cycle progression. Bioinformatics analysis was performed to predict the molecular targets of COP. Quantitative real-time PCR and western blot were adopted to determine the expression levels of exportin 1 (XPO1) mRNA and protein, respectively. Gene set enrichment analysis was applied to predict the signaling pathways related to XPO1. This study showed that COP treatment markedly suppressed the malignant biological behaviors of bladder carcinoma cells. XPO1 was identified as a downstream molecular target of COP in bladder carcinoma, and COP treatment inhibited the expression of XPO1 in bladder carcinoma cell lines. Overexpression of XPO1 reversed the impacts of COP on the malignant biological behaviors of bladder carcinoma cells. COP treatment modulated the expression level of cyclin D1 and CYP450 via XPO1. In summary, COP represses the malignant biological behaviors of bladder carcinoma cells and regulates XPO1 expression, which is promising to be a complementary drug for bladder carcinoma treatment.
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Affiliation(s)
- Jie Li
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiuheng Liu
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
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13
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Yang J, Tan Y, Yao C. Study on anxiety, depression, and subjective wellbeing of patients with bladder cancer in their different chemotherapy stages. Front Psychol 2023; 14:1226712. [PMID: 37771813 PMCID: PMC10525307 DOI: 10.3389/fpsyg.2023.1226712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/25/2023] [Indexed: 09/30/2023] Open
Abstract
Aims and objectives This study aims to explore the changes in anxiety, depression, and subjective wellbeing in patients with bladder perfusion during different stages of their chemotherapy, and analyze the correlation among their anxiety, depression, and subjective wellbeing. Methods A total of 174 patients with bladder cancer who received bladder perfusion chemotherapy were selected. The questionnaire survey was conducted with SAS, SDS, and GWB. The patients were surveyed and the data were analyzed. Results The results of patients' anxiety, depression, and subjective wellbeing show a dynamic change trend. The change is most obvious after 1 month of chemotherapy and tends to be flat after 3 months of chemotherapy. The scores of anxiety, depression, and subjective wellbeing in patients with bladder perfusion at different stages are statistically significant (P < 0.05). There is a negative correlation among anxiety, depression, and subjective wellbeing in patients (r = -0.605, 0.601). Conclusion Patients' emotions change obviously in the first 3 months of their chemotherapy. Clinical workers can take active intervention measures in this period, guide patients to relieve their anxiety and depression, increase their subjective wellbeing level, and improve their quality of life, which is helpful to ensure the successful completion of chemotherapy.
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Affiliation(s)
- Jie Yang
- School of Nursing and Health, Caofeidian College of Technology, Tangshan, China
| | - Yingchun Tan
- Department of School Clinic, Tianjin Chengjian University, Tianjin, China
| | - Chunlin Yao
- School of Foreign Languages, Tianjin Chengjian University, Tianjin, China
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14
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Stewart R, Richards HL, Houghton S, Sweeney P, Fortune DG. 'I Had It. I Don't Think I Have It…But I Do Feel It Will Come Back Somewhere': A Qualitative Investigation of the Experience of People With Non-Muscle Invasive Bladder Cancer. QUALITATIVE HEALTH RESEARCH 2023; 33:969-982. [PMID: 37485658 DOI: 10.1177/10497323231170089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Very little is known about the impact of living with non-muscle invasive bladder cancer (NMIBC). NMIBC patients' experiences of their illness-in terms of their perceptions, coping strategies and psychological wellbeing-were explored. This study describes an interpretative phenomenological analysis (IPA) of individuals' accounts of living with NMIBC while on routine surveillance for cancer recurrence. Ten individuals took part in face-to-face semi-structured interviews. Three superordinate themes were derived from the data. The first theme, Being Diagnosed and Treated for NMIBC, concerned the observation that participants considered the physical implications, timeline and practicalities of their illness of primary importance and focused less on its psychological aspects. The second theme, Grappling with the Illness, outlined the impact of the doctor-patient relationship. The final theme, 'I don't treat it as a problem. I treat it as an issue', delineated how participants managed difficult emotions in the context of the illness. Findings from this study demonstrated that participants generally found effective ways to cope with their illness and experience of ongoing surveillance, though delay of emotional responses was common. Clinical implications for healthcare professionals are outlined including the importance of high-quality communication with the urology team.
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Affiliation(s)
- Ruth Stewart
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Helen L Richards
- Department of Psychology, University of Limerick, Limerick, Ireland
- Department of Uro-Oncology, Mercy University Hospital, Cork, Ireland
- Department of Clinical Health Psychology, Mercy University Hospital, Cork, Ireland
| | - Sharon Houghton
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Paul Sweeney
- Department of Uro-Oncology, Mercy University Hospital, Cork, Ireland
| | - Donal G Fortune
- Department of Psychology, University of Limerick, Limerick, Ireland
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15
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Soorojebally Y, Neuzillet Y, Lebret T, Allory Y, Descotes F, Ferlicot S, Kassab-Chahmi D, Lamy PJ, Oudard S, Rébillard X, Roy C, Roumiguié M, Rouprêt M, Audenet F. Photodynamic cystoscopy for bladder cancer diagnosis and for NMIBC follow-up: An overview of systematic reviews and meta-analyses. Prog Urol 2023; 33:307-318. [PMID: 37088584 DOI: 10.1016/j.purol.2023.03.003] [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: 12/20/2022] [Revised: 03/07/2023] [Accepted: 03/31/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION Currently, bladder cancer detection is based on cytology and cystoscopy. White light cystoscopy (WLC) is an invasive procedure and may under-detect flat lesions. Blue light cystoscopy (BLC) and narrow band imaging (NBI) cystoscopy are new modalities that could improve the detection of non-muscle invasive bladder cancer (NMIBC) and its recurrence or progression to muscle invasive bladder cancer. We present a systematic review on BLC and NBI cystoscopy for bladder cancer diagnosis and NMIBC follow-up. MATERIAL AND METHODS All available systematic reviews and meta-analyses on cystoscopy published in PubMed® between May 2010 and March 2021 were identified and reviewed. The main endpoints were clinical performance for bladder cancer diagnosis and for recurrence or progression detection during NMIBC follow-up, and additional value compared with cytology and/or WLC. RESULTS Most of the meta-analyses and systematic reviews published suggest a better sensitivity of BLC and NBI cystoscopy compared to WLC, particularly for the detection of flat lesions (CIS). NBI- and BLC-guided TURBT could decrease the recurrence rates. However, their clinical utility to reduce progression rate and increase survival is still unclear. CONCLUSIONS BLC and NBI cystoscopy are efficient techniques for bladder cancer diagnosis and NMIBC follow-up. However, their clinical benefit remains to be confirmed.
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Affiliation(s)
- Y Soorojebally
- Department of urology, Foch Hospital, Paris Saclay University, Suresnes, France
| | - Y Neuzillet
- Department of urology, Foch Hospital, Paris Saclay University, Suresnes, France
| | - T Lebret
- Department of urology, Foch Hospital, Paris Saclay University, Suresnes, France
| | - Y Allory
- Department of pathology, Institut Curie, Saint-Cloud, France
| | - F Descotes
- Biochemistry, biology and pathology centre South, Hospices civils de Lyon (HCL), Université Claude-Bernard Lyon I, Pierre-Bénite, France
| | - S Ferlicot
- Service d'anatomie pathologique, Hôpital de Bicêtre, AP-HP, Le Kremlin Bicêtre, France
| | | | - P-J Lamy
- Biopathologie et génétique des cancers, Institut médical d'analyse génomique, Imagenome, Inovie, Montpellier, France
| | - S Oudard
- Department of medical oncology, Hôpital européen Georges-Pompidou, AP-HP.Centre, Université Paris Cité, Paris, France
| | - X Rébillard
- Urology Department, Beausoleil Private Hospital, Montpellier, France
| | - C Roy
- Department of radiology B, Strasbourg University Hospital - New Civil Hospital, Strasbourg, France
| | - M Roumiguié
- Department of urology, andrology and renal transplantation, CHU Rangueil, Paul-Sabatier University, Toulouse cedex, France
| | - M Rouprêt
- Sorbonne University, GRC 5 predictive Onco-Uro, Urology, Pitié-Salpêtrière Hospital, AP-HP, 75013 Paris, France
| | - F Audenet
- Department of urology, Hôpital européen Georges-Pompidou, AP-HP.Centre, Université Paris Cité, Paris, France.
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16
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Grivas P, Kopyltsov E, Su PJ, Parnis FX, Park SH, Yamamoto Y, Fong PC, Tournigand C, Climent Duran MA, Bamias A, Caserta C, Chang J, Cislo P, di Pietro A, Wang J, Powles T. Patient-reported Outcomes from JAVELIN Bladder 100: Avelumab First-line Maintenance Plus Best Supportive Care Versus Best Supportive Care Alone for Advanced Urothelial Carcinoma. Eur Urol 2023; 83:320-328. [PMID: 35654659 DOI: 10.1016/j.eururo.2022.04.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 03/17/2022] [Accepted: 04/21/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND In JAVELIN Bladder 100, avelumab first-line maintenance plus best supportive care (BSC) significantly prolonged overall survival (OS; primary endpoint) versus BSC alone in patients with advanced urothelial carcinoma (aUC) without disease progression with first-line platinum-containing chemotherapy. OBJECTIVE To evaluate patient-reported outcomes (PROs) with avelumab plus BSC versus BSC alone. DESIGN, SETTING, AND PARTICIPANTS A randomized phase 3 trial (NCT02603432) was conducted in 700 patients with locally advanced or metastatic urothelial carcinoma that had not progressed with first-line gemcitabine plus cisplatin or carboplatin. PROs were a secondary endpoint. INTERVENTION Avelumab plus BSC (n = 350) or BSC alone (n = 350). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Bladder Symptom Index-18 (FBlSI-18) and EuroQol five-level EQ-5D (EQ-5D-5L) assessments were analyzed using descriptive statistics and mixed-effect models. Time to deterioration (TTD; prespecified definition: a ≥3-point decrease from baseline in the FBlSI-18 disease-related symptoms-physical subscale for two consecutive assessments) was evaluated via Kaplan-Meier analyses. RESULTS AND LIMITATIONS Completion rates for scheduled on-treatment PRO assessments were >90% (overall and average per assessment). Results from descriptive analyses and mixed-effect or repeated-measures models of FBlSI-18 and EQ-5D-5L were similar between arms. TTD was also similar, both in the prespecified analysis (hazard ratio 1.26 [95% confidence interval: 0.90, 1.77]) and in the post hoc analyses including off-treatment assessments and different event definitions. Limitations included the open-label design and limited numbers of evaluable patients at later time points. CONCLUSIONS Addition of avelumab first-line maintenance to BSC in patients with aUC that had not progressed with first-line platinum-containing chemotherapy prolonged OS, with a relatively minimal effect on quality of life. PATIENT SUMMARY In this trial of people with advanced urothelial carcinoma who had benefited from first-line chemotherapy (ie, had stable disease or reduced tumor size), treatment with avelumab maintenance plus best supportive care (BSC) versus BSC alone improved survival significantly, without compromising quality of life, as reported by the patients themselves.
