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Zheng F, Du Y, Yuan Y, Wang Z, Li S, Xiong S, Zeng J, Tan Y, Liu X, Xu S, Fu B, Liu W. Risk analysis of enfortumab vedotin: A real-world approach based on the FAERS database. Heliyon 2024; 10:e37544. [PMID: 39309793 PMCID: PMC11415710 DOI: 10.1016/j.heliyon.2024.e37544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 09/02/2024] [Accepted: 09/04/2024] [Indexed: 09/25/2024] Open
Abstract
Purpose To analyze the risk of enfortumab vedotin (EV), a targeted therapy for advanced bladder cancer, using real-world data from the U.S. Food and Drug Administration's Federal Adverse Event Reporting System (FAERS). Methods A retrospective pharmacovigilance analysis was conducted using FAERS data from Q1 2020 to Q1 2024. Adverse drug events (ADEs) related to EV were identified and categorized according to the System Organ Classes (SOCs) and specific events. Statistical methods, such as the proportional reporting ratio, reporting odds ratio (ROR), Bayesian confidence propagation neural network, and empirical Bayesian geometric mean were used to detect safety signals. Results Of the 7,449,181 FAERS case reports, 1,617 EV-related ADEs were identified, including 101 preferred terms and 22 SOCs. The key SOCs included skin and subcutaneous tissue, metabolic, and nutritional disorders. Rare ADEs, such as lichenoid keratosis (n = 4; ROR 26.89), small intestinal perforation (n = 3; ROR 24.51), pigmentation disorder (n = 9; ROR 18.16), and cholangitis (n = 8; ROR 17.48), showed significant disproportionality. Conclusion While most findings aligned with the existing data, new signs such as lichenoid keratosis and small intestinal perforation were identified. Further studies are necessary to validate these findings and emphasize the need for the clinical monitoring of EV-related ADEs.
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Affiliation(s)
- Fuchun Zheng
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, China
- Key Laboratory of Urinary System Diseases of Jiangxi Province, Nanchang, China
| | - Yuanzhuo Du
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, China
- Key Laboratory of Urinary System Diseases of Jiangxi Province, Nanchang, China
| | - Yuyang Yuan
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, China
- Key Laboratory of Urinary System Diseases of Jiangxi Province, Nanchang, China
| | - Zhipeng Wang
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, China
- Key Laboratory of Urinary System Diseases of Jiangxi Province, Nanchang, China
| | - Sheng Li
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, China
- Key Laboratory of Urinary System Diseases of Jiangxi Province, Nanchang, China
| | - Situ Xiong
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, China
- Key Laboratory of Urinary System Diseases of Jiangxi Province, Nanchang, China
| | - Jin Zeng
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, China
- Key Laboratory of Urinary System Diseases of Jiangxi Province, Nanchang, China
| | - Yifan Tan
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, China
- Key Laboratory of Urinary System Diseases of Jiangxi Province, Nanchang, China
| | - Xiaoqiang Liu
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, China
- Key Laboratory of Urinary System Diseases of Jiangxi Province, Nanchang, China
| | - Songhui Xu
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, China
- Key Laboratory of Urinary System Diseases of Jiangxi Province, Nanchang, China
| | - Bin Fu
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, China
- Key Laboratory of Urinary System Diseases of Jiangxi Province, Nanchang, China
| | - Wei Liu
- Department of Urology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, China
- Key Laboratory of Urinary System Diseases of Jiangxi Province, Nanchang, China
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Liu K, Nicoletti R, Zhao H, Chen X, Wu H, Leung CH, D'Andrea D, Laukhtina E, Soria F, Gallioli A, Wroclawski ML, Castellani D, Gauhar V, Rivas JG, Enikeev D, Gontero P, Shariat SF, Chiu PKF, Ng CF, Teoh JYC. Young age and adequate BCG are key factors for optimal BCG treatment efficacy in non-muscle-invasive bladder cancer. World J Urol 2024; 42:547. [PMID: 39331198 DOI: 10.1007/s00345-024-05218-4] [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: 06/27/2024] [Accepted: 08/12/2024] [Indexed: 09/28/2024] Open
Abstract
OBJECTIVE To investigate the impact of ageing on survival outcomes in Bacillus Calmette-Guérin (BCG) treated non-muscle invasive bladder cancer (NMIBC) patients and its synergy with adequate BCG treatment. METHOD Patients with NMIBC who received BCG treatment from 2001 to 2020 were divided into group 1 (< = 70 years) and group 2 (> 70 years). Overall Survival (OS), Cancer-Specific Survival (CSS), Recurrence-Free Survival (RFS), and Progression-Free Survival (PFS) were analyzed using the Kaplan-Meier method. Multivariable Cox regression analysis was used to adjust potential confounding factors and to estimate Hazard Ratio (HR) and 95% Confidence Interval (CI). Subgroup analysis was performed according to adequate versus inadequate BCG treatment. RESULTS Overall, 2602 NMIBC patients were included: 1051 (40.4%) and 1551 (59.6%) in groups 1 and 2, respectively. At median follow-up of 11.0 years, group 1 (< = 70 years) was associated with better OS, CSS, and RFS, but not PFS as compared to group 2 (> 70 years). At subgroup analysis, patients in group 1 treated with adequate BCG showed better OS, CSS, RFS, and PFS as compared with inadequate BCG treatment in group 2, while patients in group 2 receiving adequate BCG treatment had 41% less progression than those treated with inadequate BCG from the same group. CONCLUSIONS Being younger (< = 70 years) was associated with better OS, CSS, and RFS, but not PFS. Older patients (> 70 years) who received adequate BCG treatment had similar PFS as those younger with adequate BCG treatment.
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Affiliation(s)
- Kang Liu
- S. H. Ho Urology Centre, Faculty of Medicine, Department of Surgery, The Chinese University of Hong Kong, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong
| | - Rossella Nicoletti
- S. H. Ho Urology Centre, Faculty of Medicine, Department of Surgery, The Chinese University of Hong Kong, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong
- Department of Experimental and Clinical Biomedical Science, University of Florence, Florence, Italy
| | - Hongda Zhao
- S. H. Ho Urology Centre, Faculty of Medicine, Department of Surgery, The Chinese University of Hong Kong, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong
| | - Xuan Chen
- S. H. Ho Urology Centre, Faculty of Medicine, Department of Surgery, The Chinese University of Hong Kong, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong
| | - Hongwei Wu
- S. H. Ho Urology Centre, Faculty of Medicine, Department of Surgery, The Chinese University of Hong Kong, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong
| | - Chi-Ho Leung
- S. H. Ho Urology Centre, Faculty of Medicine, Department of Surgery, The Chinese University of Hong Kong, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong
| | - David D'Andrea
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Urothelial Cancer Working Group, European Association of Urology-Young Academic Urologists (EAU-YAU), Amsterdam, Netherlands
| | - Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Francesco Soria
- Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, 10024, Turin, Italy
| | - Andrea Gallioli
- Urothelial Cancer Working Group, European Association of Urology-Young Academic Urologists (EAU-YAU), Amsterdam, Netherlands
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Marcelo Langer Wroclawski
- Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Department of Urology, Hospital Beneficencia Portuguesa de Sao Paulo, São Paulo, Brazil
- Department of Urology, Faculdade de Medicina Do ABC, Santo André, Brazil
| | - Daniele Castellani
- Urology Unit, Azienda Ospedaliero-Universitaria Delle Marche, Università Politecnica Delle Marche, Ancona, Italy
| | - Vineet Gauhar
- Department of Urology, Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore
| | - Juan Gomez Rivas
- Department of Urology, Clinico San Carlos University Hospital, Madrid, Spain
| | - Dmitry Enikeev
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
- Division of Urology, Rabin Medical Center, Petah Tikva, Israel
| | - Paolo Gontero
- Department of Urology, Città Della Salute E Della Scienza, University of Torino School of Medicine, Turin, Italy
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- 2nd Faculty of Medicine, Hospital Motol, Department of Urology, Charles University, Prague, Czech Republic
- Department of Urology, Weill Cornell Medical College, New York, NY, USA
- Department of Urology, University of Texas Southwestern, Dallas, TX, USA
- Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada
- Research Center for Evidence-Based Medicine, Iranian EBM Center: A Joanna Briggs Institute Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Peter Ka-Fung Chiu
- S. H. Ho Urology Centre, Faculty of Medicine, Department of Surgery, The Chinese University of Hong Kong, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong
| | - Chi-Fai Ng
- S. H. Ho Urology Centre, Faculty of Medicine, Department of Surgery, The Chinese University of Hong Kong, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong.
| | - Jeremy Yuen-Chun Teoh
- S. H. Ho Urology Centre, Faculty of Medicine, Department of Surgery, The Chinese University of Hong Kong, 4/F LCW Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong.
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
- Urothelial Cancer Working Group, European Association of Urology-Young Academic Urologists (EAU-YAU), Amsterdam, Netherlands.
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Meguro S, Johmura Y, Wang TW, Kawakami S, Tanimoto S, Omori S, Okamura YT, Hoshi S, Kayama E, Yamaguchi K, Hatakeyama S, Yamazaki S, Shimizu E, Imoto S, Furukawa Y, Kojima Y, Nakanishi M. Preexisting senescent fibroblasts in the aged bladder create a tumor-permissive niche through CXCL12 secretion. NATURE AGING 2024:10.1038/s43587-024-00704-1. [PMID: 39251867 DOI: 10.1038/s43587-024-00704-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/08/2024] [Indexed: 09/11/2024]
Abstract
Aging is a major risk factor for cancer, but the precise mechanism by which aging promotes carcinogenesis remains largely unknown. Here, using genetically modified mouse models, we show that p16high senescent (p16h-sn) fibroblasts accumulate with age, constitute inflammatory cancer-associated fibroblasts (CAFs) and promote tumor growth in bladder cancer models. Single-cell RNA sequencing of fibroblasts from aged mice revealed higher expression of the C-X-C motif chemokine 12 gene (Cxcl12) in p16h-sn fibroblasts than in p16low fibroblasts. Elimination of p16h-sn cells or inhibition of CXCL12 signaling notebly suppressed bladder tumor growth in vivo. We identified high expression levels of SMOC2, GUCY1A1 (GUCY1A3), CXCL12, CRISPLD2, GAS1 and LUM as a signature of p16h-sn CAFs in humans and mice, which was associated with age and poor prognosis in patients with advanced and nonadvanced bladder cancer. Here we show that p16h-sn fibroblasts in the aged bladder create a cancer-permissive niche and promote tumor growth by secreting CXCL12.
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Affiliation(s)
- Satoru Meguro
- Division of Cancer Cell Biology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshikazu Johmura
- Division of Cancer Cell Biology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
- Division of Cancer and Senescence Biology, Cancer Research Institute, Institute for Frontier Science Initiative, Kanazawa University, Kanazawa, Japan.
| | - Teh-Wei Wang
- Division of Cancer Cell Biology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Satoshi Kawakami
- Division of Cancer Cell Biology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Shota Tanimoto
- Division of Cancer Cell Biology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Satotaka Omori
- Division of Cancer Cell Biology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
- Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Yuki T Okamura
- Division of Cancer Cell Biology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Seiji Hoshi
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Emina Kayama
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kiyoshi Yamaguchi
- Division of Clinical Genome Research, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Seira Hatakeyama
- Division of Clinical Genome Research, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Satoshi Yamazaki
- Division of Stem Cell Biology, Center for Stem Cell Biology and Regenerative Medicine, Institute of Medical Science, University of Tokyo, Tokyo, Japan
- Laboratory of Stem Cell Therapy, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Eigo Shimizu
- Division of Health Medical Intelligence, Human Genome Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Seiya Imoto
- Division of Health Medical Intelligence, Human Genome Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Yoichi Furukawa
- Division of Clinical Genome Research, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Yoshiyuki Kojima
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan.
| | - Makoto Nakanishi
- Division of Cancer Cell Biology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
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Luo LS, Luan HH, Zhang P, Jiang JF, Zeng XT, Huang J, Jin YH. The disease burden of bladder cancer and its attributable risk factors in five Eastern Asian countries, 1990-2019: a population-based comparative study. BMC Public Health 2024; 24:2404. [PMID: 39232688 PMCID: PMC11373407 DOI: 10.1186/s12889-024-19909-5] [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: 10/25/2023] [Accepted: 08/27/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUNDS The study aimed to estimate bladder cancer burden and its attributable risk factors in China, Japan, South Korea, North Korea and Mongolia from 1990 to 2019, to discuss the potential causes of the disparities. METHODS Data were obtained from the Global Burden of Disease Study 2019. The annual percent change (APC) and average annual percent change (AAPC) were calculated by Joinpoint analysis, and the independent age, period and cohort effects were estimated by age-period-cohort analysis. RESULTS In 2019, the highest incidence (7.70 per 100,000) and prevalence (51.09 per 100,000) rates of bladder cancer were in Japan, while the highest mortality (2.31 per 100,000) and DALY rates (41.88 per 100,000) were in South Korea and China, respectively. From 1990 to 2019, the age-standardized incidence and prevalence rates increased in China, Japan and South Korea (AAPC > 0) and decreased in Mongolia (AAPC < 0), while mortality and DALY rates decreased in all five countries (AAPC < 0). Age effects showed increasing trends for incidence, mortality and DALY rates, while the prevalence rates increased first and then decreased in older groups. The cohort effects showed downward trends from 1914-1918 to 2004-2008. Smoking was the greatest contributor and males had the higher burden than females. CONCLUSION Bladder cancer was still a major public health problem in East Asia. Male and older population suffered from higher risk, and smoking played an important role. It is recommended that more efficient preventions and interventions should be operated among high-risk populations, thereby reduce bladder cancer burden in East Asia.
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Affiliation(s)
- Li-Sha Luo
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Hang-Hang Luan
- Department of Forensic Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Ping Zhang
- Department of Urology, Yichang Central People's Hospital, China Three Gorges University, 443003, Yichang, China
| | - Jun-Feng Jiang
- School of Sociology, Central China Normal University, No.152 Luoyu Road, 430079, Wuhan, China
| | - Xian-Tao Zeng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Jiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, China.
| | - Ying-Hui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, China.
