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Mazzaschi G, Giudice GC, Corianò M, Campobasso D, Perrone F, Maffezzoli M, Testi I, Isella L, Maestroni U, Buti S. Upper Tract Urinary Carcinoma: A Unique Immuno-Molecular Entity and a Clinical Challenge in the Current Therapeutic Scenario. Technol Cancer Res Treat 2023; 22:15330338231159753. [PMID: 36855829 PMCID: PMC9983117 DOI: 10.1177/15330338231159753] [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: 03/02/2023] Open
Abstract
Urothelial carcinoma (UC) is the most frequent malignancy of the urinary tract, which consists of bladder cancer (BC) for 90%, while 5% to 10%, of urinary tract UC (UTUC). BC and UTUC are characterized by distinct phenotypical and genotypical features as well as specific gene- and protein- expression profiles, which result in a diverse natural history of the tumor. With respect to BC, UTUC tends to be diagnosed in a later stage and displays poorer clinical outcome. In the present review, we seek to highlight the individuality of UTUC from a biological, immunological, genetic-molecular, and clinical standpoint, also reporting the most recent evidence on UTUC treatment. In this regard, while the role of surgery in nonmetastatic UTUC is undebated, solid data on adjuvant or neoadjuvant chemotherapy are still an unmet need, not permitting a definite paradigm shift in the standard treatment. In advanced setting, evidence is mainly based on BC literature and retrospective studies and confirms platinum-based combination regimens as bedrock of first-line treatment. Recently, immunotherapy and target therapy are gaining a foothold in the treatment of metastatic disease, with pembrolizumab and atezolizumab showing encouraging results in combination with chemotherapy as a first-line strategy. Moreover, atezolizumab performed well as a maintenance treatment, while pembrolizumab as a single agent achieved promising outcomes in second-line setting. Regarding the target therapy, erdafitinib, a fibroblast growth factor receptor inhibitor, and enfortumab vedotin, an antibody-drug conjugate, proved to have a strong antitumor property, likely due to the distinctive immune-genetic background of UTUC. In this context, great efforts have been addressed to uncover the biological, immunological, and clinical grounds in UTUC patients in order to achieve a personalized treatment.
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Affiliation(s)
- Giulia Mazzaschi
- Medical Oncology Unit, 18630University Hospital of Parma, Parma, Italy.,Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giulia Claire Giudice
- Medical Oncology Unit, 18630University Hospital of Parma, Parma, Italy.,Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Matilde Corianò
- Medical Oncology Unit, 18630University Hospital of Parma, Parma, Italy.,Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Davide Campobasso
- Department of Urology, 18630University Hospital of Parma, Parma, Italy
| | - Fabiana Perrone
- Medical Oncology Unit, 18630University Hospital of Parma, Parma, Italy
| | - Michele Maffezzoli
- Medical Oncology Unit, 18630University Hospital of Parma, Parma, Italy.,Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Irene Testi
- Medical Oncology Unit, 18630University Hospital of Parma, Parma, Italy.,Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Luca Isella
- Medical Oncology Unit, 18630University Hospital of Parma, Parma, Italy.,Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Umberto Maestroni
- Department of Urology, 18630University Hospital of Parma, Parma, Italy
| | - Sebastiano Buti
- Medical Oncology Unit, 18630University Hospital of Parma, Parma, Italy.,Department of Medicine and Surgery, University of Parma, Parma, Italy
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Xia Z, Fu X, Yuan X, Li J, Wang H, Sun J, Wu J, Tang L. Serum albumin to globulin ratio prior to treatment as a potential non-invasive prognostic indicator for urological cancers. Front Nutr 2022; 9:1012181. [PMID: 36386921 PMCID: PMC9643875 DOI: 10.3389/fnut.2022.1012181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/12/2022] [Indexed: 11/26/2022] Open
Abstract
Background Numerous clinical studies have reported an association between the pretreatment albumin to globulin ratio (AGR) and survival outcomes of urological cancers. However, these conclusions remain controversial. Therefore, we performed a meta-analysis to explore the prognostic value of the AGR in urinary system tumors. Methods We retrieved eligible studies published up to June 2022 through a comprehensive search of multiple databases. Pooled hazard ratios (HRs) with 95% confidence intervals (CI) for overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), progression-free survival (PFS), and biochemical recurrence-free survival (BRFS) were used to evaluated the predictive effect of the AGR before treatment in urinary system tumors. Heterogeneity test, random-effects models, fixed-effects models and sensitivity tests were used for analyses. Results A total of 21 studies with 18,269 patients were enrolled in our meta-analysis. We found that patients with urinary system cancer with low AGR prior to treatment had poor OS [HR = 1.93, 95% CI (1.56–2.39), p < 0.001], CSS [HR = 2.22, 95% CI (1.67–2.96), p < 0.001], RFS [HR = 1.69, 95% CI (1.29–2.22), p < 0.001], and PFS [HR = 1.29, 95% CI (0.54–3.07), p < 0.001]. For prostate cancer (PCa), a low pretreatment AGR was associated with poor BRFS [HR = 1.46, 95% CI (1.28–1.67), p < 0.001]. Also, a subgroup analysis, stratified by ethnicity, cancer type, cutoff value, sample size and publication year, was conducted. The results showed that worse OS and CSS were significantly associated with these factors. Conclusion Our meta-analysis revealed that the AGR before treatment could be used as a non-invasive predictive biomarker to evaluate the prognosis of urological cancer patients in clinical practice.