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Affiliation(s)
- Petros Grivas
- Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA, USA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, Seattle, WA, USA.
| | - Evgeny Kopyltsov
- State Institution of Healthcare Regional Clinical Oncology Dispensary, Omsk, Russia
| | - Po-Jung Su
- Chang Gung Memorial Hospital, LinKuo, Taiwan
| | - Francis X Parnis
- Adelaide Cancer Centre, University of Adelaide, Adelaide, Australia
| | - Se Hoon Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | - Peter C Fong
- The University of Auckland and Auckland City Hospital, Auckland, New Zealand
| | - Christophe Tournigand
- Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, Créteil, France
| | | | - Aristotelis Bamias
- Alexandra General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Claudia Caserta
- Medical Oncology Unit, Azienda Ospedaliera S. Maria, Terni, Italy
| | | | | | | | | | - Thomas Powles
- Barts Cancer Institute, Experimental Cancer Medicine Centre, Queen Mary University of London, St Bartholomew's Hospital, London, UK
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17
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Renner S, Loussikian P, Foulquié P, Marrel A, Barbier V, Mebarki A, Schück S, Bharmal M. Patient and Caregiver Perceptions of Advanced Bladder Cancer Systemic Treatments: Infodemiology Study Based on Social Media Data. JMIR Cancer 2023; 9:e45011. [PMID: 36972135 PMCID: PMC10131927 DOI: 10.2196/45011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND In 2022, it was estimated that more than 80,000 new cases of bladder cancer (BC) were diagnosed in the United States, 12% of which were locally advanced or metastatic BC (advanced BC). These forms of cancer are aggressive and have a poor prognosis, with a 5-year survival rate of 7.7% for metastatic BC. Despite recent therapeutic advances for advanced BC, little is known about patient and caregiver perceptions of different systemic treatments. To further explore this topic, social media can be used to collect the perceptions of patients and caregivers when they discuss their experiences on forums and online communities. OBJECTIVE The aim of this study was to assess patient and caregiver perceptions of chemotherapy and immunotherapy for treating advanced BC from social media-posted data. METHODS Public posts on social media in the United States between January 2015 and April 2021 from patients with advanced BC and their caregivers were collected. The posts included in this analysis were geolocalized to the United States; collected from publicly available domains and sites, including social media sites such as Twitter and forums such as patient association forums; and were written in English. Posts mentioning any line of chemotherapy or immunotherapy were qualitatively analyzed by two researchers to classify perceptions of treatments (positive, negative, mixed, or without perception). RESULTS A total of 80 posts by 69 patients and 142 posts by 127 caregivers mentioning chemotherapy, and 42 posts by 31 patients and 35 posts by 32 caregivers mentioning immunotherapy were included for analysis. These posts were retrieved from 39 public social media sites. Among patients with advanced BC and their caregivers, treatment perceptions of chemotherapy were more negative (36%) than positive (7%). Most of the patients' posts (71%) mentioned chemotherapy factually without expressing a perception of the treatment. The caregivers' perceptions of treatment were negative in 44%, mixed in 8%, and positive in 7% of posts. In combined patient and caregiver posts, immunotherapy was perceived positively in 47% of posts and negatively in 22% of posts. Caregivers also posted more negative perceptions (37%) of immunotherapy than patients (9%). Negative perceptions of both chemotherapy and immunotherapy were mainly due to side effects and perceived lack of effectiveness. CONCLUSIONS Despite chemotherapy being standard first-line therapy for advanced BC, negative perceptions were identified on social media, particularly among caregivers. Addressing these negative perceptions of treatment may improve treatment adoption. Strengthening support for patients receiving chemotherapy and their caregivers to help them manage side effects and understand the role of chemotherapy in the treatment of advanced BC would potentially enable a more positive experience.
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Yohana C, Bakuza JS, Kinung’hi SM, Nyundo BA, Rambau PF. The trend of schistosomiasis related bladder cancer in the lake zone, Tanzania: a retrospective review over 10 years period. Infect Agent Cancer 2023; 18:10. [PMID: 36800971 PMCID: PMC9938995 DOI: 10.1186/s13027-023-00491-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 09/28/2022] [Indexed: 02/21/2023] Open
Abstract
INTRODUCTION Bladder cancer is a possible outcome of chronic urinary schistosomiasis in many endemic countries. In Tanzania, the Lake Victoria area is one of the areas with the highest prevalence of urinary schistosomiasis and higher incidences of squamous cell carcinoma (SCC) of the urinary bladder. A previous study in the area over one decade (2001-2010) showed SCC to be common in patients aged below 50 years. With various prevention and intervention programs there are likely to be notable changes in schistosomiasis-related urinary bladder cancer, which is currently unknown. Updated information on the status of SCC in this area will be useful for giving an insights into efficacy of control interventions implemented and help guide the initiation of new ones. Therefore, this study was done to determine the current trend of schistosomiasis-related bladder cancer in lake zone, Tanzania. METHODS This was a descriptive retrospective study of histologically confirmed urinary bladder cancer cases diagnosed at the Pathology Department of Bugando Medical Centre over 10 years period. The patient files and histopathology reports were retrieved and information was extracted. Data were analyzed using Chi-square and student t-test. RESULTS A total of 481 patients were diagnosed with urinary bladder cancer during the study period whereby, 52.6% were males and 47.4% were females. The mean age regardless of histological type of cancer was 55 ± 14.2 years. The SCC was the commonest histological type accounting for 57.0%, followed by transitional cell carcinoma 37.6%, and 5.4% were adenocarcinomas. The Schistosoma haematobium eggs were observed in 25.2% and were commonly associated with SCC (p = 0.001). Poorly differentiated cancers were observed mostly in females (58.6%) compared to males (41.4%) (p = 0.003). Muscular invasion of the urinary bladder by cancer was observed in 11.4% of the patients, and this was significantly higher in non-squamous than in squamous cancers (p = 0.034). CONCLUSION Schistosomiasis-related cancers of the urinary bladder in the Lake zone of Tanzania is still a problem. Schistosoma haematobium eggs were associated with SCC type indicating the persistence of infection in the area. This calls for more efforts on preventive and intervention programs to reduce the burden of urinary bladder cancer in the lake zone.
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Affiliation(s)
- Coletha Yohana
- Department of Natural Sciences, Mbeya University of Science and Technology (MUST), P.O Box 131, Mbeya, Tanzania.
| | - Jared S. Bakuza
- grid.8193.30000 0004 0648 0244Department of Biological Sciences, Dar es Salaam University College of Education (DUCE), P.O Box 2329, Dar es Salaam, Tanzania
| | - Safari M. Kinung’hi
- grid.416716.30000 0004 0367 5636National Institute for Medical Research (NIMR), P.O Box 1462, Mwanza, Tanzania
| | - Bruno A. Nyundo
- grid.8193.30000 0004 0648 0244Department of Zoology and Wildlife Conservation, University of Dar Es Salaam, P.O Box 35064, Dar es Salaam, Tanzania
| | - Peter F. Rambau
- grid.411961.a0000 0004 0451 3858Department of Pathology, Catholic University of Health and Allied Sciences-Bugando (CUHAS-Bugando), Box 1464, Mwanza, Tanzania
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19
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Soorojebally Y, Neuzillet Y, Roumiguié M, Lamy PJ, Allory Y, Descotes F, Ferlicot S, Kassab-Chahmi D, Oudard S, Rébillard X, Roy C, Lebret T, Rouprêt M, Audenet F. Urinary biomarkers for bladder cancer diagnosis and NMIBC follow-up: a systematic review. World J Urol 2023; 41:345-359. [PMID: 36592175 DOI: 10.1007/s00345-022-04253-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/08/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Bladder cancer detection and follow-up is based on cystoscopy and/or cytology, but it remains imperfect and invasive. Current research focuses on diagnostic biomarkers that could improve bladder cancer detection and follow-up by discriminating patients at risk of aggressive cancer who need confirmatory TURBT (Transurethral Resection of Bladder Tumour) from patients at no risk of aggressive cancer who could be spared from useless explorations. OBJECTIVE To perform a systematic review of data on the clinical validity and clinical utility of eleven urinary biomarkers (VisioCyt®, Xpert®Bladder, BTA stat®, BTA TRAK™, NMP22 BC®, NMP22® BladderChek® Test, ImmunoCyt™/uCyt1+™, UroVysion Bladder Cancer Kit®, Cxbladder, ADXBLADDER, Urodiag®) for bladder cancer diagnosis and for non-muscle invasive bladder cancer (NMIBC) follow-up. METHODS All available studies on the 11 biomarkers published between May 2010 and March 2021 and present in MEDLINE® were reviewed. The main endpoints were clinical performance for bladder cancer detection, recurrence or progression during NMIBC monitoring, and additional value compared to cytology and/or cystoscopy. RESULTS Most studies on urinary biomarkers had a prospective design and high level of evidence. However, their results should be interpreted with caution given the heterogeneity among studies. Most of the biomarkers under study displayed higher detection sensitivity compared with cytology, but lower specificity. Some biomarkers may have clinical utility for NMIBC surveillance in patients with negative or equivocal cystoscopy or negative or atypical urinary cytology findings, and also for recurrence prediction. CONCLUSION Urinary biomarkers might have a complementary place in bladder cancer diagnosis and NMIBC surveillance. However, their clinical benefit remains to be confirmed.