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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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6
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Wu K, Liu X, Tang Y, Wang X, Li X. Clinicopathologic characteristics and outcomes of prostate cancer incidentally discovered at the time of radical cystoprostatectomy: a population-based cohort study. Int J Surg 2024; 110:4023-4030. [PMID: 38537072 PMCID: PMC11254266 DOI: 10.1097/js9.0000000000001401] [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: 12/19/2023] [Accepted: 03/11/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVE This study aimed to comprehensively analyze the clinical characteristics and prognosis of patients with concomitant bladder cancer (BCa) and prostate cancer (PCa) using a large population-based database. METHODS Within the Surveillance, Epidemiology, and End Results (SEER) database (2000-2019), the authors identified patient with concomitant PCa at the time of radical cystoprostatectomy (RCP). Logistic regression and propensity score matching (PSM) analyses were employed to identify risk factors and mitigate confounders, respectively. Kaplan-Meier survival curves were used to estimate cancer-specific survival (CSS). RESULTS A total of 14 199 BCa patients undergoing RCP were identified, with 28.8% incidentally discovered to have concurrent PCa. Among them, 89.9% exhibited organ-confined (T1-2) PCa. An increased risk of concomitant tumors was observed among older age, white race, and high tumor grade of BCa. Survival analysis revealed no significant difference in CSS between patients with BCa alone and those with concurrent PCa (5-year CSS rate: 71.3 vs. 67.2%, P =0.076). Subgroup analysis and multivariable analysis, however, indicated that concurrent high-risk PCa adversely impacted survival (5-year CSS rate: 71.3 vs. 63.4%, HR 1.27, 95% CI: 1.01-1.58, P =0.038) compared to solitary BCa. Notably, the presence of low/intermediate-risk PCa did not affect survival outcomes ( P =0.584). CONCLUSION In conclusion, incidentally discovered PCa in RCP specimens is frequent and characterized by organ-confined presentation, lower PSA levels, and Gleason scores. Patients with concurrent high-risk PCa have a worse prognosis compared to those with solitary BCa, while the presence of low/intermediate-risk PCa does not influence oncological prognosis.
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Affiliation(s)
- Kan Wu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University
| | - Xu Liu
- Breast Center, West China Hospital, Sichuan University, Sichuan, People’s Republic of China
| | - Yaxiong Tang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University
| | - Xianding Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University
| | - Xiang Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University
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Khalabazyane B, Zuaiter M, Salah R, Kassim A, Omer A. An Extremely Rare Case of a 24-Year-Old Female Diagnosed With High-Grade Muscle-Invasive Urothelial Carcinoma in the Bladder. Cureus 2024; 16:e63566. [PMID: 39087144 PMCID: PMC11289743 DOI: 10.7759/cureus.63566] [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: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Bladder cancer most commonly affects older adults. Although extremely rare, it can still be detected in the younger population. Bladder cancer often exhibits distinct behavior in these cases, typically manifesting as a low-grade, non-muscle-invasive disease. We documented a remarkable case involving a 24-year-old female diagnosed with high-grade muscle-invasive bladder cancer. Our report emphasizes the distinctive challenges encountered by clinicians in the journey of diagnosis, treatment, and follow-up of bladder cancer in young patients.
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Affiliation(s)
| | | | - Roza Salah
- Plastic and Reconstructive Surgery, Salisbury NHS Foundation Trust, Bournemouth, GBR
| | - Abdirashid Kassim
- Urology, University Hospitals of Coventry and Warwickshire, Coventry, GBR
| | - Atlan Omer
- Urology, University Hospitals of Coventry and Warwickshire, Coventry, GBR
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Rutten VC, Al CM, Festen S, Zuiverloon TCM, Boormans JL, Polinder-Bos HA. Selecting the right treatment: Health outcome priorities in older patients with bladder cancer. J Geriatr Oncol 2024; 15:101811. [PMID: 38896950 DOI: 10.1016/j.jgo.2024.101811] [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: 02/22/2024] [Revised: 04/09/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024]
Abstract
INTRODUCTION Selecting the appropriate treatment for older patients with non-muscle invasive (NMIBC) or muscle-invasive bladder cancer (MIBC) is challenging due to smoking-related comorbidities, treatment toxicity, and an increased risk of adverse health outcomes. Considering patient preferences prior to treatment is therefore crucial. Here, we aimed to identify the health outcome priorities of older patients with high-risk NMIBC (HR-NMIBC) or MIBC. MATERIALS AND METHODS Patients aged 70 years or older or at risk for frailty, diagnosed with HR-NMIBC or MIBC without distant metastases, were referred for a comprehensive geriatric assessment (CGA). The CGA consisted of an interview, physical examination, and several tests to examine physical, cognitive, functional, and social status. Quality of life was assessed using EQ5D and EORTC QLQ-C30 questionnaires. Health outcome priorities were discussed using the Outcome Prioritization Tool (OPT) and associations between health outcome priorities and CGA-determinants and quality of life were studied. RESULTS Of 146 patients (14 HR-NMIBC, 132 MIBC), OPT data was available for 139. Life extension was most often prioritized (44%), closely followed by preserving independence (40%). Reducing pain (7%) and other symptoms (9%) were less often prioritized. Patients prioritizing life extension had fewer musculoskeletal problems than patients prioritizing reducing pain or other symptoms (p = 0.02). Patients at risk of or suffering from malnutrition more frequently selected reducing pain or other symptoms as their health outcome priority (p = 0.004). For all other CGA-determinants and quality of life, there were no significant differences between groups based on health outcome priorities. DISCUSSION In older patients with HR-NMIBC and MIBC, life extension and preserving independence are the most common health outcomes priorities. CGA-determinants and quality of life are generally not associated with the prioritization of health outcomes. As health outcome priorities cannot be predicted by CGA-determinants or quality of life, it is crucial to discuss health outcome priorities with patients to promote shared decision-making.
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Affiliation(s)
- Vera C Rutten
- Department of Urology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
| | - Cornelia M Al
- Division of Geriatric Medicine, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Suzanne Festen
- University of Groningen, University Center for Geriatric Medicine, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Joost L Boormans
- Department of Urology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Harmke A Polinder-Bos
- Division of Geriatric Medicine, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
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Pakmanesh H, Khajehsalimi A, Hesamarefi M, Ebadzadeh MR, Bazrafshan A, Malekpourafshar R, Mirzaei M, Daneshpajouh A, Shahesmaeili A, Eslami N. Comparison of the overall survival of different treatment methods in patients with Muscle-invasive bladder cancer: A retrospective study. Urologia 2024:3915603241256009. [PMID: 38867469 DOI: 10.1177/03915603241256009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
OBJECTIVES Bladder-Sparing Approach was presented in patients who are not willing or not suitable for Radical Cystectomy (RC). There have been inconsistencies in the literature regarding the comparison of survival rates of these two methods. Our objective is to evaluate the survival rate of patients with muscle-invasive bladder cancer (MIBC) undergoing different treatment methods. DESIGN Retrospective cross-sectional study. SETTING A secondary care, multicenter study in Kerman, Iran 2008 to 2016. PARTICIPANTS All 200 patients who were diagnosed with Muscle Invasive Bladder Cancer and were admitted to our hospitals. Patients with inaccessible medical files and patients with pathologies other than TCC were excluded. MAIN OUTCOME MEASURES Radical cystectomy and different methods of bladder preservation were compared based on their survival rate. INTERVENTIONS Radical cystectomy or bladder preservation. RESULTS Overall survival of the patients was 2 years [95% CI: 1.37-2.63]. The overall 5-year survival rate of patients with MIBC was 32%. Having a 6.4 years overall survival, the RC group showed the highest survival compared with others (p = 0.01); the overall survival of patients undergoing TMT, TURT, chemotherapy, or radiotherapy monotherapy was 3.15 years [95% CI: 2.242-4.061], 4.06 [95% CI: 3.207-4.931], 2.58 [95% CI: 1.767-3.399], and 3.14 [95% CI: 1.614-4.672] years, respectively. Patients younger than 65 undergoing RC had an overall survival of 7 years, compared with 2 years for the TMT group. (p = 0.0001). CONCLUSIONS The Bladder-Preservation method, as a replacement for RC, showed a lower overall survival rate in our study. A prospective randomized clinical trial may declare the best treatment.
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Affiliation(s)
- Hamid Pakmanesh
- Department of Urology, School of Medicine, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Azadeh Khajehsalimi
- Department of Urology, School of Medicine, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammadamin Hesamarefi
- Department of Urology, School of Medicine, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohamad Reza Ebadzadeh
- Department of Urology, School of Medicine, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Azam Bazrafshan
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Malekpourafshar
- Pathology and Stem Cell Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahboubeh Mirzaei
- Department of Urology, School of Medicine, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Azar Daneshpajouh
- Department of Urology, School of Medicine, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Armita Shahesmaeili
- Department of Urology, School of Medicine, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Nazanin Eslami
- Department of Urology, School of Medicine, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
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10
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Steffens F, Grüne B, Rassweiler-Seyfried MC. [Urinary bladder tamponade-an urological emergency]. UROLOGIE (HEIDELBERG, GERMANY) 2024; 63:578-584. [PMID: 38639783 DOI: 10.1007/s00120-024-02340-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/21/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Urinary bladder tamponade is a urological emergency that is part of the clinical routine of every urologist and requires immediate and adequate diagnosis and therapy. OBJECTIVES Presentation of the clinical picture of urinary bladder tamponade including etiology, diagnostics, and therapy as well as formulation of recommendations for action for clinical routine. MATERIALS AND METHODS Structured presentation of the diagnosis and therapy of urinary bladder tamponade with practical recommendations for action based on a current literature search and a clinical case study. RESULTS Urinary bladder tamponade is a usually painful filling of the urinary bladder with blood clots as part of gross hematuria. The central pillars of diagnostics are anamnesis, targeted physical examination, and sonography. Therapy involves the rapid insertion of a flushing catheter with manual evacuation of the tamponade. A flushing catheter with at least 20 French should be used here. CONCLUSION Timely diagnosis and prompt treatment are crucial. This usually includes transurethral catheter insertion with manual evacuation. If the tamponade is unsuccessfully removed, further measures such as endoscopic evacuation or, as a last resort, sectio alta or radical cystectomy are available.
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Affiliation(s)
- Felix Steffens
- Klinik für Urologie und Urochirurgie, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
| | - Britta Grüne
- Klinik für Urologie und Urochirurgie, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
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11
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Agarwal S, Pandey P, Ralli M, Agarwal R, Yadav A, Dwivedi N. A Clinicopathologic Study of Urinary Bladder Lesions Amongst North Indian Population: An Experience From a Tertiary Care Centre. Cureus 2024; 16:e59792. [PMID: 38846211 PMCID: PMC11154845 DOI: 10.7759/cureus.59792] [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: 05/07/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Urinary bladder cancer (UBC) is amongst the most common urological malignancies. AIM To study different types of urinary bladder lesions in the north Indian population and to correlate various clinical and pathological findings. MATERIALS AND METHODS The present prospective study was conducted on 100 cases undergoing transurethral resection of bladder tumor (TURBT) and/or radical cystectomy over a period of 2.5 years followed by histopathological examination. Liquid-based cytology for malignant cells in urine was also performed. Immunohistochemistry was employed for tumor typing wherever needed. RESULTS A total of 100 cases were studied. Male to female ratio was 15.7:1 and most of the patients were in the sixth decade (40%). Painless hematuria was the commonest clinical presentation (60%) and smoking was the commonest risk factor (80%). The most common lesion was infiltrating urothelial carcinoma seen in 72 cases followed by papillary urothelial neoplasm of low malignant potential (PUNLMP) seen in eight cases. Grade and depth of invasion were assessed and correlated. Several variants of infiltrating urothelial carcinoma such as squamous differentiation, glandular differentiation, microcystic, clear cell, nested, and micropapillary were also identified. Clinical, cystoscopic and histopathological findings were correlated in all the cases. CONCLUSION Infiltrating urothelial carcinoma high grade was the most common bladder lesion identified and muscle invasion was more common with higher-grade lesions. A decade-younger age group was found to be more affected in the present series. Urine cytology for malignant cells is useful for early diagnosis of cancer. Immunohistochemistry is an important ancillary adjunct.
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Affiliation(s)
- Savita Agarwal
- Pathology, Uttar Pradesh University of Medical Sciences, Saifai, IND
| | - Pinki Pandey
- Pathology, Uttar Pradesh University of Medical Sciences, Saifai, IND
| | - Megha Ralli
- Pathology, Post Graduate Institute of Child Health, New Delhi, IND
| | - Roopak Agarwal
- Pathology, Uttar Pradesh University of Medical Sciences, Saifai, IND
| | - Alka Yadav
- Pathology, Uttar Pradesh University of Medical Sciences, Saifai, IND
| | - Neetu Dwivedi
- Pathology, Uttar Pradesh University of Medical Sciences, Saifai, IND
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12
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Stangl FP, Buehler OD, Wuethrich PY, Furrer MA, Burkhard FC. Sex Does Not Affect Survival: A Propensity Score-Matched Comparison in a Homogenous Contemporary Radical Cystectomy Cohort. Clin Genitourin Cancer 2024; 22:171-180. [PMID: 38008691 DOI: 10.1016/j.clgc.2023.10.009] [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: 08/18/2023] [Revised: 10/06/2023] [Accepted: 10/25/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVES To determine whether biological sex affects oncological outcome after extended pelvic lymph node dissection, radical cystectomy, and urinary diversion for muscle-invasive bladder cancer, and to identify risk factors impacting outcome. PATIENTS AND METHODS We performed a single-center, retrospective observational cohort study with prospective data collection with a propensity score matched population. A total of 1165 consecutive patients from 2000 to 2020, (317 women and 848 men) scheduled for open extended pelvic lymph node dissection, radical cystectomy, and urinary diversion for urothelial bladder cancer were included in the final analysis. Overall Survival (OS), Cancer-Specific-Survival (CSS), and Recurrence-Free-survival (RFS) were assessed with multivariable weighted Cox regression analysis as well as with propensity score matched Cox-Regression. RESULTS No significant difference was found between sexes regarding OS (HR 1.18, [0.93-1.49], P = .16), CSS (HR 0.87, [0.64-1.18], P = .38), or RFS (HR 0.80, [0.59-1.07], P = .13). These results were confirmed after propensity score matching: female sex was not associated with inferior OS (HR 1.20, [0.91-1.60], P = .19), CSS (HR 1.01, [0.75-1.35], P = .97) or RFS (HR 0.98, [0.75-1.27], P = .86). CONCLUSIONS We did not find a significant difference in cancer-related outcomes or overall survival after extended pelvic lymph node dissection, open radical cystectomy, and urinary diversion for urothelial cancer between males and females even after adjustment with propensity matching score for multiple factors including oncological parameters, smoking status, and renal function.
