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Bracarda S, Iacovelli R, Baldazzi V, Zucali PA, Gernone A, Conti GN, Pappagallo G, Brunelli M, Bruzzi P, Fiorini E, Magenta L, Diomede F, Mereta F, D’Aria I, Magliano D, Liberatori M, Cantù D, Croce D, Eandi S, Colombo GL, Ferrante F, Salè EO, Marinozzi A, Lenzi D, Remiddi F, Remiddi S. U-CHANGE Project: a multidimensional consensus on how clinicians, patients and caregivers may approach together the new urothelial cancer scenario. Front Oncol 2023; 13:1186103. [PMID: 37576880 PMCID: PMC10422043 DOI: 10.3389/fonc.2023.1186103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/29/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Advanced urothelial carcinoma remains aggressive and very hard to cure, while new treatments will pose a challenge for clinicians and healthcare funding policymakers alike. The U-CHANGE Project aimed to redesign the current model of care for advanced urothelial carcinoma patients to identify limitations ("as is" scenario) and recommend future actions ("to be" scenario). Methods Twenty-three subject-matter experts, divided into three groups, analyzed the two scenarios as part of a multidimensional consensus process, developing statements for specific domains of the disease, and a simplified Delphi methodology was used to establish consensus among the experts. Results Recommended actions included increasing awareness of the disease, increased training of healthcare professionals, improvement of screening strategies and care pathways, increased support for patients and caregivers and relevant recommendations from molecular tumor boards when comprehensive genomic profiling has to be provided for appropriate patient selection to ad hoc targeted therapies. Discussion While the innovative new targeted agents have the potential to significantly alter the clinical approach to this highly aggressive disease, the U-CHANGE Project experience shows that the use of these new agents will require a radical shift in the entire model of care, implementing sustainable changes which anticipate the benefits of future treatments, capable of targeting the right patient with the right agent at different stages of the disease.
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Affiliation(s)
- Sergio Bracarda
- President of Italian Society of Uro-Oncology, Department of Medical Oncology, Santa Maria Hospital, Terni, Italy
| | - Roberto Iacovelli
- Department of Medical Oncology, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Valentina Baldazzi
- Department of Medical Oncology, Santa Maria Annunziata Hospital, Florence, Italy
| | - Paolo Andrea Zucali
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Angela Gernone
- Department of Medical Oncology, Policlinico Universitario Azienda Ospedaliera (A.O), Bari, Italy
| | | | | | - Matteo Brunelli
- Pathology Unit, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Paolo Bruzzi
- Department of Clinical Epidemiology, National Institute for Cancer Research, Istituto Scientifico Tumori (IST), Genoa, Italy
| | | | | | - Francesco Diomede
- Federazione Associazioni Volontariato in Oncologia (F.A.V.O) Federation, Rome, Italy
| | | | | | | | - Monica Liberatori
- Department of Medical Oncology, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Daniela Cantù
- Italian Association of Physiotherapists, Milan, Italy
| | - Davide Croce
- Centro di Ricerca sull’Economia e il Management in Sanità e nel Sociale, Libero Istituto Universitario Cattaneo (LIUC) Business School, Castellanza (VA), Turin, Italy
| | - Simone Eandi
- Social Innovation EcosystEm Development (SEEd) Medica Publishers, Turin, Italy
| | | | - Fulvio Ferrante
- Department of Diagnostic and Pharmaceutical Assistance, Unità Operativa Complessa (UOC) Pharmacy, Local Health Unit Azienda Sanitaria Locale (ASL) Frosinone, Frosinone, Italy
| | - Emanuela Omodeo Salè
- Department Hospital Pharmacy, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Andrea Marinozzi
- Clinical Pharmacy, Azienda Ospedaliera Universitaria (AOU) Ospedali Riuniti, Ancona, Italy
| | - Daniele Lenzi
- Medical Department, Azienda Ospedaliera Università, Siena, Italy
| | | | - Stefano Remiddi
- Medical Writing & Statistics Department, NUME PLUS, Florence, Italy
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2