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Affiliation(s)
- Yanish Soorojebally
- Department of Urology, Foch Hospital, Paris Saclay University, Suresnes, France
| | - Yann Neuzillet
- Department of Urology, Foch Hospital, Paris Saclay University, Suresnes, France
| | - Mathieu Roumiguié
- Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Paul-Sabatier University, Toulouse Cedex, France
| | - Pierre-Jean Lamy
- Biopathologie et Génétique des Cancers, Institut Médical d'Analyse Génomique, Imagenome, Inovie, Montpellier, France
| | - Yves Allory
- Department of Pathology, Institut Curie, Saint-Cloud, France
| | - Françoise Descotes
- Biochemistry, Biology and Pathology Center South, Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon I, Pierre-Bénite, France
| | - Sophie Ferlicot
- Service d'Anatomie Pathologique, AP-HP,, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | | | - Stéphane Oudard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, AP-HP.Centre, Université Paris Cité, Paris, France
| | - Xavier Rébillard
- Urology Department, Beausoleil Private Hospital, Montpellier, France
| | - Catherine Roy
- Department of Radiology B, Strasbourg University Hospital - New Civil Hospital, Strasbourg, France
| | - Thierry Lebret
- Department of Urology, Foch Hospital, Paris Saclay University, Suresnes, France
| | - Morgan Rouprêt
- GRC 5 Predictive Onco-Uro, AP-HP, Urology, Pitié-Salpêtrière Hospital, Sorbonne University, F-75013, Paris, France
| | - François Audenet
- Department of Urology, Hôpital Européen Georges Pompidou, AP-HP.Centre, Université Paris Cité, Paris, France.
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20
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Grobet-Jeandin E, Pinar U, Parra J, Rouprêt M, Seisen T. Health-related quality of life after curative treatment for muscle-invasive bladder cancer. Nat Rev Urol 2023; 20:279-293. [PMID: 36653671 DOI: 10.1038/s41585-022-00693-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 01/19/2023]
Abstract
Muscle-invasive bladder cancer (MIBC) is an aggressive disease for which the gold-standard treatment is radical cystectomy (RC) in combination with cisplatin-based neoadjuvant chemotherapy. Bladder-sparing strategies such as trimodal therapy (TMT) have also emerged to improve health-related quality of life (HRQoL) of patients. However, an improved understanding of the effect of all these treatment modalities on HRQoL is essential to provide personalized patient care. Different combinations of generic, cancer-specific and bladder cancer-specific questionnaires can be used as instruments for HRQoL evaluation in patients with MIBC before and after curative treatments, which can largely affect multiple domains of HRQoL including general health as well as physical, functional, social and emotional well-being. However, diagnosis of MIBC per se is also likely to affect HRQoL, and the perspective of cure after RC or TMT could induce a return to baseline HRQoL values for most of these domains. A considerable amount of data on HRQoL after RC is available, but conflicting results have been reported regarding the effect of urinary diversion (ileal conduit or orthotopic neobladder) and surgical approach (open or robotic surgery) on patient quality of life. Data on HRQoL after TMT are scarce, and additional comparative studies including patients receiving RC (especially using ileal orthotopic neobladder) are needed.
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Affiliation(s)
- Elisabeth Grobet-Jeandin
- Sorbonne University, GRC 5, Predictive Onco-Urology, APHP, Pitié-Salpêtrière Hospital, Urology, Paris, France. .,Division of Urology, Geneva University Hospitals, Geneva, Switzerland.
| | - Ugo Pinar
- Sorbonne University, GRC 5, Predictive Onco-Urology, APHP, Pitié-Salpêtrière Hospital, Urology, Paris, France
| | - Jérôme Parra
- Sorbonne University, GRC 5, Predictive Onco-Urology, APHP, Pitié-Salpêtrière Hospital, Urology, Paris, France
| | - Morgan Rouprêt
- Sorbonne University, GRC 5, Predictive Onco-Urology, APHP, Pitié-Salpêtrière Hospital, Urology, Paris, France
| | - Thomas Seisen
- Sorbonne University, GRC 5, Predictive Onco-Urology, APHP, Pitié-Salpêtrière Hospital, Urology, Paris, France
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21
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Performance of CellDetect for detection of bladder cancer: Comparison with urine cytology and UroVysion. Urol Oncol 2023:S1078-1439(22)00497-5. [PMID: 36642638 DOI: 10.1016/j.urolonc.2022.12.012] [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: 08/20/2022] [Revised: 11/28/2022] [Accepted: 12/26/2022] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To compare the performance of CellDetect, a new biomarker with urine cytology and UroVysiontechnology for bladder cancer detection. PATIENTS AND METHODS We performed an IRB approved prospective, blinded single center study in patients on routine surveillance for nonmuscle invasive bladder cancer and those scheduled for transurethral resection of bladder tumor or radical cystectomy. Patients with bladder catheters, neobladder, ileal conduit, urinary stones, or those with upper tract carcinoma were excluded from the study. Voided urine sample was collected from the participants and each sample was divided into three equal aliquots (CellDetect, Urine cytology and Urovysion). Pathology of the operative specimen was considered the gold standard to which the three markers were compared. RESULTS The study group included 93 patients with median age was 68 years (range: 34-92 years) with male to female ratio of 12:1. Pathologic evaluation revealed malignancy in 43 cases (46%) of whom 81% had previous history of urothelial bladder cancer. Among all studied markers CellDetect exhibited the best performance followed by urine cytology and U-FISH with diagnostic odds ratio of 4.33, 3.85, and 2.5 respectively. The overall sensitivity, specificity, negative predictive value, and positive predictive value for this test were 84%, 80%, 88%, and 74% respectively. The advantage of this new biomarker was observed both in high grade and low-grade cases. CONCLUSIONS This study demonstrates the advantage of CellDetect as a urine-based assay to detect urothelial bladder cancer over urine cytology and U-FISH test. The high performance was maintained across all cancer grades and stages without compromising the assay specificity. Additional studies are required to test if it can be a noninvasive alternative to cystoscopy.
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22
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Yang H, Zhang Z, Zhao K, Zhang Y, Yin X, Zhu G, Wang Z, Sui Y, Li X, Li C, Wang Q, Xing N, Wang K. Initial Experience With Extraperitoneal Laparoscopic Radical Cystectomy With Pelvic Organ-Preserving and Orthotopic Neobladder Techniques for Bladder Cancer in Female Patients. Urology 2023; 171:77-82. [PMID: 36395869 DOI: 10.1016/j.urology.2022.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To present the extraperitoneal laparoscopic radical cystectomy (ELRC) technique, and initial outcomes of organ-preserving and orthotopic neobladder (ONB) techniques for bladder cancer in selected females. MATERIALS AND METHODS Data including patient characteristics, operative time, blood loss, transfusion rate, length of hospital stay, and pathologic outcomes, as well as 30- and 90-day complications were collected between April 2018 and May 2021 from females who underwent ONB after ELRC. Regular follow-up focused on patients' oncological and functional outcomes, and postoperative sexual function status was assessed using the Female Sexual Function Index (FSFI). RESULTS Eleven females with a mean age of 53 years who underwent ELRC with pelvic organ-preservation and ONB were analyzed retrospectively. All procedures were completed successfully. The mean operative time was 264.82 ± 33.81 min, and the average intraoperative blood loss was 128 ± 18.19 mL. All patients had negative pathological margins and no lymph node metastases. The average hospital stay was 10.72 days. The single J ureteral stent and catheter were usually removed 3-4 weeks after the procedure. The FIFS assessment of postoperative sexual function showed that the patients were relatively satisfied. CONCLUSION ELRC with pelvic organ preservation and ONB technology was a safe and feasible surgical strategy for the selected female patients. Preserving organs and vascular nerve bundles seemed to be safe in oncological and produced encouraging functional results. Further rigorous prospective studies with more patients and long-term follow-up data are needed to assess the oncologic and functional results.
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Affiliation(s)
- Han Yang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
| | - Zongliang Zhang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
| | - Kai Zhao
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
| | - Yulian Zhang
- Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
| | - Xinbao Yin
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
| | - Guanqun Zhu
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
| | - Zhenlin Wang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
| | - Yuanming Sui
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
| | - Xueyu Li
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
| | - Chen Li
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
| | - Qinglei Wang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China
| | - Nianzeng Xing
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ke Wang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China.
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23
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Differential changes in self-reported quality of life in elderly populations after diagnosis of a genitourinary malignancy. Urol Oncol 2022; 40:455.e1-455.e10. [DOI: 10.1016/j.urolonc.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/19/2022] [Accepted: 07/19/2022] [Indexed: 11/18/2022]
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24
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Houédé N, Flahault C, Gross-Goupil M, Le Clanche S, Le Goff Y, Merlier F, Pignot G, Pourroy B, Thibault C, Xylinas E, Solbes MN, Dénéchère G, Roupret M. Cancer de la vessie localement avancé ou métastatique : identification des freins et leviers du parcours des patients en France. Bull Cancer 2022; 109:925-937. [DOI: 10.1016/j.bulcan.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/01/2022] [Accepted: 04/14/2022] [Indexed: 11/17/2022]
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25
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Treatment with opioids in patients with locally advanced or metastatic urothelial carcinoma and matched non-cancer controls. Urol Oncol 2022; 40:411.e9-411.e18. [DOI: 10.1016/j.urolonc.2022.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/19/2022] [Accepted: 06/16/2022] [Indexed: 11/24/2022]
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26
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Wei Z, Xu J, Li W, Ou L, Zhou Y, Wang Y, Shi B. SMARCC1 Enters the Nucleus via KPNA2 and Plays an Oncogenic Role in Bladder Cancer. Front Mol Biosci 2022; 9:902220. [PMID: 35669562 PMCID: PMC9163745 DOI: 10.3389/fmolb.2022.902220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/02/2022] [Indexed: 11/25/2022] Open
Abstract
Background: SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin subfamily C member 1 (SMARCC1), a component of the SWI/SNF complex, is thought to be an oncogene in several kinds of cancer. Materials and methods: The potential interaction between SMARCC1 and KPNA2 was inquired by Spearman’s correlation analysis, immunofluorescence staining and co-immunoprecipitation (Co-IP) assays. The immunohistochemistry staining, RT-PCR and western blot assay were taken for determining the expression levels of SMARCC1. And CCK-8, transwell assay, cell apoptosis assay, cell cycle analysis and subcutaneous tumor model were conducted to explore the role of SMARCC1 in carcinogenesis of bladder cancer. Results: In our experiments, Spearman’s correlation analysis, immunofluorescence staining and co-immunoprecipitation (Co-IP) assays showed that SMARCC1 interacted with KPNA2, and after knockdown of KPNA2, Nup50 and Nup153, the nuclear content of SMARCC1 decreased while the amount of SMARCC1 protein remaining in the cytoplasm increased, indicating that SMARCC1 could be transported into the nucleus via KPNA2 and thus acted as an oncogene. We found that both the mRNA and protein expression levels of SMARCC1 were increased in bladder cancer, and increased SMARCC1 expression was significantly associated with a higher T stage and poorer prognosis in bladder cancer patients. Knockdown of SMARCC1 slowed the growth of the two tested cell lines and clearly arrested the cell cycle at the G0/G1 phase checkpoint. Moreover, the migratory ability was significantly decreased and the number of apoptotic cells was increased. Conclusion: On the whole, our results demonstrate KPNA2, Nup50 and Nup153 regulate the process of SMARCC1 nuclear translocation in BC. SMARCC1 may be a competent candidate as a diagnostic and therapeutic target for BC. Further studies are required to research the mechanism and assess the role of SMARCC1 in vivo.