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Affiliation(s)
- Fabian P Stangl
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Oliver D Buehler
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Patrick Y Wuethrich
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marc A Furrer
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fiona C Burkhard
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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13
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Saleh M, Raffoul P, Akil A, Bassil P, Salameh P. Arab world's impact on bladder cancer research and opportunities for growth: A bibliometric review study. Medicine (Baltimore) 2024; 103:e37554. [PMID: 38518049 PMCID: PMC10956953 DOI: 10.1097/md.0000000000037554] [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: 10/17/2023] [Accepted: 02/19/2024] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND Bladder Cancer (BC) is a widespread form of cancer that affects over 1.6 million people globally. The majority of cases are diagnosed as urothelial carcinoma, with a higher likelihood of diagnosis in men and with increasing age. The Arab world (AW) is one of the regions with the highest incidence and mortality rates of BC, and the average age of diagnosis is between 40 and 49 years in North Africa and the Middle East. This study aims to assess the activity and distribution of BC publications in the AW. METHODS A systematic search across MEDLINE and Embase databases spanning 2007 to 2021 identified 1208 English-language articles on bladder cancer with Arab affiliations. The dataset was normalized against the average population and GDP (2007-2020) for 22 Arab countries. Statistical analyses via SPSS and visualizations with VOSviewer unveiled collaboration patterns and thematic trends in Arab bladder cancer research. RESULTS A total of 1208 BC publications were published in the AW, representing 0.24% of all biomedical publications. Egypt topped the list with the highest number of publications. The co-authorship analysis generated by VOSviewer revealed that out of 4766 authors, 161 met the minimum threshold of 5 publications. CONCLUSION The findings reveal that Egypt and Jordan are at the forefront of BC research in the region, while other Arab countries are lagging behind despite being heavily impacted by the disease. To drive progress in the field, it's important to uncover the obstacles impeding BC research in these countries and implement effective solutions to overcome them.
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Affiliation(s)
- Mustafa Saleh
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Peter Raffoul
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Alvar Akil
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Paul Bassil
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Pascale Salameh
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- School of Medicine, Lebanese American University, Byblos, Lebanon
- Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie (INSPECT-LB), Beirut, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
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14
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Rosenbaum CM, Filmar S, Gross AJ, Jobst N, Schultz A. The influence of socioeconomic status and gender on incidence and survival in bladder cancer: a longitudinal study based on the Hamburg Cancer Registry. World J Urol 2024; 42:166. [PMID: 38492172 DOI: 10.1007/s00345-024-04888-4] [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: 11/23/2023] [Accepted: 02/12/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND To investigate the influence of socioeconomic status (SES) and gender on the incidence and survival of patients with bladder cancer on a small scale within the city of Hamburg, Germany. METHODS Patients documented in the Hamburg Cancer Registry aged ≥ 18 years with primary bladder carcinoma (ICD-10: C67, D09.0), diagnosed in the period 2004-2020 (follow-up until 31.12.2021), and residing in Hamburg were included. The patients were divided into three groups (low, intermediate, and high SES) based on the socioeconomic situation at the district level, defined by the proportion of unemployed individuals, social housing, benefit recipients according to law, etc. Relative survival in the years 2004-2020 was calculated using a period approach. RESULTS Among the 10,659 patients included, age-standardized 5-year relative survival (5YRS) in 2004-2020 correlated with SES. The age-standardized 5YRS differed significantly between patients with high and intermediate SES vs low SES. Women with low SES had the worst 5YRS at 58.2%, while men with high SES presented the best relative 5YRS at 73.5%. This effect remained after stratification by UICC stages. Concerning incidence, there is an indication that women with low SES were more often diagnosed in higher UICC stages III or IV than women with high SES (18.3% versus 12.6%). CONCLUSIONS The socioeconomic situation at the time of diagnosis, as well as gender, has a substantial impact on the incidence and cancer survival rates in patients with bladder cancer. Further research, including the study of patient care, is needed to better understand and address these inequalities.
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Affiliation(s)
- Clemens M Rosenbaum
- Department of Urology, Asklepios Hospital Barmbek, Rübenkamp 220, 22307, Hamburg, Germany.
| | - Simon Filmar
- Department of Urology, Asklepios Hospital Barmbek, Rübenkamp 220, 22307, Hamburg, Germany
| | - Andreas J Gross
- Department of Urology, Asklepios Hospital Barmbek, Rübenkamp 220, 22307, Hamburg, Germany
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15
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Li S, Wang J, Zhang Z, Wu Y, Liu Z, Yin Z, Liu J, He D. Establishment and validation of nomograms to predict the overall survival and cancer-specific survival for non-metastatic bladder cancer patients: A large population-based cohort study and external validation. Medicine (Baltimore) 2024; 103:e37492. [PMID: 38489693 PMCID: PMC10939645 DOI: 10.1097/md.0000000000037492] [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: 10/14/2023] [Revised: 01/08/2024] [Accepted: 02/14/2024] [Indexed: 03/17/2024] Open
Abstract
This study aimed to develop nomograms to accurately predict the overall survival (OS) and cancer-specific survival (CSS) of non-metastatic bladder cancer (BC) patients. Clinicopathological information of 260,412 non-metastatic BC patients was downloaded from the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2020. LASSO method and Cox proportional hazard regression analysis were utilized to discover the independent risk factors, which were used to develop nomograms. The accuracy and discrimination of models were tested by the consistency index (C-index), the area under the subject operating characteristic curve (AUC) and the calibration curve. Decision curve analysis (DCA) was used to test the clinical value of nomograms compared with the TNM staging system. Nomograms predicting OS and CSS were constructed after identifying independent prognostic factors. The C-index of the training, internal validation and external validation cohort for OS was 0.722 (95%CI: 0.720-0.724), 0.723 (95%CI: 0.721-0.725) and 0.744 (95%CI: 0.677-0.811). The C-index of the training, internal validation and external validation cohort for CSS was 0.794 (95%CI: 0.792-0.796), 0.793 (95%CI: 0.789-0.797) and 0.879 (95%CI: 0.814-0.944). The AUC and the calibration curves showed good accuracy and discriminability. The DCA showed favorable clinical potential value of nomograms. Kaplan-Meier curve and log-rank test uncovered statistically significance survival difference between high- and low-risk groups. We developed nomograms to predict OS and CSS for non-metastatic BC patients. The models have been internally and externally validated with accuracy and discrimination and can assist clinicians to make better clinical decisions.
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Affiliation(s)
- Shan Li
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
- China International Science and Technology Cooperation base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Jinkui Wang
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
- China International Science and Technology Cooperation base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Zhaoxia Zhang
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
- China International Science and Technology Cooperation base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Yuzhou Wu
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhenyu Liu
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhikang Yin
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Junhong Liu
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
- China International Science and Technology Cooperation base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Dawei He
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
- China International Science and Technology Cooperation base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, China
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16
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Bostanci E, Kirkik D, Kalkanli Tas S, Uyeturk U. Genetic insights into bladder cancer: the impact of SIRT1 gene polymorphism. NUCLEOSIDES, NUCLEOTIDES & NUCLEIC ACIDS 2024:1-12. [PMID: 38305254 DOI: 10.1080/15257770.2024.2310710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024]
Abstract
Bladder cancer (BC) has shown a significant global health concern with distinct pathological, genetic, and epigenetic characteristics. Its prevalence is influenced by various risk factors, including age, gender, and genetic predisposition. This study investigates the association between BC and the Sirtuin 1 (SIRT1) gene polymorphism rs369274325 in the Turkish population. Genomic DNA was isolated from peripheral blood samples and genotyping of rs369274325 polymorphism in SIRT 1 was investigated in 200 individuals (in 100 Turkish bladder cancer patients and 100 healthy individuals as the control group.) by real-time PCR. Demographic information, smoking and alcohol consumption status was analyzed by statistical analysis. Statistical analysis was performed by Pearson's Chi-square test. Smoking and alcohol consumption were significantly higher in BC patients compared to controls (p < 0.00018 and p < 0.0001, respectively). The genotypic distribution of SIRT1 rs369274325 did not show a significant difference between BC patients and controls (p = 0.5550). BC, influenced by genetic and environmental factors, has been linked to various gene mutations. SIRT1, involved in diverse physiological processes, is proposed to play a role in BC. However, our study did not find a significant association between SIRT1 rs369274325 polymorphism and BC in the Turkish population.
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Affiliation(s)
- Emre Bostanci
- Medicine Faculty, Department of Urology, Abant Izzet Baysal University, Bolu, Turkey
| | - Duygu Kirkik
- Hamidiye Medicine Faculty, Department of Medical Biology, University of Health Sciences, Istanbul, Turkey
| | - Sevgi Kalkanli Tas
- Hamidiye Medicine Faculty, Department of Immunology, University of Health Sciences, Istanbul, Turkey
| | - Ugur Uyeturk
- Medicine Faculty, Department of Urology, Abant Izzet Baysal University, Bolu, Turkey
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17
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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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18
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Kao CC, Lai CR, Lin YH, Chen TM, Tsai YL, Tsai WC, Ong TY, Wang HH, Wu ST, Chen Y. GW4064 inhibits migration and invasion through cathepsin B and MMP2 downregulation in human bladder cancer. Chem Biol Interact 2024; 389:110869. [PMID: 38216027 DOI: 10.1016/j.cbi.2024.110869] [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: 04/20/2023] [Revised: 12/24/2023] [Accepted: 01/09/2024] [Indexed: 01/14/2024]
Abstract
The ability of bladder cancer to invade and metastasize often leads to poor prognosis in bladder cancer patients. The aim of this study was to evaluate the effect of the farnesoid X receptor (FXR) agonist GW4064 on the migration and invasion of human bladder cancer cells. Long-term exposure to GW4064 decreased the colony formation of RT4 and T24 cells. The wound healing migration assay revealed an inhibitory effect of GW4064 on both of these bladder cancer cell lines. In addition, integrin β3 expression and myosin light chain phosphorylation were decreased after GW4064 treatment. Immunocytochemistry showed an increase in E-cadherin and a decrease in β-catenin in the cell membrane of bladder cancer cells. Total protein expression and membrane fractionation assays also indicated upregulation of E-cadherin and downregulation of β-catenin. Moreover, GW4064 reduced the invasion of muscle-invasive T24 cells. The GW4064-decreased migration and invasion were reversed by the proteasome inhibitor MG132 and the lysosome inhibitor NH4Cl. Furthermore, the GW4064-induced inhibition of matrix metalloproteinase-2 (MMP2) and cathepsin B expression was reversed by NH4Cl. Xenograft animal studies revealed that GW4064 declined MMP2, cathepsin B and lung metastasis of bladder cancer. In conclusion, GW4064 decreases the migration and invasion of human bladder cancer cells, which may provide a new therapeutic strategy for the treatment of human bladder cancer.
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Affiliation(s)
- Chien-Chang Kao
- Division of Urology, Department of Surgery, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Chien-Rui Lai
- Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Hsuan Lin
- Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan
| | - Tzu-Min Chen
- Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Ling Tsai
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Chiuan Tsai
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Tze-Yun Ong
- Department of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Hisao-Hsien Wang
- Department of Urology, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Sheng-Tang Wu
- Division of Urology, Department of Surgery, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan; Division of Urology, Department of Surgery, Hualien Armed Forces General Hospital, Hualien, Taiwan.
| | - Ying Chen
- Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan.
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19
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Xu S, Huang J. Machine learning algorithms predicting bladder cancer associated with diabetes and hypertension: NHANES 2009 to 2018. Medicine (Baltimore) 2024; 103:e36587. [PMID: 38277522 PMCID: PMC10817101 DOI: 10.1097/md.0000000000036587] [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: 07/21/2023] [Accepted: 11/20/2023] [Indexed: 01/28/2024] Open
Abstract
Bladder cancer is 1 of the 10 most common cancers in the world. However, the relationship between diabetes, hypertension and bladder cancer are still controversial, limited study used machine learning models to predict the development of bladder cancer. This study aimed to explore the association between diabetes, hypertension and bladder cancer, and build predictive models of bladder cancer. A total of 1789 patients from the National Health and Nutrition Examination Survey were enrolled in this study. We examined the association between diabetes, hypertension and bladder cancer using multivariate logistic regression model, after adjusting for confounding factors. Four machine learning models, including extreme gradient boosting (XGBoost), Artificial Neural Networks, Random Forest and Support Vector Machine were compared to predict for bladder cancer. Model performance was assessed by examining the area under the subject operating characteristic curve, accuracy, recall, specificity, precision, and F1 score. The mean age of bladder cancer group was older than that of the non-bladder cancer (74.4 years vs 65.6 years, P < .001), and men were more likely to have bladder cancer. Diabetes was associated with increased risk of bladder cancer (odds ratio = 1.24, 95%confidence interval [95%CI]: 1.17-3.02). The XGBoost model was the best algorithm for predicting bladder cancer; an accuracy and kappa value was 0.978 with 95%CI:0.976 to 0.986 and 0.01 with 95%CI:0.01 to 0.52, respectively. The sensitivity was 0.90 (95%CI:0.74-0.97) and the area under the curve was 0.78. These results suggested that diabetes is associated with risk of bladder cancer, and XGBoost model was the best algorithm to predict bladder cancer.