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Development of a Pocket Nomogram to Predict Cancer and Disease Specific Survival After Radical Cystectomy For Bladder Cancer: The CRAB Nomogram. Clin Genitourin Cancer 2023; 21:108-114. [PMID: 36175311 DOI: 10.1016/j.clgc.2022.08.011] [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: 04/19/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To develop an easy tool to predict cancer specific (CSS) and disease-free survival (DFS) in patients with bladder cancer treated with radical cystectomy. METHODS Data from a consecutive series of 2395 patients with primitive or progression to muscle invasive bladder cancer (MIBC) undergone to radical cystectomy and lymph nodes dissection in 5 centers were evaluated. Using Cox proportional hazards analyses, the Cancer of the bladder risk assessment (CRAB) nomogram was generated. Accuracy of the nomogram was evaluated by Harrell's C test. Internal validation of the model was performed using 200 bootstraps. RESULTS Median age was 66 (IQR 58/73) years; 612/2395 (26%) patients presented an advanced pathological stage (≥pT3a); 478/2395 (20%) presented positive lymph nodes. Overall, 729/2395 (30%) presented local or distant recurrence with a median DFS of 42 (IQR 14/89) months. Overall, 642/2395 (27%) died of bladder cancer with a median follow up of 48 (IQR 22/92) months. On univariate Cox proportional hazards analyses, age, stage, and lymph nodes density were a significant predictor of 3 and5 years CSS and DFS. Accuracy of the CRAB nomogram was 0.73 and 0.71 respectively. CONCLUSION CRAB nomogram can be a practical and easily applicable tool that may help urologists to classify the long-term CSS and DFS of patients treated with radical cystectomy and to predict the oncological outcome.
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Renner S, Loussikian P, Foulquié P, Arnould B, Marrel A, Barbier V, Mebarki A, Schück S, Bharmal M. Perceived Unmet Needs in Patients and Caregivers Living With Advanced Bladder Cancer: An Infodemiology Study Using Data From Social Media in the United States (Preprint). JMIR Cancer 2022; 8:e37518. [PMID: 36125861 PMCID: PMC9533198 DOI: 10.2196/37518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 11/19/2022] Open
Abstract
Background Locally advanced or metastatic bladder cancer (BC), which is generally termed advanced BC (aBC), has a very poor prognosis, and in addition to its physical symptoms, it is associated with emotional and social challenges. However, few studies have assessed the unmet needs and burden of aBC from patient and caregiver perspectives. Infodemiology, that is, epidemiology based on internet health-related content, can help obtain more insights on patients’ and caregivers’ experiences with aBC. Objective The study aimed to identify the main discussion themes and the unmet needs of patients with aBC and their caregivers through a mixed methods analysis of social media posts. Methods Social media posts were collected between January 2015 and April 2021 from US geolocalized sites using specific keywords for aBC. Automatic natural language processing (regular expressions and machine learning) methods were used to filter out irrelevant content and identify verbatim posts from patients and caregivers. The verbatim posts were analyzed to identify main discussion themes using biterm topic modeling. Difficulties or unmet needs were further explored using qualitative research methods by 2 independent annotators until saturation of concepts. Results A total of 688 posts from 262 patients and 1214 posts from 679 caregivers discussing aBC were identified. Analysis of 340 randomly selected patient posts and 423 randomly selected caregiver posts uncovered 33 unique unmet need categories among patients and 36 among caregivers. The main unmet patient needs were related to challenges regarding adverse events (AEs; 28/95, 29%) and the psychological impact of aBC (20/95, 21%). Other patient unmet needs identified were prognosis or diagnosis errors (9/95, 9%) and the need for better management of aBC symptoms (9/95, 9%). The main unmet caregiver needs were related to the psychological impacts of aBC (46/177, 26.0%), the need for support groups and to share experiences between peers (28/177, 15.8%), and the fear and management of patient AEs (22/177, 12.4%). Conclusions The combination of manual and automatic methods allowed the extraction and analysis of several hundreds of social media posts from patients with aBC and their caregivers. The results highlighted the emotional burden of cancer for both patients and caregivers. Additional studies on patients with aBC and their caregivers are required to quantitatively explore the impact of this disease on quality of life.