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Affiliation(s)
- Zhengmao Wei
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, China
- Department of Urology, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Jinming Xu
- Department of Urology, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Weiqing Li
- Karamay Central Hospital of Xinjiang, Karamay, China
| | - Longhua Ou
- Department of Urology, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Yingchen Zhou
- Department of Surgery, Fuwai Hospital Chinese Academy of Medical Sciences Shenzhen, University of South China, Shenzhen, China
| | - Yan Wang
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, China
- *Correspondence: Yan Wang, ; Bentao Shi,
| | - Bentao Shi
- Department of Urology, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
- *Correspondence: Yan Wang, ; Bentao Shi,
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27
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Schulz A, Loloi J, Pina Martina L, Sankin A. The Development of Non-Invasive Diagnostic Tools in Bladder Cancer. Onco Targets Ther 2022; 15:497-507. [PMID: 35529887 PMCID: PMC9075009 DOI: 10.2147/ott.s283891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/22/2022] [Indexed: 11/23/2022] Open
Abstract
Bladder cancer is a common urinary tract cancer with a difficult clinical course. With frequent recurrence, patients with a history of bladder cancer often undergo surveillance that involves invasive cystoscopies and biopsies. Not only is this financially burdensome for patients but it is also mentally and physically intensive. Given this predicament, the field has shifted towards the use of non-invasive urinary tests to detect bladder cancer earlier in the disease course and to avoid unnecessary procedures. The first non-invasive test developed was urine cytology; however, that was found to have a low sensitivity, especially for low-grade lesions. There are many tests that are available that utilize common protein biomarkers to enhance the sensitivity of detection. However, many of these tests lack the specificity seen with cytology. With recent technological and research advancements, there are newer detection systems such as RNA sequencing and microfluidics along with novel bladder cancer biomarkers including mRNAs, methylation patterns and exosomes, which have potential to be used in clinical practice. The aim of this review is to highlight established non-invasive bladder cancer diagnostic tests as well as innovative methodologies that are on the horizon for use in bladder cancer detection.
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Affiliation(s)
- Alison Schulz
- Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Justin Loloi
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, 11061, USA
| | - Luis Pina Martina
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, 11061, USA
| | - Alexander Sankin
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, 11061, USA
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28
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Li X, Zhang C, Peng X, Li Y, Chen G, Gou X, Zhou X, Ma C. A novel risk score model based on five angiogenesis-related long non-coding RNAs for bladder urothelial carcinoma. Cancer Cell Int 2022; 22:157. [PMID: 35440045 PMCID: PMC9019982 DOI: 10.1186/s12935-022-02575-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/06/2022] [Indexed: 01/09/2023] Open
Abstract
Background Tumour angiogenesis is an independent risk factor for bladder urothelial carcinoma (BUC) progression, but viable and promising antiangiogenic targets are understudied. Emerging evidence suggests that long non-coding RNAs (lncRNAs) play prominent role in the tumour microenvironment and tumour angiogenesis. Methods The clinical data of BUC patients were obtained from TCGA database and clinical specimens of 138 BUC patients. Univariate and multivariate COX regression analyses were used to identify survival-related ARLNRs (sARLNRs) from The Molecular Signatures Database v4.0. Fisher’s exact probability method was used to detect the correlations between sARLNRs levels and clinicopathological characteristics. A chain of experiments including FACS, qPCR, immunohistochemistry, tube formation, migration and invasion assays, combining with co-culture models, were utilized to validate the clinical significance and angiogenetic correlation of sARLNRs. Results Five sARLNRs were employed to establish an angiogenesis-related risk score model, by which patients in the low-risk group obtained better overall survival than those in the high-risk group. The expression of AC005625.1 and AC008760.1 was significantly related to ECs percentage, tumour size and muscle invasion status. Besides, AC005625.1 and AC008760.1 expressed lower in BUC cell lines and tumour tissues than that in normal urothelial cells and adjacent normal tissues, with much lower levels in more advanced T stages. A prominently higher proportion of ECs was detected in tumour tissues with lower expression of AC005625.1 and AC008760.1. In the co-culture models, we found that knockdown of AC005625.1 and AC008760.1 in BUC cells increased the tube formation, migration and invasion abilities of HUVEC. The expression levels of CD31, VEGF-A, VIMENTIN and N-CADHERIN were also enhanced in HUVEC cells co-cultured with siR-AC005625.1 and siR-AC008760.1-treated T24 cells. Conclusion In the study, we identify five sARLNRs and validate their clinical significance, angiogenesis correlation and prognosis-predictive values in BUC. These findings may provide a new perspective and some promising antiangiogenic targets for clinical diagnosis and treatment strategies of BUC. Supplementary Information The online version contains supplementary material available at 10.1186/s12935-022-02575-1.
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Affiliation(s)
- Xinyuan Li
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.,CAS Centre for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, Shanghai, China
| | - Chunlin Zhang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.,Chongqing Key Laboratory of Molecular Oncology and Epigenetics, Chongqing, China
| | - Xiang Peng
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.,Chongqing Key Laboratory of Molecular Oncology and Epigenetics, Chongqing, China
| | - Yang Li
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.,Chongqing Key Laboratory of Molecular Oncology and Epigenetics, Chongqing, China
| | - Guo Chen
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.,Chongqing Key Laboratory of Molecular Oncology and Epigenetics, Chongqing, China
| | - Xin Gou
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Xiang Zhou
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China. .,Chongqing Key Laboratory of Molecular Oncology and Epigenetics, Chongqing, China.
| | - Chao Ma
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China. .,The Fifth People's Hospital of Chongqing, Chongqing, China.
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29
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Renner S, Loussikian P, Foulquié P, Arnould B, Marrel A, Barbier V, Mebarki A, Schück S, Bharmal M. Perceived Unmet Needs in Patients and Caregivers Living With Advanced Bladder Cancer: An Infodemiology Study Using Data From Social Media in the United States (Preprint). JMIR Cancer 2022; 8:e37518. [PMID: 36125861 PMCID: PMC9533198 DOI: 10.2196/37518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 11/19/2022] Open
Abstract
Background Locally advanced or metastatic bladder cancer (BC), which is generally termed advanced BC (aBC), has a very poor prognosis, and in addition to its physical symptoms, it is associated with emotional and social challenges. However, few studies have assessed the unmet needs and burden of aBC from patient and caregiver perspectives. Infodemiology, that is, epidemiology based on internet health-related content, can help obtain more insights on patients’ and caregivers’ experiences with aBC. Objective The study aimed to identify the main discussion themes and the unmet needs of patients with aBC and their caregivers through a mixed methods analysis of social media posts. Methods Social media posts were collected between January 2015 and April 2021 from US geolocalized sites using specific keywords for aBC. Automatic natural language processing (regular expressions and machine learning) methods were used to filter out irrelevant content and identify verbatim posts from patients and caregivers. The verbatim posts were analyzed to identify main discussion themes using biterm topic modeling. Difficulties or unmet needs were further explored using qualitative research methods by 2 independent annotators until saturation of concepts. Results A total of 688 posts from 262 patients and 1214 posts from 679 caregivers discussing aBC were identified. Analysis of 340 randomly selected patient posts and 423 randomly selected caregiver posts uncovered 33 unique unmet need categories among patients and 36 among caregivers. The main unmet patient needs were related to challenges regarding adverse events (AEs; 28/95, 29%) and the psychological impact of aBC (20/95, 21%). Other patient unmet needs identified were prognosis or diagnosis errors (9/95, 9%) and the need for better management of aBC symptoms (9/95, 9%). The main unmet caregiver needs were related to the psychological impacts of aBC (46/177, 26.0%), the need for support groups and to share experiences between peers (28/177, 15.8%), and the fear and management of patient AEs (22/177, 12.4%). Conclusions The combination of manual and automatic methods allowed the extraction and analysis of several hundreds of social media posts from patients with aBC and their caregivers. The results highlighted the emotional burden of cancer for both patients and caregivers. Additional studies on patients with aBC and their caregivers are required to quantitatively explore the impact of this disease on quality of life.
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30
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Park J, Choi YD, Lee K, Seo M, Cho A, Lee S, Nam KH. Quality of life patterns and its association with predictors among non-muscle invasive bladder cancer survivors: A latent profile analysis. Asia Pac J Oncol Nurs 2022; 9:100063. [PMID: 35665310 PMCID: PMC9157190 DOI: 10.1016/j.apjon.2022.04.002] [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: 12/01/2021] [Accepted: 04/05/2022] [Indexed: 11/17/2022] Open
Abstract
Objective This study identified group patterns in the quality of life (QOL), as well as examining factors associated with group membership, among non-muscle invasive bladder cancer (NMIBC) survivors. Methods This was a cross-sectional study involving 278 participating NMIBC survivors. Mplus version 7.2 was used to perform the latent profile analysis of QOL using the EORTC QLQ-NMIBC-24. The participants’ social support, self-efficacy, knowledge level, depression, perceived severity of and susceptibility of cancer recurrence, and their demographic and clinical characteristics were compared between the subgroups, with a logistic regression analysis being adopted to examine the factors associated with the QOL subgroups. Results The NMIBC survivors based on the QOL were classified into two subgroups: “QOL-high” (81.3%) and “QOL-low” (18.7%). Having ≥ 3 disease recurrences, perceived susceptibility toward and severity of cancer recurrence, and having depressive symptoms were significantly associated with the “QOL-low” group. Conclusions Participants with frequent recurrences of NMIBC, higher perceived susceptibility and severity levels, and depressive symptoms had lower QOL. Therefore, it is necessary to develop intervention programs targeting participants with these characteristics to improve their QOL.