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Affiliation(s)
- Zhongyou Xia
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical University, Nanchong, Sichuan, China
| | - Xueqin Fu
- Department of Breast Surgery, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
| | - Xinzhu Yuan
- Department of Nephrology, Blood Purification Center, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical University, Nanchong, Sichuan, China
| | - Jinze Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hao Wang
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical University, Nanchong, Sichuan, China
| | - Jing Sun
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical University, Nanchong, Sichuan, China
| | - Ji Wu
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical University, Nanchong, Sichuan, China
- *Correspondence: Ji Wu,
| | - Lingtong Tang
- Department of Clinical Laboratory, The People’s Hospital of Gao County, Yibin, Sichuan, China
- Lingtong Tang,
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Chen H, Huang C, Ge H, Chen Q, Chen J, Li Y, Chen H, Luo S, Zhao L, Xu X. A novel LASSO-derived prognostic model predicting survival for non-small cell lung cancer patients with M1a diseases. Cancer Med 2022; 11:1561-1572. [PMID: 35128839 PMCID: PMC8921928 DOI: 10.1002/cam4.4560] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 11/16/2021] [Accepted: 11/30/2021] [Indexed: 11/12/2022] Open
Abstract
Introduction The current American Joint Committee on Cancer (AJCC) M1a staging of non‐small cell lung cancer (NSCLC) encompasses a wide disease spectrum, showing diverse prognosis. Methods Patients who diagnosed in an earlier period formed the training cohort, and those who diagnosed thereafter formed the validation cohort. Kaplan–Meier analysis was performed for the training cohort by dividing the M1a stage into three subgroups: (I) malignant pleural effusion (MPE) or malignant pericardial effusion (MPCE); (II) separate tumor nodules in contralateral lung (STCL); and (III) pleural tumor nodules on the ipsilateral lung (PTIL). Gender, age, histologic, N stage, grade, surgery for primary site, lymphadenectomy, M1a groups, and chemotherapy were selected as independent prognostic factors using the least absolute shrinkage and selection operator (LASSO) Cox regression analysis. And a nomogram was constructed using Cox hazard regression analysis. Accuracy and clinical practicability were separately tested by Harrell's concordance index, the receiver operating characteristic (ROC) curve, calibration plots, residual plot, the integrated discrimination improvement (IDI), net reclassification improvement (NRI), and decision curve analysis (DCA). Results The concordance index (0.661 for the training cohort and 0.688 for the validation cohort) and the area under the ROC curve (training cohort: 0.709 for 1‐year and 0.727 for 2‐year OS prediction; validation cohort: 0.737 for 1‐year and 0.734 for 2‐year OS prediction) indicated satisfactory discriminative ability of the nomogram. Calibration curve and DCA presented great prognostic accuracy, and clinical applicability. Its prognostic accuracy preceded the AJCC staging with evaluated NRI (1‐year: 0.327; 2‐year: 0.302) and IDI (1‐year: 0.138; 2‐year: 0.130). Conclusion Our study established a nomogram for the prediction of 1‐ and 2‐year OS in patients with NSCLC diagnosed with stage M1a, facilitating healthcare workers to accurately evaluate the individual survival of M1a NSCLC patients. The accuracy and clinical applicability of this nomogram were validated.