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Affiliation(s)
- Siying Xu
- Department of Urology, Wuhan Fourth Hospital, Wuhan, China
| | - Jing Huang
- Department of Urology, Wuhan Fourth Hospital, Wuhan, China
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20
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Moria FA, Park CL, Eigl BJ, Macfarlane R, Pavic M, Saleh RR. A Real-World Retrospective Analysis of the Management of Advanced Urothelial Carcinoma in Canada. Curr Oncol 2024; 31:704-722. [PMID: 38392046 PMCID: PMC10887988 DOI: 10.3390/curroncol31020052] [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: 12/03/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
Locally advanced or metastatic urothelial carcinoma (aUC) presents a significant challenge with high mortality rates. Platinum-based chemotherapy remains the established frontline standard of care, and a switch-maintenance strategy with immunotherapy has now emerged as a new standard for aUC patients without disease progression, following initial platinum therapy. Examining the treatment patterns is imperative, given the evolving therapeutic landscape. In this study, we conducted a retrospective medical chart review of 17 Canadian oncologists treating patients with aUC to assess unmet needs in Canadian aUC patient care. Data from 146 patient charts were analyzed, revealing important clinical insights about the management of aUC. A substantial proportion of patients (53%) presented with de novo metastatic disease, which was possibly influenced by pandemic-related care disruptions. Variability was evident in the cisplatin eligibility criteria, with a majority (70%) of oncologists utilizing a 50 mL/min threshold. Most favored four cycles of platinum-based chemotherapy to spare the bone marrow for future therapies and prevent patient fatigue. Notably, some eligible patients were kept under surveillance rather than receiving maintenance therapy, suggesting a potential gap in awareness regarding evidence-based recommendations. Furthermore, managing treatment-related adverse events was found to be one of the biggest challenges in relation to maintenance immunotherapy. In conclusion, our findings provide the first comprehensive overview of aUC treatment patterns in Canada following the approval of maintenance immunotherapy, offering insights into the decision-making process and underscoring the importance of evidence-based guidelines in aUC patient management.
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Affiliation(s)
- Feras A. Moria
- McGill University Health Center, Montreal, QC H4A 3J1, Canada; (F.A.M.); (C.L.P.)
| | - Changsu L. Park
- McGill University Health Center, Montreal, QC H4A 3J1, Canada; (F.A.M.); (C.L.P.)
| | | | | | - Michel Pavic
- Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada;
| | - Ramy R. Saleh
- McGill University Health Center, Montreal, QC H4A 3J1, Canada; (F.A.M.); (C.L.P.)
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21
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Martins EP, Vieira de Castro J, Fontes R, Monteiro-Reis S, Henrique R, Jerónimo C, Costa BM. Relevance of HOTAIR rs920778 and rs12826786 Genetic Variants in Bladder Cancer Risk and Survival. Cancers (Basel) 2024; 16:434. [PMID: 38275875 PMCID: PMC10814037 DOI: 10.3390/cancers16020434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
The long non-coding RNA HOX transcript antisense intergenic RNA (HOTAIR) is associated with oncogenic features in bladder cancer and is predictive of poor clinical outcomes in patients diagnosed with this disease. In this study, we evaluated the impact of the HOTAIR single nucleotide polymorphisms rs920778 and rs12826786 on bladder cancer risk and survival. This case-control study included 106 bladder cancer patients and 199 cancer-free controls. Polymorphisms were evaluated through PCR-restriction fragment length polymorphism. The odds ratio and 95% confidence intervals were tested using univariable and multivariable logistic regressions. The effects on patient survival were evaluated using the log-rank test and Cox regression models. Our data showed that the HOTAIR rs920778 and rs12826786 genetic variants are not associated with the risk of developing bladder cancer. Nevertheless, survival analyses suggested that the HOTAIR rs920778 TT genotype and rs12826786 CC genotype are associated with increased survival in male bladder cancer patients and in patients, both male and female, who have primary tumors with a pathological stage of pT2. Together, these results suggest that, despite not being associated with bladder cancer risk, HOTAIR rs920778 and rs12826786 polymorphisms might represent new prognostic factors in this type of cancer. This is particularly important as these polymorphisms might be easily evaluated in bladder cancer patients in a minimally invasive manner to better predict their clinical outcomes.
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Affiliation(s)
- Eduarda P. Martins
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Campus de Gualtar, University of Minho, 4710-057 Braga, Portugal; (E.P.M.); (J.V.d.C.); (R.F.)
- ICVS/3B’s-PT Government Associate Laboratory, 4710-057/4805-017 Braga/Guimarães, Portugal
| | - Joana Vieira de Castro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Campus de Gualtar, University of Minho, 4710-057 Braga, Portugal; (E.P.M.); (J.V.d.C.); (R.F.)
- ICVS/3B’s-PT Government Associate Laboratory, 4710-057/4805-017 Braga/Guimarães, Portugal
| | - Rita Fontes
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Campus de Gualtar, University of Minho, 4710-057 Braga, Portugal; (E.P.M.); (J.V.d.C.); (R.F.)
- ICVS/3B’s-PT Government Associate Laboratory, 4710-057/4805-017 Braga/Guimarães, Portugal
| | - Sara Monteiro-Reis
- Cancer Biology & Epigenetics Group, Research Center of IPO Porto (CI-IPOP), CI-IPOP @RISE (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto), Porto Comprehensive Cancer Center Raquel Seruca (Porto.CCC), 4200-072 Porto, Portugal; (S.M.-R.); (R.H.); (C.J.)
- Institute of Science and Innovation in Mechanical and Industrial Engineering (INEGI), University of Porto, 4200-465 Porto, Portugal
| | - Rui Henrique
- Cancer Biology & Epigenetics Group, Research Center of IPO Porto (CI-IPOP), CI-IPOP @RISE (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto), Porto Comprehensive Cancer Center Raquel Seruca (Porto.CCC), 4200-072 Porto, Portugal; (S.M.-R.); (R.H.); (C.J.)
- Department of Pathology & Molecular Immunology, ICBAS-School of Medicine & Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal
- Department of Pathology, Portuguese Oncology Institute of Porto (IPO Porto), 4200-072 Porto, Portugal
| | - Carmen Jerónimo
- Cancer Biology & Epigenetics Group, Research Center of IPO Porto (CI-IPOP), CI-IPOP @RISE (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto), Porto Comprehensive Cancer Center Raquel Seruca (Porto.CCC), 4200-072 Porto, Portugal; (S.M.-R.); (R.H.); (C.J.)
- Department of Pathology & Molecular Immunology, ICBAS-School of Medicine & Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal
| | - Bruno M. Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Campus de Gualtar, University of Minho, 4710-057 Braga, Portugal; (E.P.M.); (J.V.d.C.); (R.F.)
- ICVS/3B’s-PT Government Associate Laboratory, 4710-057/4805-017 Braga/Guimarães, Portugal
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22
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Zhu S, Zhao H. Sexual dimorphism in bladder cancer: a review of etiology, biology, diagnosis, and outcomes. Front Pharmacol 2024; 14:1326627. [PMID: 38283839 PMCID: PMC10811034 DOI: 10.3389/fphar.2023.1326627] [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: 10/23/2023] [Accepted: 12/26/2023] [Indexed: 01/30/2024] Open
Abstract
Bladder carcinoma represents a prevalent malignancy, wherein the influence of sex extends across its incidence, biological attributes, and clinical outcomes. This scholarly exposition meticulously examines pertinent investigations, elucidating the nuanced impact of sex on bladder cancer, and posits cogent avenues for future research and intervention modalities. In the initial discourse, an exhaustive scrutiny is undertaken of the etiological underpinnings of bladder cancer, encompassing variables such as tobacco consumption, occupational exposures, and genetic aberrations. Subsequently, a comprehensive dissection unfolds, delving into the intricate biological disparities inherent in sex vis-à-vis the initiation and progression of bladder cancer. This analytical framework embraces multifaceted considerations, spanning sex hormones, sex chromosomal dynamics, metabolic enzymatic cascades, and the intricate interplay with the microbiome. Lastly, a synthesized exposition encapsulates the ramifications of gender differentials on the diagnostic and prognostic landscapes of bladder cancer, underscoring the imperative for intensified investigative endeavors directed towards elucidating gender-specific variances and the formulation of tailored therapeutic strategies.
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Affiliation(s)
- Sheng Zhu
- Department of Urology, Guilin Hospital of the Second Xiangya Hospital, Central South University, Guilin, China
| | - Huasheng Zhao
- Department of Urology, ShaoYang Hosptial, Affiliated to University of South China, ShaoYang, China
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23
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Spruijt LE, Mosch A, Hoffmann CF, van Nieuwkoop C, Tijsterman JD, Zutt R, van der Gaag NA, Contarino MF. Mycobacterium bovis Infection of a Deep Brain Stimulation System Following Intravesical Bacillus Calmette-Guérin (BCG) Instillation. JOURNAL OF PARKINSON'S DISEASE 2024; 14:1061-1069. [PMID: 38788088 PMCID: PMC11307081 DOI: 10.3233/jpd-230426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 05/26/2024]
Abstract
Deep brain stimulation (DBS) is an advanced treatment in Parkinson's disease. We describe a 71-year-old patient in whom the DBS got infected with Mycobacterium bovis shortly after intravesical BCG instillations as an adjuvant treatment of bladder cancer. The DBS internal pulse generator and extension wires had to be replaced, and the patient was treated successfully with rifampicin, isoniazid, and ethambutol during three months. This case suggests that physicians need to be aware of the risk of this kind of infection and add a specific Mycobacterial test to the regular cultures.
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Affiliation(s)
- Linda E. Spruijt
- Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Arne Mosch
- Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Carel F.E. Hoffmann
- Department of Neurosurgery, Haga Teaching Hospital, The Hague, The Netherlands
| | - Cees van Nieuwkoop
- Department of Internal Medicine, Haga Teaching Hospital, The Hague, The Netherlands
| | | | - Rodi Zutt
- Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Niels A. van der Gaag
- Department of Neurosurgery, Haga Teaching Hospital, The Hague, The Netherlands
- University Neurosurgical Center Holland, The Netherlands
| | - M. Fiorella Contarino
- Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
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24
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Contieri R, Grajales V, Tan WS, Martini A, Sood A, Hensley P, Bree K, Lobo N, Nogueras-Gonzalez GM, Guo CC, Navai N, Dinney CP, Kamat AM. Impact of age >70 years on oncological outcomes in patients with non-muscle-invasive bladder cancer treated with Bacillus Calmette-Guérin. BJU Int 2024; 133:63-70. [PMID: 37442564 PMCID: PMC10787034 DOI: 10.1111/bju.16127] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
OBJECTIVE To evaluate the impact of age on oncological outcomes in a large contemporary cohort of patients with non-muscle-invasive bladder cancer (NMIBC) treated with adequate Bacillus Calmette-Guérin (BCG). PATIENTS AND METHODS We performed an Institutional Review Board-approved retrospective study analysing patients with NMIBC treated with adequate BCG at our institution from 2000 to 2020. Adequate BCG was defined as per United States Food and Drug Administration (FDA) guidelines as being receipt of at least five of six induction BCG instillations with a minimum of two additional doses (of planned maintenance or of re-induction) of BCG instillations within a span of 6 months. The study's primary outcome was to determine if age >70 years was associated with progression to MIBC cancer or distant metastasis. The cumulative incidence method and the competing-risk regression analyses were used to investigate the association of advanced age (>70 years) with progression, high-grade (HG) recurrence and cancer-specific mortality (CSM). RESULTS Overall, data from 632 patients were analysed: 355 patients (56.2%) were aged ≤70 years and 277 (43.8%) were >70 years. Age >70 years did not adversely affect either cumulative incidence of progression or HG recurrence (P = 0.067 and P = 0.644, respectively). On competing-risk regression analyses, age >70 years did not emerge as an independent predictor of progression or HG recurrence (sub-standardised hazard ratio [SHR] 1.57, 95% confidence interval [CI] 0.87-2.81, P = 0.134; and SHR 1.05, 95% CI 0.77-1.44, P = 0.749). Not unexpectedly, patients in the older group did have higher overall mortality (P < 0.001) but not CSM (P = 0.057). CONCLUSION Age >70 years was not associated with adverse oncological outcomes in a large contemporary cohort of patients receiving adequate intravesical BCG for NMIBC. BCG should not be withheld from older patients seeking for bladder sparing options.
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Affiliation(s)
- Roberto Contieri
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Humanitas University, Milan, Italy
| | - Valentina Grajales
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wei Shen Tan
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alberto Martini
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Akshay Sood
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Patrick Hensley
- Department of Urology, University of Kentucky, Lexington, KY, USA
| | - Kelly Bree
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Niyati Lobo
- Department of Urology, Guy's and St Thomas NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
| | | | - Charles C Guo
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Neema Navai
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Colin P Dinney
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ashish M Kamat
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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25
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Barbos V, Feciche B, Bratosin F, Tummala D, Shetty USA, Latcu S, Croitor A, Dema V, Bardan R, Cumpanas AA. Pandemic Stressors and Adaptive Responses: A Longitudinal Analysis of the Quality of Life and Psychosocial Dynamics among Urothelial Cancer Patients. J Pers Med 2023; 13:1547. [PMID: 38003862 PMCID: PMC10672688 DOI: 10.3390/jpm13111547] [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: 09/19/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
The 2019 coronavirus disease (COVID-19) pandemic has had a profound influence on different sectors of society, including health. This study hypothesized a significant impact of the pandemic on the quality of life and psychosocial well-being of urothelial cancer patients, specifically anticipating a decrease in anxiety and depression scores as the pandemic progressed. The primary objectives were to assess longitudinal changes in quality of life indexes, evaluate Healthcare Anxiety and Depression Scale (HADS) score trends over three years (2020-2022), and identify any correlational patterns between the progression of the pandemic and anxiety, depression, and stress levels among this cohort. A cross-sectional analysis was conducted on Eastern Cooperative Oncology Group (ECOG) 1 and Tumor Node Metastasis (TNM) stage 1 bladder cancer patients from the Timis County Emergency Clinical Hospital in Romania. Sixty patients were evaluated each year from 2020 to 2022, utilizing a detailed selection process involving the review of both the hospital database and paper records. Key data included demographic information, medical history, and responses to the Patient Health Questionnaire (PHQ-9), Short Form (SF-36), HADS, and Generalized Anxiety Disorder (GAD-7) questionnaires. A total of 163 completed questionnaires were analyzed, providing insight into various aspects of patients' experiences during the pandemic. Notably, the mean hospitalization days ranged from 3.6 ± 2.1 days in 2020 to 4.0 ± 2.4 days in 2022 (p = 0.663). Concerns that current symptoms might be pandemic-related spiked to 63.5% in 2021, but reduced to 50.9% in 2022, with this fluctuation being significant (p = 0.026). The perception of decreased quality of or accessibility to medical care was significant over the years, with a decline to 52.7% in 2022 (p = 0.033). Quality of life assessments demonstrated an upward trend, from an average score of 55.9 ± 8.9 in 2020 to 59.3 ± 8.8 in 2022 (p = 0.049). Interestingly, anxiety levels, as indicated by the HADS survey, revealed a significant decline from a score of 7.8 in 2020 to 6.5 in 2022 (p = 0.008). On the other hand, GAD-7 scores displayed a downward trend over the years, potentially indicative of developed coping strategies (p = 0.034). This study provides a comprehensive insight into the fluctuating dynamics of psychosocial factors and quality of life among urothelial cancer patients during the pandemic years. It underscores a potential adaptive response, as evidenced by the decrease in anxiety levels and an upward trend in the quality of life scores over the period. These findings highlight the resilience and adaptability of this patient cohort amidst the challenges posed by the pandemic, potentially guiding future interventions and supports in similar health crises.