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Affiliation(s)
- Jeongok Park
- College of Nursing and Mo-Im Kim Nursing Research Institute, Faculty of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Young Deuk Choi
- College of Medicine, Faculty of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Kyoungjin Lee
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, South Korea and College of Nursing, Faculty of Nursing, Kyungbok University, Namyangju, Republic of Korea
| | - Miae Seo
- College of Nursing and Mo-Im Kim Nursing Research Institute, Research Assistant, Yonsei University, Seoul, South Korea and Division of Nursing, Registered Nurse, Severance Hospital, Seoul, Republic of Korea
| | - Ahyoung Cho
- College of Nursing and Mo-Im Kim Nursing Research Institute, Research Assistant, Yonsei University, Seoul, Republic of Korea
| | - Sejeong Lee
- College of Nursing and Brain Korea 21 FOUR Project, Graduate Student, Yonsei University, Seoul, Republic of Korea
| | - Keum-hee Nam
- College of Nursing, Faculty of Nursing, Kosin University, Busan, Republic of Korea
- Corresponding author.
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31
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Feng F, Yang J, Chen A, Cui M, Li L. Long non-coding RNA long intergenic non-protein coding RNA 1232 promotes cell proliferation, migration and invasion in bladder cancer via modulating miR-370-5p/PIM3 axis. J Tissue Eng Regen Med 2022; 16:575-585. [PMID: 35338769 DOI: 10.1002/term.3291] [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: 09/29/2021] [Revised: 01/10/2022] [Accepted: 02/04/2022] [Indexed: 11/08/2022]
Abstract
Increasing evidences have suggested that long non-coding RNAs are critical regulators in the progression of tumor growth. Long intergenic non-protein coding RNA 1232 (LINC01232) was verified as an oncogene in multiple cancers. Nevertheless, its function in bladder cancer (BC) remains to be uncovered. In the current study, we detected LINC01232 expression utilizing quantitative real-time polymerase chain reaction (RT-qPCR) and discovered that LINC01232 was overexpressed in BC cell lines versus normal cell line. Besides, the effect of LINC01232 on BC cell behaviors was measured by colony formation, Cell Counting Kit-8 (CCK-8), transwell, TdT-mediated dUTP Nick-End Labeling and caspase-3/8 activity assays. Functionally, LINC01232 deficiency suppressed cell proliferation, migration and invasion. Next, miR-370-5p was proved to bind with LINC01232 by RNA pull down, RNA-binding protein immunoprecipitation (RIP) and luciferase reporter assays. Furthermore, PIM3 expression was negatively modulated by miR-370-5p and markedly increased in BC cell lines. Moreover, PIM3 silence repressed proliferation, migration and invasion but triggered apoptosis of BC cells. The rescue assays validated that upregulation of PIM3 recovered the effects of LINC01232 silence on the growth of BC cells. To summarize, our study manifested that LINC01232 accelerates BC progression by targeting miR-370-5p/PIM3 axis. Targeting LINC01232 might offer novel insight into BC treatment.
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Affiliation(s)
- Feng Feng
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Jing Yang
- Department of Central Sterile Supply, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Aiping Chen
- Department of Gastroenterology, Liaocheng People's Hospital, Liao Cheng, Shandong, China
| | - Meng Cui
- Department of Gynecology, Shandong Provincial Maternity and Childcare Hospital, Jinan, Shandong, China
| | - Lianjun Li
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.,Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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32
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Yuan Z, Guo G, Sun G, Li Q, Wang L, Qiao B. Magnesium isoglycyrrhizinate suppresses bladder cancer progression by modulating the miR-26b/Nox4 axis. Bioengineered 2022; 13:7986-7999. [PMID: 35293283 PMCID: PMC9161837 DOI: 10.1080/21655979.2022.2031677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Magnesium isoglycyrrhizinate (MI), a magnesium salt of 18α-GA stereoisomer, has been reported to exert efficient hepatoprotective activity. However, its effect on bladder cancer remains unclear. The study explored the effects of MI on the growth, colony formation, apoptosis, invasion, and migration of bladder cancer cells (HTB9 and BIU87 cells). Typical apoptotic changes of bladder cancer cells such as nuclear concentration and fragmentation were observed using Hoechst staining. The effects of MI on the expression levels of microRNA-26b (miR-26b), NADPH oxidase 4 (Nox4), nuclear transcription factor-κB (NF-κB), and hHypoxia inducible factor-1α (HIF-1α) were detected using qRT-PCR and Western blot. The potential targets of miR-26b were predicted using Targetscan, and their interactions were determined by luciferase reporter assay. A xenograft mouse model was established to evaluate the anti-tumor effects of MI in vivo. MI significantly suppressed the proliferation, colony formation, invasion, and migration and induced apoptosis of human bladder cancer cells, and MI significantly increased miR-26b expression. Nox 4 was identified to be a direct target of miR-26b. MiR-26b mimics significantly decreased the relative luciferase activity of wild type (WT) Nox 4 but not mutant type (MUT) Nox4. Meanwhile, MI markedly downregulated the expression levels of Nox4, NF-κB, and HIF-1α both in vitro and in vivo. Moreover, MI inhibited xenograft tumor growth in vivo and decreased the expression of Nox4, NF-κB, and HIF-1α. Overall, MI showed a potent anti-tumor effect against bladder cancer partially via modulating the miR-26b/Nox4 axis.
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Affiliation(s)
- Zhihao Yuan
- Department of Emergency, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China
| | - Guancheng Guo
- Department of Emergency, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China
| | - Guifang Sun
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China
| | - Qi Li
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China
| | - Lihui Wang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China
| | - Baoping Qiao
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China
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33
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Martin S, Shah SN, Hepp Z, Harris N, Morgans AK. Qualitative Analysis of Pain in Patients With Locally Advanced or Metastatic Urothelial Carcinoma. Bladder Cancer 2022; 8:45-53. [PMID: 38994514 PMCID: PMC11181679 DOI: 10.3233/blc-211518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 11/09/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Pain is not well described in patients with locally advanced or metastatic urothelial cancer (la/mUC). OBJECTIVE To characterize pain and assess the content validity of the Brief Pain Inventory Short Form (BPI-SF) worst pain item in patients with la/mUC receiving first-line treatment in the US. METHODS Qualitative interviews were conducted in patients aged≥45 years with confirmed la/mUC, self-reported la/mUC-attributed pain before enrollment, and no major surgery≤3 months prior to being interviewed. Interview participants were asked open-ended questions about their la/mUC symptoms and pain. "Think aloud" cognitive debriefing was conducted for the BPI-SF worst pain item. RESULTS Ten participants with laUC and six (38%) with mUC were interviewed. First-line treatments included cisplatin (n = 14; 88%) or carboplatin (n = 2; 13%). The average past-week worst pain score (0-10 scale) was 6.2 (range, 3-10); seven (44%) participants reported severe pain (score≥7). Pain was most frequently reported in the back (n = 14; 88%) and/or pelvic/lower abdominal area (n = 10; 63%). Pain impacted all participants' physical and daily activities; 81% reported it impacted their overall quality of life. All participants interpreted and completed the BPI-SF worst pain item without difficulty; 15 (94%) reported it was relevant to their la/mUC experience. Participants understood the 24-hour recall period; most supported daily (n = 13; 81%) or weekly (n = 14; 88%) assessment, preferring electronic administration using their phone (n = 14; 88%). CONCLUSIONS Pain attributed to la/mUC impacted physical and daily activities in all participants undergoing first-line treatment for la/mUC. Content validity was demonstrated for the BPI-SF worst pain item in this population.
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Affiliation(s)
| | | | | | | | - Alicia K Morgans
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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34
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Volz Y, Eismann L, Pfitzinger P, Westhofen T, Ebner B, Jokisch JF, Buchner A, Schulz G, Schlenker B, Karl A, Stief CG, Kretschmer A. Long-term health-related quality of life (HRQOL) after radical cystectomy and urinary diversion - A propensity score-matched analysis. Clin Genitourin Cancer 2022; 20:e283-e290. [DOI: 10.1016/j.clgc.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/12/2022]
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35
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Cook GS, Howard JM. Patterns in the Management of Low-Grade Non-Muscle-Invasive Bladder Cancer-the Human and Economic Costs of Excessive Surveillance. JAMA Netw Open 2022; 5:e223055. [PMID: 35302637 DOI: 10.1001/jamanetworkopen.2022.3055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Grayden S Cook
- School of Medicine, University of Texas Southwestern Medical Center, Dallas
| | - Jeffrey M Howard
- Department of Urology, University of Texas Southwestern Medical Center, Dallas
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36
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Nishihara K, Ueda K, Kurose H, Ogasawara N, Hiroshige T, Chikui K, Ejima K, Uemura K, Nakiri M, Suekane S, Igawa T. Survival outcomes of non‑definitive therapy for muscle‑invasive bladder cancer. Oncol Lett 2022; 23:126. [DOI: 10.3892/ol.2022.13246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/20/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Kiyoaki Nishihara
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Kosuke Ueda
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Hirofumi Kurose
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Naoyuki Ogasawara
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Tasuku Hiroshige
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Katsuaki Chikui
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Kazuhisa Ejima
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Keiichiro Uemura
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Makoto Nakiri
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Shigetaka Suekane
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Tsukasa Igawa
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
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Health-related Quality of Life of Patients with Locally Advanced or Metastatic Urothelial Cancer Treated with Enfortumab Vedotin after Platinum and PD-1/PD-L1 Inhibitor Therapy: Results from Cohort 1 of the Phase 2 EV-201 Clinical Trial. Eur Urol 2022; 81:515-522. [PMID: 35168844 PMCID: PMC9385268 DOI: 10.1016/j.eururo.2022.01.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/20/2021] [Accepted: 01/19/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The EV-201 trial (NCT03219333) demonstrated a clinically meaningful and durable response rate and a tolerable safety profile with enfortumab vedotin (EV) in patients with locally advanced/metastatic urothelial carcinoma (LA/mUC) treated with prior PD-1/PD-L1 inhibitor therapy and platinum-containing chemotherapy (cohort 1). Patient-reported outcome (PRO) measures were included in EV-201 as exploratory endpoints. OBJECTIVE To evaluate PRO data for cohort 1 of EV-201 to better understand the relationship between EV therapy and health-related quality of life (HRQoL). DESIGN, SETTING, AND PARTICIPANTS Enrolled patients with LA/mUC who received EV were invited to electronically complete two HRQoL instruments (EORTC QLQ-C30 and EQ-5D-3L) at baseline and day 1 of each cycle until treatment discontinuation. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Patient demographics, completion and compliance rates, and PRO scores were analysed using descriptive statistics. Selected EORTC QLQ-C30 scores were analysed post hoc using a repeated-measures mixed model. RESULTS AND LIMITATIONS Among treated patients (n = 125), 95% completed both baseline questionnaires. Compliance rates were ≥86% throughout the study. Descriptive analyses showed that global health status, physical functioning, and symptom scores remained stable over time, with average scores similar at each cycle. Lower pain and fatigue scores were observed in responders at cycles following an objective response. Pain was lower at cycle 3 than at baseline in patients with bone metastases. Mean EQ-5D-3L utility score (0.80 at baseline; range from 0.77 at cycle 2 to 0.91 at cycle 10) and visual analogue scale scores (66.9 at baseline; range from 65.5 at cycle 2 to 78.4 at cycle 10) remained similar over time. Variability and the small sample size limited definitive conclusions. CONCLUSIONS PRO scores remained stable throughout EV treatment, further supporting the overall value of EV in the treatment of patients with LA/mUC. The potential benefit of EV therapy on overall HRQoL and symptoms such as pain and fatigue is currently being explored. PATIENT SUMMARY In this study of adult patients with advanced cancer of the urinary tract that progressed after previous medications, quality of life, ability to function, and symptoms did not worsen on treatment with enfortumab vedotin, which is an antibody + drug combination. Some improvements in pain and fatigue were reported by patients, but further research needs to be conducted. These data complement the efficacy and safety data from the EV-201 trial.