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Affiliation(s)
- Hongchao Chen
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Chen Huang
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Huiqing Ge
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Qianshun Chen
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Jing Chen
- Department of Pharmacy, Fujian Children's hospital, Fuzhou, Fujian, China
| | - Yuqiang Li
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Haiyong Chen
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Shiyin Luo
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Lilan Zhao
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Xunyu Xu
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
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Qian S, Liang C, Ding Y, Wang C, Shen H. Preoperative hydronephrosis predicts adverse pathological features and postoperative survival in patients with high-grade upper tract urothelial carcinoma. Int Braz J Urol 2021; 47:159-168. [PMID: 33047921 PMCID: PMC7712693 DOI: 10.1590/s1677-5538.ibju.2020.0021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/29/2020] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Epidemiological studies reported conflicting results about preoperative hydronephrosis in upper tract urothelial carcinoma (UTUC). This study aimed to investigate the association between preoperative hydronephrosis and pathologic features and oncologic outcomes in patients with UTUC treated by radical nephroureterectomy (RNU). MATERIALS AND METHODS This was a retrospective, single-center cohort study of 377 patients treated by RNU without perioperative chemotherapy between January 2001 and December 2014. Logistic regression, Cox regression, and survival analyses were performed. RESULTS Among the 226 patients with high-grade UTUC, 132 (58%) had preoperative hydronephrosis. Multivariable logistic regression revealed that hydronephrosis was independently associated with advanced pT stage (P=0.017) and lymph node or lymphovascular invasion (P=0.002). Median follow-up was 36 months (interquartile range: 20-48 months). The 3- and 5-year overall survival (OS) rates in patients with hydronephrosis were significantly lower than in those without hydronephrosis (both P <0.001). The 3- and 5-year cancer-specific survival (CSS) rates in patients with hydronephrosis were significantly lower than in those without hydronephrosis (both P=0.001). Hydronephrosis was independently associated with OS and CSS (P=0.001 and P=0.004, respectively). Among the 151 patients with low-grade UTUC, hydronephrosis was not associated with pathologic features and postoperative survival. CONCLUSIONS Preoperative hydronephrosis was significantly associated with adverse pathologic features and postoperative survival in patients with high-grade UTUC.
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Affiliation(s)
- Subo Qian
- Shanghai Jiao Tong UniversitySchool of MedicineXinhua HospitalShanghaiChinaDepartment of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chengcai Liang
- Sun Yat-Sen University Cancer CenterState Key Laboratory of Oncology in South ChinaDepartment of Gastric and Pancreatic SurgeryGuangzhouChinaDepartment of Gastric and Pancreatic Surgery, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou, China
| | - Yu Ding
- Shanghai Jiao Tong UniversitySchool of MedicineXinhua HospitalShanghaiChinaDepartment of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chen Wang
- Shanghai Jiao Tong UniversitySchool of MedicineXinhua HospitalShanghaiChinaDepartment of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Haibo Shen
- Shanghai Jiao Tong UniversitySchool of MedicineXinhua HospitalShanghaiChinaDepartment of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Valenberg FJPV, Hiar AM, Wallace E, Bridge JA, Mayne DJ, Beqaj S, Sexton WJ, Lotan Y, Weizer AZ, Jansz GK, Stenzl A, Danella JF, Cline KJ, Williams MB, Montgomery S, David RD, Harris R, Klein EW, Bradford TJ, Wolk FN, Westenfelder KR, Trainer AF, Richardson TA, Egerdie RB, Goldfarb B, Zadra JA, Lu X, Simon IM, Campbell SA, Bates MP, Higuchi RG, Witjes JA. Validation of an mRNA-based Urine Test for the Detection of Bladder Cancer in Patients with Haematuria. Eur Urol Oncol 2020; 4:93-101. [PMID: 33004290 DOI: 10.1016/j.euo.2020.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/04/2020] [Accepted: 09/01/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND In patients with haematuria, a fast, noninvasive test with high sensitivity (SN) and negative predictive value (NPV), which is able to detect or exclude bladder cancer (BC), is needed. A newly developed urine assay, Xpert Bladder Cancer Detection (Xpert), measures five mRNA targets (ABL1, CRH, IGF2, UPK1B, and ANXA10) that are frequently overexpressed in BC. OBJECTIVE To validate the performance of Xpert in patients with haematuria. DESIGN, SETTING, AND PARTICIPANTS Voided precystoscopy urine specimens were prospectively collected at 22 sites from patients without prior BC undergoing cystoscopy for haematuria. Xpert, cytology, and UroVysion procedures were performed. Technical validation was performed and specificity (SP) was determined in patients without BC. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Test characteristics were calculated based on cystoscopy and histology results, and compared between Xpert, cytology, and UroVysion. RESULTS AND LIMITATIONS We included 828 patients (mean age 64.5 yr, 467 males, 401 never smoked). Xpert had an SN of 78% (95% confidence interval [CI]: 66-87) overall and 90% (95% CI: 76-96) for high-grade (HG) tumours. The NPV was 98% (95% CI: 97-99) overall. The SP was 84% (95% CI: 81-86). In patients with microhaematuria, only one HG patient was missed (NPV 99%). Xpert had higher SN and NPV than cytology and UroVysion. Cytology had the highest SP (97%). In a separate SP study, Xpert had an SP of 89% in patients with benign prostate hypertrophy and 92% in prostate cancer patients. CONCLUSIONS Xpert is an easy-to-use, noninvasive test with improved SN and NPV compared with cytology and UroVysion, representing a promising tool for identifying haematuric patients with a low likelihood of BC who might not need to undergo cystoscopy. PATIENT SUMMARY Xpert is an easy-to-perform urine test with good performance compared with standard urine tests. It should help identify (micro)haematuria patients with a very low likelihood to have bladder cancer.