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Affiliation(s)
- Vlad Barbos
- Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (V.B.); (S.L.); (A.C.); (V.D.); (R.B.); (A.A.C.)
- Doctoral School, Victor Babes University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
| | - Bogdan Feciche
- Department of Urology, Emergency County Hospital Oradea, Strada Gheorghe Doja 65, 410169 Oradea, Romania
| | - Felix Bratosin
- Doctoral School, Victor Babes University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
- Department XIII, Discipline of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
| | - Durganjali Tummala
- Department of General Medicine, K.S. Hegde Medical Academy, Mangaluru 575018, India;
| | | | - Silviu Latcu
- Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (V.B.); (S.L.); (A.C.); (V.D.); (R.B.); (A.A.C.)
| | - Alexei Croitor
- Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (V.B.); (S.L.); (A.C.); (V.D.); (R.B.); (A.A.C.)
| | - Vlad Dema
- Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (V.B.); (S.L.); (A.C.); (V.D.); (R.B.); (A.A.C.)
| | - Razvan Bardan
- Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (V.B.); (S.L.); (A.C.); (V.D.); (R.B.); (A.A.C.)
| | - Alin Adrian Cumpanas
- Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (V.B.); (S.L.); (A.C.); (V.D.); (R.B.); (A.A.C.)
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26
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Mariotti A, Spatafora P, Sessa F, Saieva C, Galli IC, Roviello G, Doni L, Zaccaro C, Bisegna C, Conte FL, Mariottini R, Marzocco A, Masieri L, Vignolini G, Minervini A, Serni S, Carini M, Nesi G, Villari D. Gender and cystectomy for bladder cancer: A high-volume tertiary urologic care center experience. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:107034. [PMID: 37639860 DOI: 10.1016/j.ejso.2023.107034] [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: 04/04/2023] [Revised: 07/23/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Differences have often been reported in the outcomes of bladder cancer (BC) patients according to gender. OBJECTIVE This study aims to provide data on patients undergoing radical cystectomy (RC) in a high-volume tertiary urologic center and to assess whether gender discrepancies do exist in terms of surgical options and clinical outcomes. MATERIALS AND METHODS Consecutive BC patients treated between 2016 and 2020 at a single center (Careggi University Hospital, Florence, Italy) were included in the study. The impact of gender on disease stage at diagnosis, overall survival (OS), and type of surgery was analyzed. RESULTS The study series comprised 447 patients (85 females and 362 males). At a median follow-up of 28.3 months (IQR: 33.5), OS was 52.6% and cancer-specific survival was 67.6%. Significant differences in OS emerged for age, acute myocardial infarction (AMI), Charlson Comorbidity Index (CCI), pT, and pN. OS rates were higher in patients undergoing robot-assisted surgery and in those receiving open orthotopic neobladder (ONB) (p = 0.0001). No statistically significant differences were found between male and female patients regarding surgical offer in any age group, surgical time, early postoperative complications, pathologic stage, and OS. CONCLUSIONS After adjustment for pathologic tumor stage and treatment modalities, female and male patients showed similar oncologic outcomes. Further studies should be undertaken to evaluate functional results in women subjected to RC.
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Affiliation(s)
- A Mariotti
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
| | - P Spatafora
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - F Sessa
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - C Saieva
- Cancer Risk Factors and LifeStyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - I C Galli
- Histopathology and Molecular Diagnostics, Careggi Hospital, Florence, Italy
| | - G Roviello
- Department of Health Sciences, University of Florence, Florence, Italy
| | - L Doni
- Department of Health Sciences, University of Florence, Florence, Italy
| | - C Zaccaro
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - C Bisegna
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - F L Conte
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - R Mariottini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - A Marzocco
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - L Masieri
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy; Department of Pediatric Surgery, Pediatric Urology Unit, Anna Meyer Children's Hospital, Florence, Italy
| | - G Vignolini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - A Minervini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - S Serni
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - M Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - G Nesi
- Histopathology and Molecular Diagnostics, Careggi Hospital, Florence, Italy
| | - D Villari
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
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27
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Giese M, Butea-Bocu M, Huber J, Groeben C. [Prehabilitation prior to radical cystectomy]. UROLOGIE (HEIDELBERG, GERMANY) 2023; 62:1034-1040. [PMID: 37656184 DOI: 10.1007/s00120-023-02172-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/02/2023]
Abstract
Urothelial carcinoma of the urinary bladder places a significant burden on the healthcare system in Germany, with 30,000 new cases annually. Radical cystectomy still remains the standard treatment for nonmetastatic, muscle invasive bladder cancer. Radical cystectomy represents the standard uro-oncologic procedure with the highest mortality. Due to the aging population, the number of elderly patients with urothelial carcinoma of the urinary bladder and reduced physical fitness and numerous comorbidities before the procedure is increasing. Prehabilitation before cystectomy aims to preoperatively identify patients at risk for postoperative complications and improve their physical condition. This includes conditioning and strength training, breathing exercises to improve lung capacity, and nutritional education. Studies on prehabilitation before various abdominal tumor surgeries have shown heterogeneous results so far. Positive effects have been shown for the improvement of functional parameters, but not for a reduction of complications or mortality. Further research, especially in the German healthcare system, is needed to confirm the benefit of prehabilitation, for example, in cystectomy.
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Affiliation(s)
- Matthias Giese
- Klinik für Urologie, Universitätsklinikum Marburg, Marburg, Deutschland
| | - Marius Butea-Bocu
- Urologisches Kompetenzzentrum für die Rehabilitation (UKR), Kliniken Hartenstein, Bad Wildungen, Deutschland
| | - Johannes Huber
- Klinik für Urologie, Universitätsklinikum Marburg, Marburg, Deutschland
| | - Christer Groeben
- Klinik für Urologie, Universitätsklinikum Marburg, Marburg, Deutschland.
- Klinik für Urologie, Universitätsklinikum Gießen und Marburg, Standort Marburg, Baldingerstr., 35043, Marburg, Deutschland.
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Sun M, Yang Y, Zhao J. Establishment of a novel survival assessment and prediction model for advanced gastric cancer patients receiving immunotherapy. Oncol Lett 2023; 26:451. [PMID: 37720671 PMCID: PMC10502925 DOI: 10.3892/ol.2023.14038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/09/2023] [Indexed: 09/19/2023] Open
Abstract
Currently, there are only a few risk assessment tools that provide predictions of survival duration for patients with gastric cancer (GC) receiving immunotherapy. The purpose of the present study was to develop and validate a nomogram that uses statistical data to predict survival and make risk assessments for patients with advanced staged GC. A total of 1,013 patients consisting of a development cohort (n=501) and validation cohort (n=512) collected during the time interval between January 2018 and June 2022 were included in the present study. The analysis consisted of the discrimination index, calibration plots and decision curve of the nomogram model. A total of 167 (33.33%) patients from the development cohort, and 158 (30.85%) from the validation cohort died during the observation period. The median overall survival (OS) of female patients was higher at 980 days (95% CI, 613-NA) compared with that of male patients, which was 748 days (95% CI, 597-NA; P=0.24). The median survival of patients with domestic immunotherapy was 789 (95% CI, 597-NA) days, which was lower compared with the imported immunotherapy group who had a median OS of 980 days (95% CI, 582-NA; P=0.22). A total of four independent predictors, age (HR=1.012; P=0.0245), histological grade (HR=1.395; P=0.016), immunotherapy cycles (HR=0.932; P=0.028) and line of first immunotherapy (HR=1.693; P=0.0003), were identified. The C-index was 0.64 and 0.67 for the development and validation cohorts, respectively. Patients who received more cycles of immunotherapy as the first-line treatment with highly differentiated tumor led to increase in the survival time of the patients. Thus, this nomogram could be used to determine the benefit of immunotherapies on patients at various stages of treatment of GC.
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Affiliation(s)
- Mingmin Sun
- Department of Epidemiology and Statistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, P.R. China
| | - Yang Yang
- Department of Oncology, Gulou Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Jun Zhao
- Academician Workstation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
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Nkemjika S, Tokede O, Okosun IS, Jadotte Y, Pigott T. Biological sex disparity in survival outcomes following treatment for renal cell carcinoma: A systematic review and meta-analysis. Cancer Epidemiol 2023; 86:102409. [PMID: 37478631 DOI: 10.1016/j.canep.2023.102409] [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: 06/26/2023] [Indexed: 07/23/2023]
Abstract
INTRODUCTION Renal cell carcinoma (RCC), a type of kidney cancer has biological sex-based differences that play a role in cancer incidence. Specifically, the incidence of urinary system cancers in men is two times greater than in women, while the incidence of genital cancers is three times greater. There is conflicting epidemiologic and limited evidence in the literature to suggest apparent biological sex discrepancy. The primary objective of this review and meta-analysis is to synthesize evidence to understand biological sex disparity in the survival outcomes of RCC following any treatment intervention. METHODS A three-step search strategy was utilized in this review. We searched MEDLINE, EMBASE and PsycINFO databases for manuscript on biological sex differences in treatment outcomes. Study screening, critical appraisal, and data extraction were executed independently by pairs of reviewers among co-authors. Studies that had any form of treatment modality in the management of RCC were included. Study designs included observational studies in the form of prospective and retrospective studies that utilized cox proportional hazard assumption to conduct survival analysis. The data synthesis was carried out using the R metafor software package (Software version of 1.2.8) and Microsoft Office Excel 2019 package (Microsoft Corporation, USA). The random effects model was estimated using restricted maximum likelihood estimation (REML). Data synthesis included narrative review and meta-analysis. RESULTS We had 23 eligible studies for this review. On review of the full text, 35 studies were excluded due to irrelevances to measure estimates utilized. Finally, 12 studies were selected for the meta-analysis with a total of n = 21,2453 individuals. Females had a better survival outcome following a treatment intervention for RCC than their male counterpart [Mean effect size = -0.1737 (95 % CI: -0.2524, -0.0949)]. CONCLUSION Females were more likely to be cancer free than their male counterpart following treatment for RCC. This finding will inform appropriate decision making for stakeholders.
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Affiliation(s)
- Stanley Nkemjika
- Department of Psychiatry and Behavioral Sciences, Interfaith Medical Center, Brooklyn, NY, USA.
| | | | - Ike S Okosun
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Yuri Jadotte
- Department of Family Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA; The Northeast Institute for Evidence Synthesis and Translation (NEST), JBI Center of Excellence, Rutgers School of Nursing, Newark, NJ, USA
| | - Therese Pigott
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
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Yao X, Xu Z, Duan C, Zhang Y, Wu X, Wu H, Liu K, Mao X, Li B, Gao Y, Xu H, Wang X. Role of human papillomavirus and associated viruses in bladder cancer: An updated review. J Med Virol 2023; 95:e29088. [PMID: 37706751 DOI: 10.1002/jmv.29088] [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: 07/10/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/15/2023]
Abstract
Bladder cancer (BC) is a complex disease affecting the urinary system and is regulated by several carcinogenic factors. Viral infection is one such factor that has attracted extensive attention in BC. Human papillomavirus (HPV) is the most common sexually transmitted infection, and although multiple researchers have explored the role of HPV in BC, a consensus has not yet been reached. In addition, HPV-associated viruses (e.g., human immunodeficiency virus, herpes simplex virus, BK virus, and JC virus) appear to be responsible for the occurrence and progression of BC. This study systematically reviews the relationship between HPV-associated viruses and BC to elucidate the role of these viruses in the onset and progression of BC. In addition, the study aims to provide a greater insight into the biology of HPV-associated viruses, and assess potential strategies for treating virus-induced BC. The study additionally focuses on the rapid development of oncolytic viruses that provide a potentially novel option for the treatment of BC.
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Affiliation(s)
- Xiangyang Yao
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhenzhen Xu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Chen Duan
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yangjun Zhang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiaoliang Wu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huahui Wu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Kai Liu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiongmin Mao
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Bo Li
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yang Gao
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hua Xu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Cancer Precision Diagnosis and Treatment and Translational Medicine Hubei Engineering Research Center, Wuhan, China
- Department of Biological Repositories, Zhongnan Hospital of Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
| | - Xinghuan Wang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Cancer Precision Diagnosis and Treatment and Translational Medicine Hubei Engineering Research Center, Wuhan, China
- Department of Biological Repositories, Zhongnan Hospital of Wuhan University, Wuhan, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
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Song Y, Qin C, Zhang C, Peng Y, Yang W, Du Y, Xu T. GNRH family genes contributed to gender-specific disparity of bladder cancer prognosis through exerting opposite regulatory roles between males and females. J Cancer Res Clin Oncol 2023; 149:6827-6840. [PMID: 36806614 DOI: 10.1007/s00432-023-04640-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/07/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE There is gender-specific disparity in bladder cancer (BlCa) prognosis. Female BlCa patients present with more advanced tumor and have higher risks of disease recurrence, progression, and mortality than males. Since gonadotropin-releasing hormone (GNRH) family genes were critical genes in gender-related biological activity and could be detected in BlCa specimens, this study aimed to explore potential roles of GNRH1 and GNRHR in gender disparity of BlCa. METHODS RNA-sequencing data from The Cancer Genome Atlas Bladder Urothelial Carcinoma dataset, IMvigor210 immunotherapy cohort and Cancer Cell Line Encyclopedia database were used to compare potential roles of GNRH1 and GNRHR in males and females, respectively. Gene set enrichment analysis was used to analyze the biological functions. RESULTS Males with higher GNRH1 and GNRHR have better overall survival (P < 0.05, HR < 1), while females with higher expression have a trend toward worse overall survival (P < 0.05, HR > 1). Gene set enrichment analysis identified GNRH1 and GNRHR exert opposite regulatory roles in myogenesis (M5909), interferon-α response (M5911), interferon-γ response (M5913), inflammatory response (M5932) and TNF-α signaling via NF-κβ (M5890) between males and females. The five functions are up-regulated in females (NES > 0), while down-regulated in males (NES < 0). GNRH1 in females was positively correlated with CD3D (R-value > 0 and P < 0.05), while GNRHR in males was negatively correlated with CD247, CD3D and CD3E (R-value < 0 and P < 0.05). CONCLUSION GNRH1 and GNRHR have opposite effects on overall survival in different genders, and exert opposite roles in immune-related functions between different genders, which could emerge as a contributor to gender disparity of BlCa prognosis.