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38
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Bladder-Sparing Approaches to Treatment of Muscle-Invasive Bladder Cancer. Urol Oncol 2022. [DOI: 10.1007/978-3-030-89891-5_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Cooke IJ, Patil D, Bobrek K, Narayan V, Master V, Rapaport M, Filson CP, Joshi SS. Longitudinal impact of bladder cancer diagnosis on common psychiatric disorders. Cancer Med 2021; 10:8412-8420. [PMID: 34773389 PMCID: PMC8633250 DOI: 10.1002/cam4.4346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/13/2021] [Accepted: 09/17/2021] [Indexed: 11/30/2022] Open
Abstract
Background The presence of psychiatric disorders in patients with cancer is associated with increased morbidity and poorer outcomes. We sought to determine the impact of a new bladder cancer diagnosis on the incidence of depression and anxiety. Methods We used a database of billing claims (MarketScan®) to identify patients newly diagnosed with bladder cancer between 2009 and 2018. Patients with preexisting psychiatric disorders or use of anxiolytics/antidepressants were excluded. We matched cases to patients without a bladder cancer or psychiatric diagnosis. Our primary outcome was a new diagnosis of depression, anxiety, or use of anxiolytics/antidepressants. Other exposures of interest included gender and treatment received. We used multivariable regression to estimate odds ratios for these exposures. Results We identified 65,846 cases with a new diagnosis of bladder cancer (31,367 privately insured; 34,479 Medicare‐eligible). Compared to controls, bladder cancer patients were more likely to develop new‐onset depression/anxiety at 6 months (privately insured: 6.9% vs. 3.4%, p < 0.001; Medicare‐eligible: 5.7% vs. 3.4%, p < 0.001) and 36 months (privately insured: 19.2% vs. 13.5%, p < 0.001; Medicare‐eligible: 19.3% vs. 16.0%, p < 0.001). Women (vs. men, privately insured: OR 1.65, 95%CI 1.53–1.78; Medicare‐eligible: OR 1.63, 95%CI 1.50–1.76) and those receiving cystectomy and chemotherapy (vs. no treatment, privately insured: OR 4.94, 95%CI 4.13–5.90; Medicare‐eligible: OR 2.35, 95%CI 1.88–2.94) were more likely to develop significant depression/anxiety. Conclusion A new diagnosis of bladder cancer was associated with increased burden of significant depression/anxiety compared with matched controls. Women and patients receiving more radical treatments had higher rates of depression and anxiety.
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Affiliation(s)
- Ian J Cooke
- Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Dattatraya Patil
- Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Katherine Bobrek
- Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Vikram Narayan
- Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Atlanta, Georgia, USA
| | - Viraj Master
- Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Atlanta, Georgia, USA
| | - Mark Rapaport
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Christopher P Filson
- Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Atlanta, Georgia, USA
| | - Shreyas S Joshi
- Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Atlanta, Georgia, USA
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40
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Xia Y, Yu W, Cheng F, Rao T, Ruan Y, Yuan R, Ning J, Zhou X, Lin F, Zheng D. Photobiomodulation With Blue Laser Inhibits Bladder Cancer Progression. Front Oncol 2021; 11:701122. [PMID: 34733776 PMCID: PMC8558536 DOI: 10.3389/fonc.2021.701122] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/30/2021] [Indexed: 01/22/2023] Open
Abstract
Blue lasers are becoming more widely used in the diagnosis and treatment of bladder cancer; however, their photobiomodulation effects on bladder cancer cells remains unclear. The purpose of the current study was to explore the photobiomodulation effect of blue laser irradiation on bladder cancer progression and the associated mechanisms. The human uroepithelial cell line SV-HUC-1 and human bladder cancer cell lines T24 and EJ were exposed to blue laser irradiation (450 nm) at various energy densities, and cell proliferation, migration, invasion, epithelial-mesenchymal transition (EMT), and the levels of the proteins associated with the MAPK pathway proteins were determined. A significant decrease in cell viability was observed in a density-dependent manner after blue laser irradiation at > 4 J/cm2 in both bladder cancer cell lines. However, the blue laser did not reduce cell viability in SV-HUC-1 cells until the energy density exceeded 16 J/cm2. Meanwhile, Ki67 levels, reflecting cell proliferation and senescence, were also significantly decreased after blue laser irradiation at 4 J/cm2 and 8 J/cm2 in the absence of cell cycle arrest. Moreover, blue laser irradiation at 4 J/cm2 and 8 J/cm2 caused a reduction in cell migration and invasion and also reduced the expression levels of MMP-2, MMP-9, Snail, N-cadherin, phospho-MEK and phospho-ERK, and elevated the expression levels of E-cadherin. Meanwhile ERK activator(tBHQ) significantly reversed the irradiation-induced suppression of proliferation, migration and invasion in T24 and EJ cell lines. The present study showed that blue laser irradiation inhibited bladder cancer proliferation in a density-dependent manner and inhibited bladder cancer progression by suppressing migration, invasion, and the EMT process in T24 and EJ cell lines. This inhibition was possibly mediated via suppression of the MAPK/MEK/ERK pathway. Thus, the use of a low-energy blue laser in the diagnosis and treatment of bladder cancer is possibly safe and may have an anti-tumor effect.
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Affiliation(s)
- Yuqi Xia
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Weimin Yu
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Fan Cheng
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ting Rao
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yuan Ruan
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Run Yuan
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jinzhuo Ning
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiangjun Zhou
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Fangyou Lin
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Di Zheng
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
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Pandit AA, Bhandari NR, Khalil MI, Kamel MH, Davis R, Payakachat N. Evaluating health-related quality of life as a prognostic tool for overall survival in routine cancer care for older patients with bladder cancer: A US based study. Urol Oncol 2021; 40:11.e1-11.e8. [PMID: 34716080 DOI: 10.1016/j.urolonc.2021.09.012] [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: 01/28/2021] [Revised: 09/07/2021] [Accepted: 09/23/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Health-related quality of life (HRQoL) outcomes, in addition to being useful for monitoring a person's health and well-being, may also predict overall survival (OS) in cancer patients. This study's objective was to examine the association of longitudinally assessed HRQoL and OS in patients with a history of bladder cancer (BC). MATERIALS AND METHODS This longitudinal retrospective cohort study used the 1998 to 2013 Surveillance, Epidemiology and End Results database linked with Medicare Health Outcomes Survey. Study cohort included patients having HRQoL assessments both pre- and post-BC diagnosis using Short Form-36/Veterans Rand-12. Using Cox Proportional Hazards adjusted for demographics, tumor characteristics, and surgery type, we studied the associations of 3-point difference in HRQoL assessed pre- and post-BC diagnosis and change from pre-to-post diagnosis with overall survival. RESULTS The study cohort included 438 BC patients with deceased patients (n = 222; 50.7%) being significantly older than those alive (77.2 vs. 75.4 years; P = 0.004). Adjusting for covariates, a 3-point difference in physical HRQoL (physical component summary [PCS]) pre-, post-, and pre-to-post BC diagnosis was associated with respectively 6.1%, 8.7%, and 7.3% (P < 0.01 for all) decreased risk of death for higher PCS. Similarly, a 3-point difference in mental HRQoL (mental component summary [MCS]) post-BC diagnosis was associated with 4.5% (P < 0.05) decreased risk of death for higher MCS. CONCLUSIONS Associations between PCS/MCS and OS imply that elderly BC patients with better physical/mental health are more likely to survive longer. Monitoring HRQoL in routine cancer care would facilitate early detection of HRQoL decline and enable timely intervention by clinicians to improve OS.
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Affiliation(s)
- Ambrish A Pandit
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR
| | - Naleen Raj Bhandari
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR
| | | | - Mohamed H Kamel
- Department of Urology, UAMS, Little Rock, AR; Department of Urology, Ain Shams University, Cairo 11566, Egypt
| | | | - Nalin Payakachat
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR.