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Affiliation(s)
| | | | | | | | | | | | - Wade J Sexton
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Yair Lotan
- UT Southwestern Medical Center, Dallas, TX, USA
| | | | - Godfrey K Jansz
- Urology Office of G. Kenneth Janz, Burlington, Ontario, Canada
| | - Arnulf Stenzl
- Department of Urology, University Medical Clinic of Tübingen, Tübingen, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | - Russell B Egerdie
- Urology Associates/Urologic Medical Research, Kitchener, Ontario, Canada
| | | | | | | | | | | | | | | | - J Alfred Witjes
- Department of Urology, Radboudumc, Nijmegen, The Netherlands
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Mori K, Janisch F, Mostafaei H, Lysenko I, Kimura S, Egawa S, Shariat SF. Prognostic value of preoperative blood-based biomarkers in upper tract urothelial carcinoma treated with nephroureterectomy: A systematic review and meta-analysis. Urol Oncol 2020; 38:315-333. [PMID: 32088103 DOI: 10.1016/j.urolonc.2020.01.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE This systematic review and meta-analysis assessed the prognostic value of preoperative blood-based biomarkers in patients with upper tract urothelial carcinoma (UTUC) treated with nephroureterectomy. METHODS PUBMED, Web of Science, Cochrane Library, and Scopus databases were searched in June 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Studies were deemed eligible if they compared cancer-specific survival in UTUC patients with and without pretreatment laboratory abnormalities. Formal meta-analyses were performed for this outcome. RESULTS The review identified 54 studies with 23,118 patients, of these, 52 studies with 22,513 patients were eligible for the meta-analysis. Several preoperative blood-based biomarkers were significantly associated with cancer-specific survival as follows: neutrophil-lymphocyte ratio (pooled hazard ratio [HR]: 1.66, 95% confidence interval [CI]: 1.34-2.06), C-reactive protein (pooled HR: 1.17, 95% CI: 1.07-1.29), platelet-lymphocyte ratio (pooled HR: 1.68, 95% CI: 1.30-2.17), white blood cell (pooled HR: 1.58, 95% CI: 1.02-2.46), De Ritis ratio (pooled HR: 2.40, 95% CI: 1.92-2.99), fibrinogen (pooled HR: 2.23, 95% CI: 1.86-2.68), albumin-globulin ratio (pooled HR: 3.00, 95% CI: 1.87-4.84), hemoglobin (pooled HR: 1.51, 95% CI: 1.22-1.87), and estimate glomerular filtration rate (pooled HR: 1.52, 95% CI: 1.19-1.94). The Cochrane's Q test and I2 test revealed significant heterogeneity for neutrophil-lymphocyte ratio, C-reactive protein, white blood cell, hemoglobin, and estimated glomerular filtration rate (P = 0.022; I2 = 50.7%, P = 0.000; I2 = 80.4%, P = 0.000; I2 = 88.3%, P = 0.010; I2 = 62.0%, P = 0.000; I2 = 83.9%, respectively). CONCLUSIONS Several pretreatment laboratory abnormalities in patients with UTUC were associated with increased risks of cancer-specific mortality. Therefore, blood-based biomarkers may have the potential to serve as prognostic factors to assist patients and physicians in selecting appropriate treatment strategies for UTUC. However, considering the study limitations including heterogeneity and retrospective nature of the primary data, the conclusions should be interpreted with caution.