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Affiliation(s)
- Yuxuan Song
- Department of Urology, Peking University People's Hospital, Beijing, 100044, China
| | - Caipeng Qin
- Department of Urology, Peking University People's Hospital, Beijing, 100044, China
| | - Chunlong Zhang
- Department of Urology, Peking University People's Hospital, Beijing, 100044, China
| | - Yun Peng
- Department of Urology, Peking University People's Hospital, Beijing, 100044, China
| | - Wenbo Yang
- Department of Urology, Peking University People's Hospital, Beijing, 100044, China
| | - Yiqing Du
- Department of Urology, Peking University People's Hospital, Beijing, 100044, China.
| | - Tao Xu
- Department of Urology, Peking University People's Hospital, Beijing, 100044, China.
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Kannan D, Sekaran PG, Sankaran S, Taur P, J SP, Paul R, Thangarasu M, Jain N. The Impact of En-bloc Transurethral Resection of Bladder Tumour on Clinical, Pathological and Oncological Outcomes: A Cohort Study. Cureus 2023; 15:e42523. [PMID: 37637640 PMCID: PMC10457497 DOI: 10.7759/cureus.42523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/29/2023] Open
Abstract
Background En-bloc transurethral resection of bladder tissue (ETURBT) has recently been proposed as a good alternative technique to trans-urethral resection of bladder tissue (TURBT) in terms of outcomes for bladder carcinoma. This study aims to assess the effectiveness of the technique in terms of clinical, pathological and oncological outcomes. Methodology In this prospective study, data was collected from patients who underwent ETURBT for bladder space-occupying lesions between June 2021 and June 2022. Demographic characteristics, tumour characteristics, and postoperative outcomes were recorded. Results A total of 52 patients were studied with the majority being male and a mean age of 50.87 years. Smoking was recorded in 22 (38.5%) patients and 8 (15.4%) were on antiplatelet therapy. The majority fell in the American Society of Anesthesiology (ASA) class I (59.6%). Most of the tumours were solitary (90.4%), primary (82.8%), papillary architecture (73.1%), and between 1-3 cm in size. The lateral wall was the most common position, and detrusor muscle was seen in 98.1% of the specimens. T1 stage (57.7%) and low grade (67.3%) were the common characteristics noted. 76.9% of the ETURBT was conducted using monopolar cautery. Recurrence was noted in 3 (5.8%) and bladder perforation in 1 patient (1.9%). Cautery artifact was seen in six patients (11.5%) and obturator jerk in nine patients (17.3%). Conclusion Our study suggests that ETURBT is a technique with a good success rate for bladder tumours less than 3 cm in size. The benefits include high chances of detrusor sampling while minimising crush artefacts and cautery damage. Specimen retrieval was challenging when the bladder tumour was solid and over 2 cm.
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Affiliation(s)
| | - Praveen G Sekaran
- General Surgery, Saveetha Medical College and Hospital, Chennai, IND
| | - Sindhu Sankaran
- Urology, Apollo Hospitals, Chennai, IND
- Urology, Addenbrooke's Hospital, Cambridge University Hospitals National Health Services (NHS) Foundation Trust, Cambridge, GBR
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Grabe-Heyne K, Henne C, Mariappan P, Geiges G, Pöhlmann J, Pollock RF. Intermediate and high-risk non-muscle-invasive bladder cancer: an overview of epidemiology, burden, and unmet needs. Front Oncol 2023; 13:1170124. [PMID: 37333804 PMCID: PMC10272547 DOI: 10.3389/fonc.2023.1170124] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/19/2023] [Indexed: 06/20/2023] Open
Abstract
Bladder cancer ranks among the most common cancers globally. At diagnosis, 75% of patients have non-muscle-invasive bladder cancer (NMIBC). Patients with low-risk NMIBC have a good prognosis, but recurrence and progression rates remain high in intermediate- and high-risk NMIBC, despite the decades-long availability of effective treatments for NMIBC such as intravesical Bacillus Calmette-Guérin (BCG). The present review provides an overview of NMIBC, including its burden and treatment options, and then reviews aspects that counteract the successful treatment of NMIBC, referred to as unmet treatment needs. The scale and reasons for each unmet need are described based on a comprehensive review of the literature, including insufficient adherence to treatment guidelines by physicians because of insufficient knowledge, training, or access to certain therapy options. Low rates of lifestyle changes and treatment completion by patients, due to BCG shortages or toxicities and adverse events as well as their impact on social activities, represent additional areas of potential improvement. Highly heterogeneous evidence for the effectiveness and safety of some treatments limits the comparability of results across studies. As a result, efforts are underway to standardize treatment schedules for BCG, but intravesical chemotherapy schedules remain unstandardized. In addition, risk-scoring models often perform unsatisfactorily due to significant differences between derivation and real-world cohorts. Reporting in clinical trials suffers from a lack of consistent outcomes reporting in bladder cancer clinical trials, paired with an under-representation of racial and ethnic minorities in many trials.
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Affiliation(s)
| | | | - Paramananthan Mariappan
- Edinburgh Bladder Cancer Surgery (EBCS), Department of Urology, Western General Hospital, Edinburgh, United Kingdom
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Dong Y, Xu C, Su G, Li Y, Yan B, Liu Y, Yin T, Mou S, Mei H. Clinical value of anoikis-related genes and molecular subtypes identification in bladder urothelial carcinoma and in vitro validation. Front Immunol 2023; 14:1122570. [PMID: 37275895 PMCID: PMC10232821 DOI: 10.3389/fimmu.2023.1122570] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/03/2023] [Indexed: 06/07/2023] Open
Abstract
Background Anoikis is a programmed cell death process that was proven to be associated with cancer. Uroepithelial carcinoma of the bladder (BLCA) is a malignant disease of the urinary tract and has a strong metastatic potential. To determine whether anoikis-associated genes can predict the prognosis of BLCA accurately, we evaluated the prognostic value of anoikis-associated genes in BLCA and constructed the best model to predict prognosis. Method The BLCA transcriptome data were downloaded from TCGA and GEO databases, and genes with differential expression were selected and then clustered using non-negative matrix factorization (NMF). The genes with the most correlation with anoikis were screened and identified using univariate Cox regression, lasso regression, and multivariate Cox regression. The GEO dataset was used for external validation. Nomograms were created based on risk characteristics in combination with clinical variants and the performance of the model was validated with receiver operating characteristic (ROC) curves. The immunotherapeutic significance of this risk score was assessed using the immune phenomenon score (IPS). IC50 values of predictive chemotherapeutic agents were calculated. Finally, we used RT-qPCR to determine the mRNA expression of four genes, CALR, FASN, CASP6, and RAD9A. Result We screened 406 tumor samples and 19 normal tissue samples from the TCGA database. Based on anoikis-associated genes, we classified patients into two subtypes (C1 and C2) using NMF method. Subsequently, nine core genes were screened by multiple methods after analysis, which were used to construct risk profiles. The design of nomograms based on risk profiles and clinical variables, ROC, and calibration curves confirmed that the model could well have the ability to predict the survival of BLCA patients at 1, 3, and 5 years. By predicting the IC50 values of chemotherapeutic drugs, it was learned that the high-risk group (HRG) was more susceptible to paclitaxel, gemcitabine, and cisplatin, and the low-risk group (LRG) was more susceptible to veriparib and afatinib. Conclusion In summary, the risk score of anoikis-associated genes can be applied as a predictor to predict the prognosis of BLCA in clinical practice.
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Affiliation(s)
- Ying Dong
- Department of Urology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen University, Shenzhen, China
- Key Laboratory of Medical Reprogramming Technology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
- Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Chaojie Xu
- Department of Urology, Peking University First Hospital, Institution of Urology, Peking University, Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, National Urological Cancer Center, Beijing, China
| | - Ganglin Su
- Department of Urology, Peking University First Hospital, Beijing, China
| | - Yanfeng Li
- Department of Urology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen University, Shenzhen, China
- Key Laboratory of Medical Reprogramming Technology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
- Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Bing Yan
- Department of Urology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen University, Shenzhen, China
- Key Laboratory of Medical Reprogramming Technology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
- Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Yuhan Liu
- Department of Urology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen University, Shenzhen, China
- Key Laboratory of Medical Reprogramming Technology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
- Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Tao Yin
- Department of Urology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen University, Shenzhen, China
- Key Laboratory of Medical Reprogramming Technology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
- Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Shuanzhu Mou
- Department of Urology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen University, Shenzhen, China
- Key Laboratory of Medical Reprogramming Technology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
- Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Hongbing Mei
- Department of Urology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen University, Shenzhen, China
- Key Laboratory of Medical Reprogramming Technology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
- Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
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Fox JJ, Hashimoto T, Navarro HI, Garcia AJ, Shou BL, Goldstein AS. Highly multiplexed immune profiling throughout adulthood reveals kinetics of lymphocyte infiltration in the aging mouse prostate. Aging (Albany NY) 2023; 15:3356-3380. [PMID: 37179121 PMCID: PMC10449296 DOI: 10.18632/aging.204708] [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: 02/06/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023]
Abstract
Aging is a significant risk factor for disease in several tissues, including the prostate. Defining the kinetics of age-related changes in these tissues is critical for identifying regulators of aging and evaluating interventions to slow the aging process and reduce disease risk. An altered immune microenvironment is characteristic of prostatic aging in mice, but whether features of aging in the prostate emerge predominantly in old age or earlier in adulthood has not previously been established. Using highly multiplexed immune profiling and time-course analysis, we tracked the abundance of 29 immune cell clusters in the aging mouse prostate. Early in adulthood, myeloid cells comprise the vast majority of immune cells in the 3-month-old mouse prostate. Between 6 and 12 months of age, there is a profound shift towards a T and B lymphocyte-dominant mouse prostate immune microenvironment. Comparing the prostate to other urogenital tissues, we found similar features of age-related inflammation in the mouse bladder but not the kidney. In summary, our study offers new insight into the kinetics of prostatic inflammaging and the window when interventions to slow down age-related changes may be most effective.
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Affiliation(s)
- Jonathan J. Fox
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, CA 90095, USA
- Current Address: Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
- Current Address: Keck School of Medicine, University of Southern California, Los Angeles, CA 90095, USA
| | - Takao Hashimoto
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, CA 90095, USA
| | - Héctor I. Navarro
- Molecular Biology Interdepartmental Program, University of California, Los Angeles, CA 90095, USA
| | - Alejandro J. Garcia
- Division of Hematology-Oncology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Benjamin L. Shou
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, CA 90095, USA
- Current Address: Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Andrew S. Goldstein
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, CA 90095, USA
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
- Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, CA 90095, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA 90095, USA
- Molecular Biology Institute, University of California, Los Angeles, CA 90095, USA
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Gupta R, Khan SM, Mahajan M, Sharma P, Mahajan A. Urinary Bladder Carcinoma in Females: A Clinico-Pathological Assessment. Cureus 2023; 15:e39753. [PMID: 37398730 PMCID: PMC10311036 DOI: 10.7759/cureus.39753] [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: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Urinary bladder cancer is an uncommon cancer in females. Despite not being an infrequent encounter, female bladder cancer remains a poorly defined entity. There is a paucity of literature regarding bladder cancer in females, especially in North India. OBJECTIVE This study aims to evaluate the clinico-pathological profile of bladder cancer in female patients managed at a single centre in north India. MATERIALS AND METHODS This retrospective observational study was carried out in a tertiary care centre in North India. Medical records and a database of female patients with bladder cancer treated between January 2012 and January 2021 were retrieved. Data regarding age, duration of disease, associated comorbidity, histopathological variants, and outcomes were studied. RESULTS Out of 56 female patients with bladder masses, 55 had transitional cell carcinoma (TCC), while one had pheochromocytoma. Painless hematuria (80.3%) was the commonest presentation. At the time of presentation, 5 patients (9.1%) had muscle-invasive bladder cancer (T2-T4), while 50 patients had non-muscle-invasive disease, out of which 31 (56.4%) patients had high-grade and 19 (34.5%) patients had low-grade papillary carcinoma. Twenty-three patients (41.8%) had a history of exposure to domestic chulha (open wood-burning cooking stove), and 11 patients (20%) were smokers; six patients (10.9%) were exposed to both risk factors. CONCLUSIONS Female bladder cancer was most prevalent in the sixth decade of life, with the majority of patients having a high-grade but non-muscle-invasive disease. Of all the risk factors, chulha exposure was the main risk factor in the aetiology of female bladder cancer.
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Affiliation(s)
- Rahul Gupta
- Urology, Government Medical College, Jammu, Jammu, IND
| | - Suhail M Khan
- Urology, Government Medical College, Jammu, Jammu, IND
| | - Manik Mahajan
- Radiology, Government Medical College, Jammu, Jammu, IND
| | - Poonam Sharma
- Pathology, All India Institute of Medical Sciences Vijaypur, Jammu, IND
| | - Arti Mahajan
- Anaesthesia, Government Medical College, Jammu, Jammu, IND
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Grant SR, Tang L, Wei L, Foster BA, Paragh G, Huss WJ. Mutation Hotspots Found in Bladder Cancer Aid Prediction of Carcinogenic Risk in Normal Urothelium. Int J Mol Sci 2023; 24:ijms24097852. [PMID: 37175559 PMCID: PMC10177765 DOI: 10.3390/ijms24097852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/11/2023] [Accepted: 04/22/2023] [Indexed: 05/15/2023] Open
Abstract
More than 80,000 new cases of bladder cancer are estimated to be diagnosed in 2023. However, the 5-year survival rate for bladder cancer has not changed in decades, highlighting the need for prevention. Numerous cancer-causing mutations are present in the urothelium long before signs of cancer arise. Mutation hotspots in cancer-driving genes were identified in non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC) tumor samples. Mutation burden within the hotspot regions was measured in normal urothelium with a low and high risk of cancer. A significant correlation was found between the mutation burden in normal urothelium and bladder cancer tissue within the hotspot regions. A combination of measured hotspot burden and personal risk factors was used to fit machine learning classification models. The efficacy of each model to differentiate between adjacent benign urothelium from bladder cancer patients and normal urothelium from healthy donors was measured. A random forest model using a combination of personal risk factors and mutations within MIBC hotspots yielded the highest AUC of 0.9286 for the prediction of high- vs. low-risk normal urothelium. Currently, there are no effective biomarkers to assess subclinical field disease and early carcinogenic progression in the bladder. Our findings demonstrate novel differences in mutation hotspots in NMIBC and MIBC and provide the first evidence for mutation hotspots to aid in the assessment of cancer risk in the normal urothelium. Early risk assessment and identification of patients at high risk of bladder cancer before the clinical presentation of the disease can pave the way for targeted personalized preventative therapy.