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Arthuso FZ, Fairey AS, Boulé NG, Courneya KS. Bladder cancer and exeRcise trAining during intraVesical thErapy-the BRAVE trial: a study protocol for a prospective, single-centre, phase II randomised controlled trial. BMJ Open 2021; 11:e055782. [PMID: 34561265 PMCID: PMC8475156 DOI: 10.1136/bmjopen-2021-055782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Non-muscle invasive bladder cancer (NMIBC) accounts for about 75% of newly diagnosed bladder cancers. The treatment for NMIBC involves surgical removal of the tumour followed by 6 weekly instillations of immunotherapy or chemotherapy directly into the bladder (ie, intravesical therapy). NMIBC has a high rate of recurrence (31%-78%) and progression (15%). Moreover, bladder cancer and its treatment may affect patient functioning and quality of life. Exercise is a safe and effective intervention for many patient with cancer groups, however, no studies have examined exercise during intravesical therapy for NMIBC. The primary objective of the Bladder cancer and exeRcise trAining during intraVesical thErapy (BRAVE) trial is to examine the safety and feasibility of an exercise intervention in patients with bladder cancer undergoing intravesical therapy. The secondary objectives are to investigate the preliminary efficacy of exercise on health-related fitness and patient-reported outcomes; examine the social cognitive predictors of exercise adherence; and explore the potential effects of exercise on tumour recurrence and progression. METHODS AND ANALYSIS BRAVE is a phase II randomised controlled trial that aims to include 66 patients with NMIBC scheduled to receive intravesical therapy. Participants will be randomly assigned to the exercise intervention or usual care. The intervention consists of three supervised, high-intensity interval training sessions per week for 12 weeks. Feasibility will be evaluated by eligibility, recruitment, adherence and attrition rates. Preliminary efficacy will focus on changes in cardiorespiratory fitness and patient-reported outcomes from baseline (prior to intravesical therapy) to pre-cystoscopy (3 months). Cancer outcomes will be tracked at 3 months, and 1-year follow-up by cystoscopy. Analysis of covariance will compare between-group differences at post-intervention (pre-cystoscopy) for all health-related fitness and patient-reported outcomes. ETHICS AND DISSEMINATION The study was approved by the Health Research Ethics Board of Alberta-Cancer Committee (#20-0184). Dissemination will include publication and presentations at scientific conferences and public channels. TRIAL REGISTRATION NUMBER NCT04593862; Pre-results.
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Affiliation(s)
- Fernanda Z Arthuso
- Faculty of Kinesiology, Sport, and Recreation, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Adrian S Fairey
- Division of Urology, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Normand G Boulé
- Faculty of Kinesiology, Sport, and Recreation, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
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43
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Vaioulis A, Bonotis K, Perivoliotis K, Kiouvrekis Y, Gravas S, Tzortzis V, Karatzas A. Quality of Life and Anxiety in Patients with First Diagnosed Non-Muscle Invasive Bladder Cancer Who Receive Adjuvant Bladder Therapy. Bladder Cancer 2021; 7:297-306. [PMID: 38993613 PMCID: PMC11181705 DOI: 10.3233/blc-201524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 05/15/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Bladder cancer (BC) is one of the most common malignancies (4.5%of all newly diagnosed cases worldwide). Most of the new BC cases are diagnosed as non-muscle invasive BC (NMIBC), needing continuous follow up after primary endoscopic therapy. Adjuvant bladder therapy with chemo- or immuno- agents, apart from the initial diagnosis, the strict surveillance program and the risk of recurrence, may have a major impact on the patients' physical and mental health. OBJECTIVE We evaluated anxiety and quality of life (QoL) in patients who underwent surgery for NMIBC and followed a bladder instillation programme. METHODS This is a prospective analysis of patients with histopathologically confirmed NMIBCs. Eligible were all adult patients with a single or multiple NMIBCs who underwent a transurethral tumor resection and followed a therapy with either BCG or Epirubicin instillations. The SF-36 questionnaire Physical and Mental health aspects were used for QoL assessment. Similarly, the STAI-Y was introduced for the state (STAI-Y1) and trait anxiety (STAI-Y2) evaluation. RESULTS 117 eligible patients were screened, with 108 entering finally the study; 9 patients were excluded due to disease recurrence. 17 patients (15.7%) received Epirubicin (Ta-T1, Low Grade tumors), whereas 91 patients (84.3%) received BCG (T1, High Grade). Regarding SF-36 Physical a 6 months decrease was followed by an improvement at 12 months (p = 0.008). Similarly, an increase of the SF-36 Mental health score was identified (p = 0.03). In contrast to STAI-Y2 scores (p = 0.945), a long-term reduction of the state anxiety was identified (p = 0.001). Preoperative SF-36 Physical was inversely correlated with age (p = 0.029), while absence of alcohol was associated with lower mental health (p = 0.003). Overall, patient characteristics, habits and the administered treatment did not affect the postoperative QoL and anxiety. CONCLUSION Patient QoL and anxiety improved during follow up. Still, further larger scale studies are required to support our findings.
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Affiliation(s)
- Alexandros Vaioulis
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Konstantinos Bonotis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Konstantinos Perivoliotis
- Department of Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Yiannis Kiouvrekis
- Department of Public and Integrated Health, University of Thessaly, Karditsa, Greece
- Business School, University of Nicosia, Nicosia, Cyprus
| | - Stavros Gravas
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Vasilios Tzortzis
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Anastasios Karatzas
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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44
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Verma M, Paik JM, Younossi I, Tan D, Abdelaal H, Younossi ZM. The impact of hepatocellular carcinoma diagnosis on patients' health-related quality of life. Cancer Med 2021; 10:6273-6281. [PMID: 34405568 PMCID: PMC8446553 DOI: 10.1002/cam4.4166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/10/2021] [Accepted: 07/15/2021] [Indexed: 12/11/2022] Open
Abstract
Background Patients with hepatocellular cancer (HCC) are known to have worse health‐related quality of life (HRQL) than the general population. However, the change in HRQL from before the diagnosis to after diagnosis remains unknown and is difficult to estimate. We aimed to compare HCC cases with matched controls to evaluate the differences in change in HRQL from before to after HCC diagnosis. Methods We performed propensity score‐matched analysis using the self‐reported HRQL data from the Surveillance, Epidemiology, and End Results registries (SEER) data linked with Medicare Health Outcomes Survey (MHOS) data (1998–2014). Cases were selected as Medicare beneficiaries (aged ≥65 years) who were diagnosed with HCC between their baseline assessment and follow‐up assessment. Matched controls were selected from the same data resource and the same time period to include subjects without cancer diagnosis by propensity scores. HRQL was assessed using the Medical Outcomes Study Short Form‐36 (SF‐36). Results The study included 62 subjects who developed HCC and 365 matched controls. Compared to their baseline HRQL scores, after diagnosis of HCC, subjects were more likely to report declines in scores related to the mental component of HRQL. When stratified by time since diagnosis, mental component remained significantly lower as the disease advanced. In contrast, only general health aspects of physical health worsened after HCC diagnosis. Conclusions Diagnosis of HCC has a profound negative impact on patients’ HRQL. Mental health component deteriorated significantly over time. The need of including mental health services within a multidisciplinary HCC care model is clearly evident.
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Affiliation(s)
- Manisha Verma
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia, USA.,Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, Virginia, USA.,Inova Medicine, Inova Health System, Falls Church, Virginia, USA
| | - James M Paik
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia, USA.,Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, Virginia, USA
| | - Issah Younossi
- Center for Outcomes Research in Liver Diseases, Washington DC, USA
| | - Daisong Tan
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia, USA.,Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, Virginia, USA
| | - Hala Abdelaal
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia, USA.,Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, Virginia, USA
| | - Zobair M Younossi
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia, USA.,Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, Virginia, USA.,Inova Medicine, Inova Health System, Falls Church, Virginia, USA.,Center for Outcomes Research in Liver Diseases, Washington DC, USA
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45
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Qian Z, Ding W, Zhou Q, Sun C, Xu K. Depression Induced by CUMS Leads to Bladder Cancer Development and Local Tumor Immunosuppression in Mice. JOURNAL OF ONCOLOGY 2021; 2021:5537523. [PMID: 34422050 PMCID: PMC8376449 DOI: 10.1155/2021/5537523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 07/04/2021] [Accepted: 08/04/2021] [Indexed: 01/07/2023]
Abstract
Depression is a common mental disease in bladder cancer patients, leading to a loss of happiness, an increase in the suicide rate, and higher mortality. However, the influence of depression on bladder tumor tissue remains unknown. In this current study, a subcutaneous bladder cancer xenograft model was established on male C57 mice with mouse bladder cell line MB49. Chronic unpredictable mild stress (CUMS) was established to simulate depression in bladder cancer patients. The depression caused by CUMS was confirmed by testing sucrose preference and plasma cortisol and adrenocorticotropic hormone (ACTH) levels. Then, we measured and weighed tumors to demonstrate the promotion of tumor growth by CUMS. Immune-related cells and molecules were examined to reveal the mechanism. There is a significant decrease of CD8+/CD4+T cells ratio, NK cells, IL-2, and IFN-γ and a significant increase of T regs, IL-6, IL-1β, TNF-α, IL-10, and PGE2 in CUMS group, indicating the inhibition of immunity in the tumor microenvironment. Our results supported the perspective that depression exacerbated bladder cancer and revealed a possible mechanism. We suggest attaching importance to the psychological health of bladder cancer patients to prevent a worse prognosis induced by depression.