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Fan J, Zhang X, Fan J, Li L, He D, Wu K. Risk Stratification for the Rate and Location of Residual Bladder Tumor for the Decision of Re-Transurethral Resection of Bladder Tumor. Front Oncol 2022; 12:788568. [PMID: 35155230 PMCID: PMC8829133 DOI: 10.3389/fonc.2022.788568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 01/07/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction To assess the rate and location of residual tumor in re-transurethral resection of bladder tumor (re-TURBT) and develop a risk stratification tool to assist clinicians in making treatment decisions. Patients and Methods The data of 144 patients with high-risk bladder cancer who received re-TURBT were retrospectively reviewed. The rate and location of residual tumors was recorded. Logistic regression was performed to explore risk factors for residual tumors, and a risk classification tool was developed. Results Among the 144 patients, the rates of residual tumor and tumor location at the base of the primary tumor were 22.2% and 10.4%, respectively. Non-urothelial carcinoma subspecialist, piecemeal resection and the absence of detrusor muscle in the first specimen were defined as risk factors. Patients were categorized into low-, intermediate-, and high-risk groups according to the number of risk factors. The rate of residual tumor in the high-risk group was significantly higher than that in the low- and intermediate-risk groups (50% vs. 7.8%, P=0.001; 50% vs. 18.6%, P=0.002). Moreover, high-risk patients benefitted more from a second resection at the base of the primary tumor due to the high rate of residual tumor located at this site than low- and intermediate-risk patients (23.5% vs. 2.0%, P=0.002; 23.5% vs. 10.2%, P=0.083). Conclusions Risk stratification based on the subspecialist category, operative method, and presence or absence of detrusor muscle in the first specimen could help identify patients who benefit from re-TURBT and second resection the base of the primary tumor.
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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 Central Hospital, Baoji, China
| | - Xing Zhang
- Department of Urology, 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
| | - 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
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5
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Dalla Volta A, Petrelli F, Luciani A, Caramella I, Grisanti S, Berruti A. Is adjuvant immunotherapy effective in patients with urothelial cancer? Minerva Urol Nephrol 2022; 74:252-254. [PMID: 35147389 DOI: 10.23736/s2724-6051.22.04841-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Alberto Dalla Volta
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Fausto Petrelli
- Medical Oncology Unit, ASST Bergamo Ovest, Treviglio, Bergamo, Italy
| | - Andrea Luciani
- Medical Oncology Unit, ASST Bergamo Ovest, Treviglio, Bergamo, Italy
| | - Irene Caramella
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Salvatore Grisanti
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Alfredo Berruti
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy -
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Del Giudice F, D'Andrea D, Mari A, Soria F, Krajewski W, Moschini M. Is there enough evidence available nowadays to suggest a paradigmatic shift in treatment of MIBC with perioperative systemic therapy administration? Minerva Urol Nephrol 2021; 73:674-676. [PMID: 34847650 DOI: 10.23736/s2724-6051.21.04762-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Francesco Del Giudice
- Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy - .,Department of Urology, Stanford Medical Center, Stanford, CA, USA -
| | - David D'Andrea
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Andrea Mari
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Florence, Italy
| | - Francesco Soria
- Division of Urology, Department of Surgical Sciences and Urology, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy
| | - Wojciech Krajewski
- Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, University Center of Excellence in Urology, Wroclaw, Poland
| | - Marco Moschini
- Division of Experimental Oncology, Department of Urology, Urological Research Institute, Vita-Salute San Raffaele University, Milan, Italy