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Affiliation(s)
- Keiichiro Mori
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Florian Janisch
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Medical University of Hamburg, Hamburg, Germany
| | - Hadi Mostafaei
- Department of Urology, Medical University of Vienna, Vienna, Austria; Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ivan Lysenko
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Shoji Kimura
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shin Egawa
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern, Dallas, TX, USA; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
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Tian T, Zhang P, Zhong F, Sun C, Zhou J, Hu W. Nomogram construction for predicting survival of patients with non-small cell lung cancer with malignant pleural or pericardial effusion based on SEER analysis of 10,268 patients. Oncol Lett 2019; 19:449-459. [PMID: 31897158 PMCID: PMC6923903 DOI: 10.3892/ol.2019.11112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 10/29/2019] [Indexed: 01/21/2023] Open
Abstract
Determining the accurate outcome of patients with non-small cell lung cancer (NSCLC) and malignant pleural effusion (MPE) or malignant pleural pericardial effusion (MPCE) at the initial diagnosis remains a challenge. The aim of the present study was to develop an effective nomogram for individualized estimation of overall survival in these patients. Patients diagnosed between January 2010 and December 2015 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Age, race, sex, grade, histology, laterality, stage and status of MPE or MPCE at initial diagnosis were included as covariates. Several survival models were created and the performance of each was evaluated. The most effective model was then validated by internal bootstrap resampling and by using an independent external cohort. A nomogram was created based on this survival model and the predictive accuracy of the nomogram was evaluated by calibration plots. Data from 10,268 patients with lung cancer with MPE or MPCE at initial diagnosis were collected. The multivariate analysis with a lognormal model suggested that age, race, sex, histology, stage and status of MPE or MPCE at initial diagnosis were significant independent factors to predict survival. A nomogram was constructed based on the lognormal survival model, which showed the best performance. The concordance index of the survival model in the SEER cohort was 0.736. Both internal and external validation showed an acceptable level of agreement between the nomogram-predicted survival probability and actual survival. The nomogram of the present study based on a large cohort from the SEER database may improve prognostic prediction of patients with NSCLC with MPE or MPCE at initial diagnosis, and allow physicians to make appropriate decisions for disease management of their patients.
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Affiliation(s)
- Tian Tian
- Department of Medical Oncology, Fuyang People's Hospital, Fuyang, Anhui 236000, P.R. China
| | - Pengpeng Zhang
- Medical Imaging Center, Fuyang Second People's Hospital, Fuyang, Anhui 236000, P.R. China
| | - Fei Zhong
- Department of Medical Oncology, Affiliated Fuyang Hospital of Anhui Medical University, Fuyang, Anhui 236000, P.R. China
| | - Cuiling Sun
- Department of Medical Oncology, Fuyang People's Hospital, Fuyang, Anhui 236000, P.R. China
| | - Jian Zhou
- Department of Medical Oncology, Fuyang People's Hospital, Fuyang, Anhui 236000, P.R. China
| | - Wenjun Hu
- Department of Medical Oncology, Fuyang People's Hospital, Fuyang, Anhui 236000, P.R. China
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van Doeveren T, van Leeuwen PJ, Aben KKH, van der Aa M, Barendrecht M, Boevé ER, Cornel EB, van der Heijden AG, Hendricksen K, Hirdes W, Kooistra A, Kroon B, Leliveld AM, Meijer RP, van Melick H, Merks B, de Reijke TM, de Vries P, Wymenga LFA, Wijsman B, Boormans JL. Reduce bladder cancer recurrence in patients treated for upper urinary tract urothelial carcinoma: The REBACARE-trial. Contemp Clin Trials Commun 2018; 9:121-129. [PMID: 29696234 PMCID: PMC5898538 DOI: 10.1016/j.conctc.2018.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 01/15/2018] [Accepted: 01/19/2018] [Indexed: 11/28/2022] Open
Abstract
Background Following radical nephro-ureterectomy for urothelial carcinoma of the upper urinary tract (UUT), the reported bladder recurrence rate of urothelial carcinoma is 22–47%. A single intravesical instillation of chemotherapy within 10 days following nephro-ureterectomy has the potential to decrease the risk of a bladder recurrence significantly. Despite recommendation by the European Association of Urology guideline to administer a single instillation postoperatively, the compliance rate is low because the risk of extravasation of chemotherapy. Aim To reduce the risk of bladder cancer recurrence by a single intravesical instillation of Mitomycin immediately (within 3 h) before radical nephro-ureterectomy or partial ureterectomy. Methods Adult patients (age ≥ 18 years) with a (suspicion of a) urothelial carcinoma of the UUT undergoing radical nephro-ureterectomy or partial ureterectomy will be eligible and will receive a single intravesical instillation of Mitomycin within 3 h before surgery. In total, 170 patients will be included in this prospective, observational study. Follow-up will be according to current guidelines. Results The primary endpoint is the bladder cancer recurrence rate up to two years after surgery. Secondary endpoints are: a) the compliance rate; b) oncological outcome; c) possible side-effects; d) the quality of life; e) the calculation of costs of a single neoadjuvant instillation with Mitomycin and f) molecular characterization of UUT tumors and intravesical recurrences. Conclusions A single intravesical instillation of Mitomycin before radical nephro-ureterectomy or partial ureterectomy may reduce the risk of a bladder recurrence in patients treated for UUT urothelial carcinoma and will circumvent the disadvantages of current therapy.