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Affiliation(s)
- Zhiyu Qian
- Department of Urology, Huashan Hospital Fudan University, Shanghai, China
| | - Weihong Ding
- Department of Urology, Huashan Hospital Fudan University, Shanghai, China
| | - Qidong Zhou
- Department of Urology, Huashan Hospital Fudan University, Shanghai, China
| | - Chuanyu Sun
- Department of Urology, Huashan Hospital Fudan University, Shanghai, China
| | - Ke Xu
- Department of Urology, Huashan Hospital Fudan University, Shanghai, China
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Cao B, Li Q, Xu P, Chen W, Hu X, Dai C, Shan Y, Ding Y, Mao W, Liu K, Wu PY, Sun W, Rao S, Zeng M, Jiang S, Zhou J. Preliminary Exploration of the Application of Vesical Imaging-Reporting and Data System (VI-RADS) in Post-treatment Patients With Bladder Cancer: A Prospective Single-Center Study. J Magn Reson Imaging 2021; 55:275-286. [PMID: 34184337 DOI: 10.1002/jmri.27807] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Vesical Imaging-Reporting and Data System (VI-RADS) has been shown to be effective in diagnosing muscle invasion of bladder cancer (BC) in primary patients. PURPOSE To evaluate the diagnostic efficacy of VI-RADS in a BC target population which included post-treatment patients, and to determine the repeatability. STUDY TYPE Prospective. POPULATION Seventy-three patients (42 with primary BC, 31 with post-treatment BC). FIELD STRENGTH/SEQUENCE 3.0 T MRI with propeller fast spin-echo T2 WI, echo planer imaging diffusion-weighted imaging (DWI), and dynamic contrast-enhanced imaging (DCEI). ASSESSMENT VI-RADS scores were independently assessed by five radiologists with different levels of experience. The diagnostic efficiency in each group (primary and post-treatment) and of each radiologist was assessed. STATISTICAL TESTS Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), and area under the curve (AUC) in receiver operating characteristic curve analysis were calculated to evaluate VI-RADS diagnostic performance. Interobserver agreement was assessed using weighted Kappa statistics. A P value <0.05 was considered statistically significant. RESULTS At the corresponding cut-off, AUC values of three groups range from 0.936 to 0.947 and AUC values of five observers range from 0.901 to 0.963. There was no significant difference between the AUCs in the primary and post-treatment groups (P = 0.870). The cut-off of the whole group and the post-treatment group was ≥4, and the cut-off of the primary group was ≥3. The Kappa values of interobserver agreements range from 0.709 to 0.923. CONCLUSIONS After expanding the target population to include post-treatment patients, VI-RADS still has good diagnostic efficacy and repeatability. VI-RADS could potentially be a preoperative staging tool for post-treatment patients. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Bohong Cao
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qing Li
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Peirong Xu
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Weijie Chen
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaoyi Hu
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chenchen Dai
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yingchan Shan
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuqin Ding
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wei Mao
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Kai Liu
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Pu-Yeh Wu
- GE Healthcare, MR Research China, Beijing, China
| | - Weiling Sun
- Faculty of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shengxiang Rao
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shuai Jiang
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China.,Department of Urology, Zhongshan Hospital Wusong Branch, Fudan University, Shanghai, China
| | - Jianjun Zhou
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
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Religioni U, Czerw A, Deptala A. Assessment of Pain, Acceptance of Illness, Adaptation to Life, and Strategies of Coping With the Disease, in Patients With Bladder Cancer. In Vivo 2021; 35:1157-1161. [PMID: 33622915 DOI: 10.21873/invivo.12363] [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: 12/01/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Bladder cancer is one of the most common cancers and causes of mortality in Poland, significantly reducing the quality of life. The objective of the study was to evaluate the strategy of coping with the disease in patients suffering from bladder cancer. PATIENTS AND METHODS Four psychometric tests were used: the beliefs about pain control questionnaire (BPCQ), the pain coping strategies questionnaire (CSQ), acceptance of illness scale (AIS), and mental adjustment to cancer (Mini-Mac) test. RESULTS Patients suffering from bladder cancer assign the greatest role in controlling pain to the influence of physicians. The most frequently chosen strategy for coping with the disease was declaring coping. The average level of acceptance of the disease among patients was mean=27.25. The most often indicated manner of coping was fighting spirit. CONCLUSION Patients with bladder cancer are characterized by a constructive attitude towards the disease.
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Affiliation(s)
- Urszula Religioni
- Collegium of Business Administration, Warsaw School of Economics, Warsaw, Poland;
| | - Aleksandra Czerw
- Department of Health Economics and Medical Law, Medical University of Warsaw, Warsaw, Poland.,Department of Economic and System Analyses, National Institute of Public Health - NIH, Warsaw, Poland
| | - Andrzej Deptala
- Division of Cancer Prevention, Medical University of Warsaw, Warsaw, Poland
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Veskimae E, Subbarayan S, Campi R, Carron D, Omar MI, Yuan C, Dimitropoulos K, Van Hemelrijck M, Bryan RT, N'Dow J, Babjuk M, Alfred Witjes J, Sylvester R, MacLennan S. A Systematic Review of Outcome Reporting, Definition and Measurement Heterogeneity in Non-Muscle Invasive Bladder Cancer Effectiveness Trials of Adjuvant, Prophylactic Treatment After Transurethral Resection. Bladder Cancer 2021; 7:221-241. [PMID: 38994538 PMCID: PMC11181687 DOI: 10.3233/blc-201510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 02/28/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Heterogenous outcome reporting in non-muscle-invasive bladder cancer (NMIBC) effectiveness trials of adjuvant treatment after transurethral resection (TURBT) has been noted in systematic reviews (SRs). This hinders comparing results across trials, combining them in meta-analyses, and evidence-based decision-making for patients and clinicians. OBJECTIVE We aimed to systematically review the extent of reporting and definition heterogeneity. METHODS We included randomized controlled trials (RCTs) identified from SRs comparing adjuvant treatments after TURBT or TURBT alone in patients with NMIBC (with or without carcinoma in situ) published between 2000-2020. Abstracts and full texts were screened independently by two reviewers. Data were extracted by one reviewer and checked by another. RESULTS We screened 807 abstracts; from 15 SRs, 57 RCTs were included. Verbatim outcome names were coded to standard outcome names and organised using the Williamson and Clarke taxonomy. Recurrence (98%), progression (74%), treatment response (in CIS studies) (40%), and adverse events (77%) were frequently reported across studies. However, overall (33%) and cancer-specific (33%) survival, treatment completion (17%) and treatment change (37%) were less often reported. Quality of Life (3%) and economic outcomes (2%) were rarely reported. Heterogeneity was evident throughout, particularly in the definitions of progression and recurrence, and how CIS patients were handled in the analysis of studies with predominantly papillary patients, highlighting further issues with the definition of recurrence and progression vs treatment response for CIS patients. Data reporting was also inconsistent, with some trials reporting event rates at various time-points and others reporting time-to-event with or without Hazard Ratios. Adverse events were inconsistently reported. QoL data was absent in most trials. CONCLUSIONS Heterogenous outcome reporting is evident in NMIBC effectiveness trials. This has profound implications for meta-analyses, SRs and evidence-based treatment decisions. A core outcome set is required to reduce heterogeneity. PATIENT SUMMARY This systematic review found inconsistencies in outcome definitions and reporting, pointing out the urgent need for a core outcome set to help improve evidence-based treatment decisions.
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Affiliation(s)
- Erik Veskimae
- Department of Urology, Tampere University Hospital, Tampere, Finland
| | | | - Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | | | - Cathy Yuan
- Division of Gastroenterology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Konstantinos Dimitropoulos
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
- Department of Urology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK
| | - Mieke Van Hemelrijck
- King's College London, Faculty of Life Sciences and Medicine, Translational and Oncology Research (TOUR), London, UK
| | - Richard T Bryan
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | - James N'Dow
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
- Department of Urology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK
| | - Marek Babjuk
- Department of Urology, 2nd Faculty of Medicine, Hospital Motol, Charles University, Prague, Czech Republic
| | - J Alfred Witjes
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
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Fu Y, Sun S, Bi J, Kong C, Yin L. Construction and analysis of a ceRNA network and patterns of immune infiltration in bladder cancer. Transl Androl Urol 2021; 10:1939-1955. [PMID: 34159075 PMCID: PMC8185653 DOI: 10.21037/tau-20-1250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Bladder cancer (BC) is the ninth most common malignant tumor, accounting for an estimate of 549,000 new BC cases and 200,000 BC-related deaths worldwide in 2018. The prognosis of BC has not substantially improved despite significant advances in the diagnosis and treatment of the disease. Methods The RNA sequencing (RNA-seq) data and clinical information of BC patients were downloaded from The Cancer Genome Atlas (TCGA) database. The Cell-type Identification By Estimating Relative Subsets Of RNA Transcripts (CIBERSORT) algorithm was used to assess immune infiltration. The survival analyses were performed using the selected components of a ceRNA network and selected immune cell types by least absolute shrinkage and selection operator (LASSO) Cox regression to calculate the risk score. The accuracy of prognosis prediction was determined by receiver operating characteristic (ROC) curves, survival curves, and nomograms. Finally, the correlation analysis was performed to investigate the relationships between the signature components of the ceRNA network and the immune cell signature. Results Two completed survival analyses included selected components of the ceRNA network (ELN, SREBF1, DSC2, TTLL7, DIP2C, SATB1, hsa-miR-20a-5p, and hsa-miR-29c-3p) and selected immune cell types (M0 macrophages, M2 macrophages, resting mast cells, and neutrophils). ROC curves, survival curves (all P values <0.05), nomograms, and calibration curves indicated that the accuracy of the two survival analyses was acceptable. Moreover, the correlations between TTLL7 and resting mast cells (R=0.24, P<0.001), DSC2 and resting mast cells (R=−0.23, P<0.001), ELN and resting mast cells (R=0.44, P<0.001), and hsa-miR-29c-3p and M0 macrophages (R=−0.29, P<0.001) were significant, indicating that interactions of these factors may play significant roles in the prognosis of BC. Conclusions TTLL7, DSC2, ELN, hsa-miR-29c-3p, resting mast cells, and M0 macrophages may play an important role in the development of BC. However, additional studies are needed to confirm this hypothesis.
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Affiliation(s)
- Yang Fu
- Department of Urology, The First Hospital of China Medical University, Shenyang, China
| | - Shanshan Sun
- Department of Pharmacy, The First Hospital of China Medical University, Shenyang, China
| | - Jianbin Bi
- Department of Urology, The First Hospital of China Medical University, Shenyang, China
| | - Chuize Kong
- Department of Urology, The First Hospital of China Medical University, Shenyang, China
| | - Lei Yin
- Department of Urology, The First Hospital of China Medical University, Shenyang, China
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Real World Outcomes of Patients with Bladder Cancer: Effectiveness Versus Efficacy of Modern Treatment Paradigms. Hematol Oncol Clin North Am 2021; 35:597-612. [PMID: 33958153 DOI: 10.1016/j.hoc.2021.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Bladder cancer remains a common and insidious disease in the United States. There have been several advances in the understanding of the biology of bladder cancer, novel diagnostic tools, improvements in multidisciplinary care pathways, and new therapeutics for advanced disease over the past few decades. Clinical trials have demonstrated efficacy for new treatments in each disease state, but additional work is needed to advance the effectiveness of bladder cancer care. Real world data provide critical information regarding patterns of care, adverse events, and outcomes helping to bridge the efficacy versus effectiveness gap.
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