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Morselli S, Campi R, Gacci M, Sebastianelli A, Fattorini C, Villari D, Carini M, Minervini A, Serni S, Raspollini MR. Potential utility of a 4-marker immunohistochemistry panel to predict response to cisplatin-based neoadjuvant chemotherapy in patients with muscle-invasive bladder cancer: a single-center preliminary experience. Minerva Urol Nephrol 2021; 73:424-427. [PMID: 34494414 DOI: 10.23736/s2724-6051.21.04592-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Simone Morselli
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy - .,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy -
| | - Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Mauro Gacci
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Arcangelo Sebastianelli
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Caterina Fattorini
- Department of Histopathology and Molecular Diagnostics, Careggi Hospital, University of Florence, Florence, Italy
| | - Donata Villari
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Unit of Urological Oncologic Minimally-Invasive Robotic Surgery and Andrology, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Unit of Urological Oncologic Minimally-Invasive Robotic Surgery and Andrology, Careggi Hospital, University of Florence, Florence, Italy
| | - Sergio Serni
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Maria R Raspollini
- Department of Histopathology and Molecular Diagnostics, Careggi Hospital, University of Florence, Florence, Italy
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8
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Izzo A, Quarto G, Grimaldi G, Castaldo L, Muscariello R, Franzese D, Del Prete P, Ferro M, Barberio D, Bolognini I, Bianchi AAM, Autorino R, Perdonà S. Robotic radical cystectomy with concomitant implantation of 3-piece penile prosthesis: a one-step solution. Ther Adv Urol 2021; 13:17562872211024512. [PMID: 34188695 PMCID: PMC8209785 DOI: 10.1177/17562872211024512] [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: 03/17/2021] [Accepted: 05/24/2021] [Indexed: 11/29/2022] Open
Abstract
Radical cystectomy (RC) remains a highly morbid urologic procedure, and erectile dysfunction (ED) represents a significant burden for bladder cancer survivors. While inflatable penile prosthesis (IPP) offers a definitive treatment option for post-RC ED, the hostile postoperative anatomy of RC patients poses some technical challenges for IPP implantation. We report the case of a 54-year-old male with high grade bladder cancer who was managed with a robotic-assisted RC with Bricker ileal conduit urinary diversion and simultaneous implantation of a 3-piece IPP. Operative time was 310 min (230 min for the RC and ileal conduit portion, 80 min for IPP implantation). Estimated blood loss was 300 ml. Postoperative course was regular. The patient was discharged home on postoperative day 6. A robotic RC with concomitant IPP implantation can be offered as “one-step” solution to bladder cancer male patients. This approach can potentially offer the advantage of better outcome in terms of sexual function, while minimizing surgical risks, ultimately improving the quality of life of these patients.
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Affiliation(s)
- Alessandro Izzo
- Uro-Gynecological Department, Fondazione "G. Pascale" IRCCS, Via M. Semmola, Naples, 80131, Italy
| | - Giuseppe Quarto
- Uro-Gynecological Department, Fondazione "G. Pascale" IRCCS, Naples, Campania, Italy
| | - Giovanni Grimaldi
- Uro-Gynecological Department, Fondazione "G. Pascale" IRCCS, Naples, Campania, Italy
| | - Luigi Castaldo
- Uro-Gynecological Department, Fondazione "G. Pascale" IRCCS, Naples, Campania, Italy
| | - Raffaele Muscariello
- Uro-Gynecological Department, Fondazione "G. Pascale" IRCCS, Naples, Campania, Italy
| | - Dario Franzese
- Uro-Gynecological Department, Fondazione "G. Pascale" IRCCS, Naples, Campania, Italy
| | - Paola Del Prete
- Scientific Directorate, Fondazione "G. Pascale" IRCCS, Naples, Campania, Italy
| | - Matteo Ferro
- Division of Urology, European Institute of Oncology IRCCS, Milan, Lombardia, Italy
| | - Daniela Barberio
- Psychology Unit, Fondazione "G. Pascale" IRCCS, Naples, Campania, Italy
| | - Ida Bolognini
- Psychology Unit, Fondazione "G. Pascale" IRCCS, Naples, Campania, Italy
| | | | | | - Sisto Perdonà
- Uro-Gynecological Department, Fondazione "G. Pascale" IRCCS, Naples, Campania, Italy
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Albisinni S, Aoun F, Diamand R, Mjaess G, Esperto F, Martinez Chanza N, Roumeguère T, De Nunzio C. Systematic review of neoadjuvant therapy by immune checkpoint inhibitors before radical cystectomy: where do we stand? MINERVA UROL NEFROL 2020; 72:663-672. [DOI: 10.23736/s0393-2249.20.03833-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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10