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Affiliation(s)
- Sydney R Grant
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
- Department of Cell Stress Biology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
| | - Li Tang
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
| | - Lei Wei
- Department of Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
| | - Barbara A Foster
- Department of Pharmacology & Therapeutics, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
| | - Gyorgy Paragh
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
- Department of Cell Stress Biology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
| | - Wendy J Huss
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
- Department of Cell Stress Biology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
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Albakri M, Abu-Hijlih R, Salah S, Al-Ibraheem A, Abuhijla F, Serhan HA, Farkouh A, Obeid Z, Shahait M. Bladder cancer in young adults: Disease and treatment characteristics of patients treated at a tertiary cancer center. Urol Ann 2023; 15:207-210. [PMID: 37304510 PMCID: PMC10252776 DOI: 10.4103/ua.ua_87_22] [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: 06/06/2022] [Accepted: 01/02/2023] [Indexed: 06/13/2023] Open
Abstract
Objectives The incidence of bladder cancer in the Middle East is increasing. Nevertheless, data on the young population with urothelial carcinoma (UC) of the urinary bladder in this region is scarce. Therefore, we evaluated clinical and tumor characteristics, in addition to treatment details in patients younger than 45 years old. Methodology We reviewed all patients presenting with UC of the urinary bladder from July 2006 to December 2019. Clinical characteristics including demographics, stage at presentation, and treatment outcomes were extracted. Results Out of 1272 new cases of bladder cancer, a total of 112 (8.8%) patients were ≤45 years old. Seven patients (6%) had nonurothelial histology and were excluded from the study. The remaining 105 eligible patients with UC had a median age at presentation of 41 years (35-43). Ninety-three patients (88.6%) were males. Tumor stage at presentation: nonmuscle invasive disease (Ta-T1), locally advanced muscle-invasive bladder cancer (MIBC) (T2-3), and metastatic disease were 84.7%, 2.8%, and 12.5%, respectively. All patients with MIBC received neoadjuvant cisplatin-based chemotherapy. Radical cystectomy was performed in 8 (7.6%) cases; three patients with MIBC and five with high-volume non-MIBC. Neobladder reconstruction was done in six patients. A total of 13 patients with metastatic disease (93%) received palliative chemotherapy (gemcitabine/cisplatin), and one (7%) was a candidate for best supportive care only. Conclusion Bladder cancer is relatively rare in the young population, although the incidence at our region is higher than other reports in the literature. Most patients present with early disease. Early diagnosis and multidisciplinary approach are paramount for the management of these patients.
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Affiliation(s)
- Mahmoud Albakri
- Department of Surgery, King Hussein Cancer Center, Amman, Jordan
| | - Ramiz Abu-Hijlih
- Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Samer Salah
- Department of Medical Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Fawzi Abuhijla
- Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan
| | | | - Ala’a Farkouh
- Department of Surgery, King Hussein Cancer Center, Amman, Jordan
| | - Zeinab Obeid
- Department of Surgery, King Hussein Cancer Center, Amman, Jordan
| | - Mohammed Shahait
- Clemenceau Medical Center, Al Jaddaf, Dubai, United Arab Emirates
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Alshehri E, Al-Dogmi AM, Al-Hazani TMI, Alwaili MA, Safhi FA, Alneghery LM, Jalal AS, Alanazi IS, AlQassim FA, Alhumaidi Alotaibi M, Al-Qahtani WS. Patterns of mutations in nine cancer-related genes and PAF development among smoking male patients diagnosed with bladder cancer. Tumour Biol 2023; 45:1-14. [PMID: 36806529 DOI: 10.3233/tub-220032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Smoking is one of the most popular risk factors provoking bladder cancer (BC). This research intended to estimate cigarette smoking effect involving PAF signs between smoking patients with BC and non-smoking patients with same diagnosis to define relations with pathological characteristics and their prognosis on zero-relapse and disease-associated recovery. METHODS Two groups of smokers (n = 54) and non-smokers (n = 62) were selected. Both cohorts of patients had BC. They were evaluated utilizing NGS on 9 cancer-related genes and confirmed through the Sanger DNA sequencing and histopathological tests based on H&E staining. The factor of smoking and impact of PAF development by ELISA assay and PAF-R manifestation in terms of immunochemical evaluation on BC areas comparing to a control group (n = 30) was examined involving healthy contributors, including the use of well-designed statistical trials. RESULTS The multivariate evaluation showed considerable rise in mutation patterns related to smoking among BC patients (group 3), increase in PAF development (***P<0.001) and vivid signs of PAF-R contrasted to non-smokers with BC (group 2) and control group (group 1). All the identified biological changes (gains/losses) were recorded at the same locations in both groups. Patients from group 3 held 3-4 various mutations, while patients from group 2 held 1-3 various mutations. Mutations were not identified in 30 respondents from control group. The most repeated mutations were identified in 3 of 9 examined genes, namely TP53, PIK3CA and PTEN, with highest rates of increase in Group 3. Moreover, histopathological tests revealed barely identifiable and abnormal traits in BC tissues, i.e. were without essential histopathological changes between groups 2 and 3. CONCLUSION Smoking of cigarettes provokes PAF development due to urothelial inflammation and rise of mutations in 9 cancer-related genes. These are indicative factors of inducing BC.
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Affiliation(s)
- Eman Alshehri
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Amal M Al-Dogmi
- Department of Biology, College of Science, Jouf University, Sakakah, Saudi Arabia
| | | | - Maha Abdulla Alwaili
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Fatmah Ahmed Safhi
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Lina Mohammed Alneghery
- Department of Biology, College of Science, Al-Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Areej Saud Jalal
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Ibtesam Sanad Alanazi
- Department of Biology, Faculty of Sciences, University of Hafr Al-Batin, Hafar al-Batin, Saudi Arabia
| | | | | | - Wedad Saeed Al-Qahtani
- Department of Forensic Sciences, College of Criminal Justice, Naif Arab University for Security Sciences, Riyadh, Saudi Arabia
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Predictive Value of Inflammatory and Nutritional Indexes in the Pathology of Bladder Cancer Patients Treated with Radical Cystectomy. Curr Oncol 2023; 30:2582-2597. [PMID: 36975410 PMCID: PMC10047817 DOI: 10.3390/curroncol30030197] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
In recent years, the focus of numerous studies has been the predictive value of inflammatory and nutritional parameters in oncology patients. The aim of our study was to examine the relationship between the inflammatory and nutritional parameters and the histopathological characteristics of patients with bladder cancer. A retrospective study included 491 patients who underwent radical cystectomy for bladder cancer between 2017 and 2021. We calculated the preoperative values of the neutrophil-to-lymphocyte ratio (NLR), the derived neutrophil-to-lymphocyte ratio (dNLR), the systemic immune-inflammation index (SII), the systemic inflammatory response index (SIRI), the platelet-to-lymphocyte ratio (PLR), the lymphocyte-to-monocyte ratio (LMR), the prognostic nutritional index (PNI), and the geriatric nutritional risk index (GNRI). Statistically significant positive correlations were observed between NLR, dNLR, SII, SIRI, and PLR and the pathological stage of the tumor. We observed statistically significant inverse correlations for LMR, PNI, and GNRI with the tumor stage. SIRI was identified as an independent predictor of the presence of LVI. dNLR was identified as an independent predictor of positive surgical margins. GNRI was identified as an independent predictor of the presence of metastases in the lymph nodes. We noticed the predictive value of SIRI, dNLR, and GNRI in the pathology of bladder cancer patients.
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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: 2] [Impact Index Per Article: 2.0] [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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Chawla NS, Sayegh N, Tripathi N, Govindarajan A, Zengin ZB, Phillip EJ, Dizman N, Meza L, Muddasani R, Chehrazi-Raffle A, Malhotra J, Hsu J, Agarwal N, Pal SK, Tripathi A. Genomic and Clinical Prognostic Factors in Patients With Advanced Urothelial Carcinoma Receiving Immune Checkpoint Inhibitors. Clin Genitourin Cancer 2023; 21:69-75. [PMID: 36509613 DOI: 10.1016/j.clgc.2022.11.007] [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: 04/25/2022] [Revised: 11/08/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Recently data suggest that telomerase reverse transcripatase (TERT) promoter mutations portend superior outcomes with immune checkpoint inhibitor (ICI) therapy in mUC. In our retrospective analysis from 2 tertiary cancer centers, we assessed the predictive role of TERT mutations along with other parameters. METHODS Patient registries were queried for patients treated with ICI for mUC with available genomic and clinical data. Select clinical and laboratory parameters, in addition to primary tumor site, histology, treatment modality, and setting were recorded. Tumor mutational burden (TMB), and mutational status of TERT, CDKN2A, CDKN2B, TMB, TP53, RB1, KMT2D, ARID1A, ERBB2, KDM6A, PIK3CA, FGFR3, and ATM were noted. Univariate analysis of significance concerning overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) was conducted. RESULTS In total, 113 patients were found to meet inclusion criteria. In our study, ORR was 55%, median PFS was 5.1 months (0.2-71.8), and median OS was 13.4 months (0.2-84.8). On univariate analysis, female sex, NLR>5, and ATM mutation were associated with inferior PFS and OS, whereas upper tract primary disease and ECOG score ≥ 2 were associated with worse OS. On multivariate analysis, NLR >5 was associated with worse PFS and OS whereas upper tract primary disease, albumin <3.4 g/dL, hemoglobin <10 g/dL and ATM mutation were significantly associated with worse OS on multivariate analysis. No significant differences were seen in ORR, PFS, or OS regarding TERT promoter mutations. CONCLUSION TERT promoter mutations were not significantly associated with any difference in outcome in patients treated with ICI.
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Affiliation(s)
- Neal S Chawla
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Nicolas Sayegh
- Division of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Nishita Tripathi
- Division of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Ameish Govindarajan
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Zeynep B Zengin
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Errol J Phillip
- School of Medicine, University of California San Francisco, San Francisco, CA
| | - Nazli Dizman
- Yale University School of Medicine, New Haven, CT
| | - Luis Meza
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Ramya Muddasani
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Alexander Chehrazi-Raffle
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Jasnoor Malhotra
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - JoAnn Hsu
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Neeraj Agarwal
- Division of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Sumanta K Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Abhishek Tripathi
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA.
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Lin W, Pan X, Zhang C, Ye B, Song J. Impact of Age at Diagnosis of Bladder Cancer on Survival: A Surveillance, Epidemiology, and End Results-Based Study 2004-2015. Cancer Control 2023; 30:10732748231152322. [PMID: 36662642 PMCID: PMC9903028 DOI: 10.1177/10732748231152322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND An older age contributes to the development of bladder cancer. However, the relationship between advanced age at the diagnosis and prognosis of bladder cancer has been few reported. This study aimed to determine the effect of age on survival in bladder cancer with different subgroups. METHODS 117,275 patients with bladder cancer, identified from the Surveillance, Epidemiology, and End Results database during 2004-2015 in America, were divided into 4 age groups (≤54, 55 to 64, 65 to 74, and ≥75 years). Multivariable Cox proportional-hazards model and competing risk model were conducted according to different age groups. Heat maps were plotted to show the impact of age on survival in subgroups classified by other clinicopathological variables. Moreover, restricted cubic spline was used to model the association between age and the risk of death. RESULTS Patients aged ≥75 years had shorter overall survival in comparison with those aged ≤54 years (hazard ratio [HR] = 5.36, 95% confidence interval [CI] = 5.13-5.59). Compared with patients aged ≤54 years, patients older than 75 years experienced a decreased rate of bladder cancer-specific survival (subdistribution HR = 2.15, 95% CI = 2.04-2.25). Heat maps also showed that older ages were associated with worse overall cumulative mortality and bladder cancer-specific cumulative mortality. Similarly, restricted cubic spline verified the impact of age on survival of bladder cancer. CONCLUSIONS Age at diagnosis of bladder cancer was found to be a significant predictor for the worse overall survival and bladder cancer-specific survival even in an era with more effective therapies. Exploring the reasons why older age contributes to poor outcomes for bladder cancer will be the focus of future research.
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Affiliation(s)
- Wu Lin
- Department of Emergency Medicine, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, P.R. China
| | - Xuming Pan
- Department of Emergency Medicine, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, P.R. China
| | - Chun Zhang
- Department of General Surgery, Hospital of Traditional Chinese Medicine of Songyang, Lishui, P.R. China
| | - Bochun Ye
- Department of Emergency Medicine, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, P.R. China
| | - Jia Song
- Department of General Practice, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, P.R. China,Jia Song, Department of General Practice, The Second Affiliate Hospital of Zhejiang Chinese Medical University, 318 Chaowang Road, Gongshu District, Hangzhou 310053, China.