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Affiliation(s)
- T van Doeveren
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - P J van Leeuwen
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - K K H Aben
- Netherlands Comprehensive Cancer Organisation, The Netherlands.,Radboud University Medical Center, Nijmegen, The Netherlands
| | - M van der Aa
- Spaarne Medical Center, Hoofddorp, The Netherlands
| | | | - E R Boevé
- Fransiscus Medical Center, Rotterdam, The Netherlands
| | - E B Cornel
- Ziekenhuis Groep Twente, Almelo and Hengelo, The Netherlands
| | | | - K Hendricksen
- Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - W Hirdes
- Isala Medical Center, Zwolle, The Netherlands
| | - A Kooistra
- Meander Medical Center, Amersfoort, The Netherlands
| | - B Kroon
- Rijnstate Medical Center, Arnhem, The Netherlands
| | - A M Leliveld
- University Medical Center Groningen, Groningen, The Netherlands
| | - R P Meijer
- University Medical Center Utrecht, Utrecht, The Netherlands
| | - H van Melick
- Sint Antonius Medical Center, Nieuwegein, The Netherlands
| | - B Merks
- Haaglanden Medical Center, Leidschendam, The Netherlands
| | | | - P de Vries
- Zuyderland Medical Center, Heerlen, The Netherlands
| | | | - B Wijsman
- Elisabeth-TweeSteden Medical Center, Tilburg, The Netherlands
| | - J L Boormans
- Erasmus University Medical Center, Rotterdam, The Netherlands
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Xian S, Shang D, Kong G, Tian Y. FOXJ1 promotes bladder cancer cell growth and regulates Warburg effect. Biochem Biophys Res Commun 2017; 495:988-994. [PMID: 29129693 DOI: 10.1016/j.bbrc.2017.11.063] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 11/08/2017] [Indexed: 12/22/2022]
Abstract
Forkhead Box J1 (FOXJ1) which belongs to Fox gene family, plays complex and crucial roles in processes of development, organogenesis, regulation of the immune system, as well as progression of several malignancies. However, how FOXJ1 functions in bladder cancer remains unclear. Here, we report that FOXJ1 is upregulated in most bladder cancer patients, and predicts poor clinical outcomes. FOXJ1 facilitates bladder cancer cell proliferation and colony formation. FOXJ1 knockdown suppresses bladder tumor growth in nude mice. Mechanistically, FOXJ1 enhances glycolysis by increasing glucose uptake, lactate production and extracellular acidification rate (ECAR), and decreasing ATP generation and oxygen consumption rate (OCR) in bladder cancer cells. Our findings provide clues regarding the role of FOXJ1 as a tumor inducer in bladder cancer and an enhancer in glycolysis. Targeting FOXJ1 could be a potential therapeutic strategy in bladder cancer.
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Affiliation(s)
- Shaozhong Xian
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China; Department of Urology, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China
| | - Donghao Shang
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Guangqi Kong
- Department of Urology, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China
| | - Ye Tian
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
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Luchini C, Cheng L. Predicting the biological behavior of non-muscle-invasive bladder cancer: from histology to molecular taxonomy. Transl Androl Urol 2017; 6:987-990. [PMID: 29184801 PMCID: PMC5673828 DOI: 10.21037/tau.2017.08.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 08/04/2017] [Indexed: 01/07/2023] Open
Affiliation(s)
- Claudio Luchini
- Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
- Surgical Pathology Unit, Santa Chiara Hospital, Trento, Italy
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA
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