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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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Xiao Y, Xu D, Jiang C, Huili Y, Nie S, Zhu H, Fan G, Guan X. Telomere maintenance-related genes are important for survival prediction and subtype identification in bladder cancer. Front Genet 2023; 13:1087246. [PMID: 36685927 PMCID: PMC9853053 DOI: 10.3389/fgene.2022.1087246] [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: 11/02/2022] [Accepted: 12/20/2022] [Indexed: 01/09/2023] Open
Abstract
Background: Bladder cancer ranks among the top three in the urology field for both morbidity and mortality. Telomere maintenance-related genes are closely related to the development and progression of bladder cancer, and approximately 60%-80% of mutated telomere maintenance genes can usually be found in patients with bladder cancer. Methods: Telomere maintenance-related gene expression profiles were obtained through limma R packages. Of the 359 differential genes screened, 17 prognostically relevant ones were obtained by univariate independent prognostic analysis, and then analysed by LASSO regression. The best result was selected to output the model formula, and 11 model-related genes were obtained. The TCGA cohort was used as the internal group and the GEO dataset as the external group, to externally validate the model. Then, the HPA database was used to query the immunohistochemistry of the 11 model genes. Integrating model scoring with clinical information, we drew a nomogram. Concomitantly, we conducted an in-depth analysis of the immune profile and drug sensitivity of the bladder cancer. Referring to the matrix heatmap, delta area plot, consistency cumulative distribution function plot, and tracking plot, we further divided the sample into two subtypes and delved into both. Results: Using bioinformatics, we obtained a prognostic model of telomere maintenance-related genes. Through verification with the internal and the external groups, we believe that the model can steadily predict the survival of patients with bladder cancer. Through the HPA database, we found that three genes, namely ABCC9, AHNAK, and DIP2C, had low expression in patients with tumours, and eight other genes-PLOD1, SLC3A2, RUNX2, RAD9A, CHMP4C, DARS2, CLIC3, and POU5F1-were highly expressed in patients with tumours. The model had accurate predictive power for populations with different clinicopathological features. Through the nomogram, we could easily assess the survival rate of patients. Clinicians can formulate targeted diagnosis and treatment plans for patients based on the prediction results of patient survival, immunoassays, and drug susceptibility analysis. Different subtypes help to further subdivide patients for better treatment purposes. Conclusion: According to the results obtained by the nomogram in this study, combined with the results of patient immune-analysis and drug susceptibility analysis, clinicians can formulate diagnosis and personalized treatment plans for patients. Different subtypes can be used to further subdivide the patient for a more precise treatment plan.
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Affiliation(s)
- Yonggui Xiao
- Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Danping Xu
- Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, China
| | - Chonghao Jiang
- Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Youlong Huili
- Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Shiwen Nie
- Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Hongfei Zhu
- Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Guorui Fan
- Affiliated Hospital of North China University of Science and Technology, Tangshan, China
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Jakus D, Čepin P, Vrhovac I, Jakus IA. Influence of the grade and invasiveness of bladder cancer on disease course severity in patients with bladder tamponade resulting from a bleeding bladder cancer. Urol Ann 2023; 15:27-30. [PMID: 37006207 PMCID: PMC10062507 DOI: 10.4103/ua.ua_181_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 08/29/2022] [Accepted: 08/10/2022] [Indexed: 04/04/2023] Open
Abstract
Introduction and Objectives Urinary bladder tamponade is a common urological emergency, but it has so far been insufficiently researched. The aim of our study was to show the association between the characteristics of bladder cancer (grade and invasiveness) and disease course severity based on blood hemoglobin (Hgb) count at admission, the need for red blood cell transfusion (RBCT), and the length of hospitalization in patients suffering from bladder tamponade. Materials and Methods A retrospective, cross-sectional study was conducted, namely, including 25 adult patients surgically treated for bladder tamponade resulting from a bleeding bladder cancer. Results Patients with low-grade cancer had statistically significantly higher mean Hgb values at admission (101.14 ± 8.26 vs. 87.22 g/L ± 10.64 g/L, P = 0.005), as well as a lower mean number of received units of RBCT (0.71 ± 0.76 vs. 2.39 ± 1.46, P < 0.001) and a shorter hospitalization (2.43 ± 0.55 vs. 4.36 ± 1.04 days, P = 0.009) than those with high-grade cancer. Patients suffering from nonmuscle-invasive bladder cancer (NMIBC) had statistically significantly higher mean Hgb values at admission (96.69 ± 9.86 g/L vs. 81.22 ± 7.23 g/L, P = 0.001), as well as a lower mean number of received units of RBCT (1.31 ± 1.2 vs. 3 ± 1.41, P = 0.004) and a shorter hospitalization (3.31 ± 1.14 vs. 4.78 ± 0.97 days, P = 0.004) than those with muscle-invasive bladder cancer. Conclusion Low-grade bladder cancer and NMIBC are associated with a milder clinical course of bladder tamponade.
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Affiliation(s)
- Dora Jakus
- Department of Urology, University Hospital Center Split, Split, Croatia
| | - Petra Čepin
- Department of Urology, University Hospital Center Split, Split, Croatia
| | - Ivana Vrhovac
- Department of Urology, University Hospital Center Split, Split, Croatia
| | - Ivana Alujević Jakus
- Department of Gynecology and Obstetrics, University Hospital Center Split, Split, Croatia
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Yu J, Li H, Liu Z, Wang T, Zhou F, Ma S, Chen B, Chen W. Meat Intake and the Risk of Bladder Cancer: A Systematic Review and Meta-Analysis of Observational Studies. Nutr Cancer 2023; 75:825-845. [PMID: 36537666 DOI: 10.1080/01635581.2022.2159043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
The evidence for the association between meat intake and the risk of bladder cancer (BC) is still inconclusive. A total of 29 studies involving 1,475,125 participants and 18,836 cases of BC were included in the meta-analysis. Among these studies, 11 reported total meat intake, 20 reported red meat intake, 19 reported processed meat intake, 15 reported white meat intake, and 15 reported fish intake. The results suggested that there was an overall increase in BC risk associated with total meat intake (RR = 1.10; 95% confidence interval: 0.92-1.31; I2 = 55.20%; P = 0.014), and a higher red meat (RR = 1.23; 95% CI: 1.08-1.39; I2 = 51.30%; P = 0.004) or processed meat (RR = 1.16; 95% CI: 1.08-1.25; I2 = 28.00%; P = 0.125) intake may increase the risk of BC. In contrast, a higher intake of fish (RR = 0.80; 95% CI: 0.67-0.95; I2 = 62.90%; P = 0.001) was inversely associated with the risk of BC. Moreover, we did not observe an association between white meat (RR = 0.96; 95% CI: 0.83-1.10; I2 = 53.70%; P = 0.007) and the risk of BC. Our findings suggested that dietary intervention may be an effective approach to preventing BC, which still needs to be confirmed by further well-designed observational studies.
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Affiliation(s)
- Jinchuan Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Haigui Li
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Zhengxiang Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Ting Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Fuding Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Baochun Chen
- Department of Anhui No.2 Provincial People' Hospital, Hefei, China
| | - Wenjun Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
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Fan J, Liang H, Fan J, Li L, Zhang G, Pei X, Yang T, He D, Wu K. Diagnostic accuracy of cystoscopic biopsy for tumour grade in outpatients with urothelial carcinoma of the bladder and the risk factors of upgrading. Asian J Urol 2023; 10:19-26. [PMID: 36721698 PMCID: PMC9875145 DOI: 10.1016/j.ajur.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 03/22/2021] [Accepted: 05/13/2021] [Indexed: 02/03/2023] Open
Abstract
Objective To assess the concordance of tumour grade in specimens obtained from diagnostic cystoscopic biopsy and transurethral resection of bladder tumour (TURBT) and explore the risk factors of upgrading. Methods The medical records of 205 outpatients who underwent diagnostic cystoscopic biopsy before initial TURBT were retrospectively reviewed. Comparative analysis of the tumour grade of biopsy and operation specimens was performed. Tumour grade changing from low-grade to high-grade with or without variant histology was defined as upgrading. Logistic regression analyses were performed to identify the risk factors of upgrading. Results For the 205 patients, the concordance of tumour grade between specimens obtained from biopsy and operation was 0.639. The concordance for patients who were preoperatively diagnosed with low-grade and high-grade was 0.504 and 0.912, respectively. Univariate and multivariate logistic regression analyses showed that older age, tumour multifocality, high neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and low lymphocyte-to-monocyte ratio (LMR) were significantly associated with upgrading (odds ratio ranging from 0.412 to 4.364). The area under the curve of the different multivariate models was improved from 0.752 to 0.821, and decision curve analysis demonstrated a high net benefit when NLR, LMR, and PLR were added. Conclusion Diagnostic cystoscopic biopsy may not accurately represent the true grade of primary bladder cancer, especially for outpatients with low-grade bladder cancer. Moreover, older age, tumour multifocality, high NLR, PLR, and low LMR are risk factors of upgrading, and systemic inflammatory markers improve the predictive ability.
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Affiliation(s)
- Junjie Fan
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China,Department of Urology, Baoji Center Hospital, Baoji, China
| | - Hua Liang
- Department of Pathology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jinhai Fan
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lei Li
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Guanjun Zhang
- Department of Pathology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xinqi Pei
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Tao Yang
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Dalin He
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Kaijie Wu
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China,Corresponding author.
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Sun Z, Zhang W, Ye Z, Yuan L, Fu M, Liu X, Liang H, Han H. NIR-II-triggered doxorubicin release for orthotopic bladder cancer chemo-photothermal therapy. NANOSCALE 2022; 14:17929-17939. [PMID: 36325926 DOI: 10.1039/d2nr04200b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Intravesical instillation has been widely utilized for bladder cancer treatment in clinic. However, due to the bladder mucosal barrier, its poor penetration efficiency and drug utilization limit the clinical therapeutic effectiveness and result in a high recurrence rate. Therefore, designing an efficient and controllable drug delivery nanoplatform is of great significance for bladder cancer treatment. Non-invasive therapy based on near-infrared-II (NIR-II) photothermal therapy (PTT) conduces to overcome bladder mucosal barrier and enhance drug delivery. Also, the photothermal nanomaterials, Au Hollow Nanorods (AuHNRs), demonstrate strong photothermal properties and drug loading capacity. Herein, a quaternized chitosan N-(2-hydroxyl)propyl-3-trimethyl ammonium chitosan chloride (HTCC)-modified nanocarrier Dox/NH4HCO3@AuHNRs-HTCC (DNAH) was designed for controlled drug release and enhanced penetration. The drug loading capacity of DNAH reached 117.20%. Also, the thermal decomposition of NH4HCO3 realized NIR-II-triggered gas-driven drug burst release, and the doxorubicin release was 2.79 times higher within 1 h after NIR-II irradiation. Also, the HTCC-modified nanocarriers significantly enhanced the bladder mucosal permeability as well as long-term drug retention, and the penetration efficiency of DNAH increased by 144%. In the orthotopic bladder cancer model, the tumor suppression rate and mouse survival time were significantly improved. DNAH showed potent inhibition of the orthotopic bladder tumor growth owing to the enhanced penetration and drug delivery. This work presents a potential drug delivery nanocarrier, which is promising for optimized bladder mucosal permeability and controlled drug burst release.
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Affiliation(s)
- Zhiduo Sun
- State Key Laboratory of Agricultural Microbiology, College of Life Science and Technology, Huazhong Agricultural University, Wuhan 430070, P. R. China.
| | - Weiyun Zhang
- Marshall Laboratory of Biomedical Engineering, Research Center for Biosensor and Nanotheranostic, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Health Science Center, Shenzhen University, Guangdong 518060, P. R. China
| | - Zhichao Ye
- Department of Urology, Union Hospital, Tongji Medical College, School of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan 430070, P. R. China
| | - Li Yuan
- Department of Ultrasonography, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, P. R. China
| | - Manli Fu
- Department of Ultrasonography, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, P. R. China
| | - Xiaoming Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, P. R. China
| | - Huageng Liang
- Department of Urology, Union Hospital, Tongji Medical College, School of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan 430070, P. R. China
| | - Heyou Han
- State Key Laboratory of Agricultural Microbiology, College of Life Science and Technology, Huazhong Agricultural University, Wuhan 430070, P. R. China.
- State Key Laboratory of Agricultural Microbiology, College of Science, Huazhong Agricultural University, Wuhan 430070, P. R. China
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Kachanov M, Vetterlein MW, Soave A, Karakiewicz PI, Liakos N, Jankowski T, Pose RM, Mandrek M, Fisch M, Witt JH, Graefen M, Leyh-Bannurah SR. Oncologic impact of concomitant prostate cancer characteristics at the time of radical cystoprostatectomy for bladder cancer: a population-based analysis. Aging Male 2022; 25:54-61. [PMID: 35179092 DOI: 10.1080/13685538.2022.2040982] [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] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the prognostic impact of concomitant prostate cancer (PCa) of the cancer-specific mortality (CSM) in the aging patient's papulation with bladder cancer (BCa) treated with radical cystoprostatectomy (RCP). MATERIALS AND METHODS Within the SEER database (2004-2015), 1468 patients were treated with RCP for BCa harboring histopathological PCa findings. To account for other cause mortality (OCM), multivariable competing risk regression (CRR) tested for potential BCa-CSM differences according to PCa characteristics risk factors predicting CSM. RESULTS CRR analysis revealed that only following BCa characteristics, as high pathological tumor stages(Ta/Tis/T1 [REF.] vs. T2; HR 2.03, 95% CI: 1.16-3.57, p = 0.014 vs. T3; HR 4.32, 95% CI: 2.45-7.61, p < 0.001 vs. T4; HR 5.06, 95% CI: 2.77-9.22, p < 0.001), as well unfavorable BCa grade IV (Grade I-II [REF.] vs. Grade IV; HR 0.58, 95% CI: 0.35-0.98, p < 0.041) achieved independent predictor status of CSM. With regard to PCa characteristics, none of the covariates yielded independent predictor status of CSM. CONCLUSIONS Our study, based on the largest population cohort, demonstrates that even in organ-confined BCa patients, concomitant PCa as second malignancy does not represent a risk factor for survival.
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Affiliation(s)
- Mykyta Kachanov
- Martini-Klinik, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Malte W Vetterlein
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Armin Soave
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada
| | - Nikolaos Liakos
- Prostate Center Northwest, Department of Urology, Paediatric Urology and Uro-Oncology, St. Antonius-Hospital, Gronau, Germany
| | - Thomas Jankowski
- Prostate Center Northwest, Department of Urology, Paediatric Urology and Uro-Oncology, St. Antonius-Hospital, Gronau, Germany
| | - Randi M Pose
- Martini-Klinik, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mikolaj Mandrek
- Prostate Center Northwest, Department of Urology, Paediatric Urology and Uro-Oncology, St. Antonius-Hospital, Gronau, Germany
| | - Margit Fisch
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jorn H Witt
- Prostate Center Northwest, Department of Urology, Paediatric Urology and Uro-Oncology, St. Antonius-Hospital, Gronau, Germany
| | - Markus Graefen
- Martini-Klinik, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sami-Ramzi Leyh-Bannurah
- Prostate Center Northwest, Department of Urology, Paediatric Urology and Uro-Oncology, St. Antonius-Hospital, Gronau, Germany
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