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Afferi L, Moschini M, Cumberbatch MG, Catto JW, Scarpa RM, Porpiglia F, Mattei A, Sanchez-Salas R, Esperto F. Biomarkers predicting oncological outcomes of high-risk non-muscle-invasive bladder cancer. MINERVA UROL NEFROL 2020; 72:265-278. [PMID: 32298067 DOI: 10.23736/s0393-2249.20.03786-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The European Organization for Research and Treatment of Cancer (EORTC) and the Spanish Urological Club for Oncological Treatment (CUETO) scoring systems show limited accuracy for the prediction of disease recurrence and progression of non-muscle-invasive bladder cancer (NMIBC). This aspect is even more relevant in the category of HR NMIBC. Biomarkers might potentially help to further categorize the outcomes of these patients. Therefore, we sought to review the evidence available on tissue-based, urinary, and serum biomarkers for the prediction of recurrence, progression, and survival in HR NMIBC. EVIDENCE ACQUISITION A systematic literature review without time restrictions was performed using PubMed/EMBASE, Web of Science, SCOPUS, and the Cochrane Libraries. The search was filtered for articles in the English, Italian, German, French, and Spanish languages, involving patients with more than 18 years of age. Relevant papers on tissue-based, serum and urinary biomarkers related to the prediction of oncological outcomes for high-risk bladder cancer patients were included in the analyses. EVIDENCE SYNTHESIS Overall, 71 studies were eligible for inclusion in this review. The majority of the investigations performed so far focused on immunohistochemical analyses on tumoral tissue. Overall, p53 was the most studied biomarker, but results regarding its prognostic and predictive role were contradictory. Ki67 seems to be a promising biomarker in the prediction of recurrence. Recently, PD-L1 has been associated with the prediction of recurrence free survival and of treatment-refractory disease. Markers developed un urine samples are focused on commercially available kits, which currently do not unequivocally show strongly superior levels of accuracy to cytology. However, they have demonstrated to be potentially helpful in the prediction of recurrence. Blood-based biomarkers represent an emerging reality with promising future applications. CONCLUSIONS Despite a long history of attempts to discover accurate biomarkers predicting oncological outcomes for HR NMIBC, contradictory or uncertain findings render the adoption of this ancillary techniques in clinical practice still unlikely. Future attempts should be directed to the development of prospective trials and the definition of standardized cut-off levels to render findings worthy of comparison.
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Affiliation(s)
- Luca Afferi
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Marco Moschini
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland - .,Department of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | | | - James W Catto
- Unit of Academic Urology, University of Sheffield, Sheffield, UK
| | - Roberto M Scarpa
- Department of Urology, Campus Bio-Medico University, Rome, Italy
| | - Francesco Porpiglia
- Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Agostino Mattei
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Rafael Sanchez-Salas
- Department of Urology, Institut Mutualiste Montsouris and Universitè Paris Descartes, Paris, France
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11
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Eissa A, Zoeir A, Ciarlariello S, Sarchi L, Sighinolfi MC, Ghaith A, Puliatti S, Inzillo R, Reggiani Bonetti L, Rizzo M, Rocco B, Micali S. En-bloc resection of bladder tumors for pathological staging: the value of lateral margins analysis. MINERVA UROL NEFROL 2020; 72:763-769. [PMID: 32003203 DOI: 10.23736/s0393-2249.20.03551-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND In endoscopic resection of colorectal tumors, the pathological assessment of the lateral margins is a strong predictor of tumor recurrence after resection. The aim of the current study is to evaluate the value of the peritumoral margins assessment in ERBT on tumor recurrence. METHODS We retrospectively analyzed the data of 50 consecutive patients with NMIBC and treated by ERBT between January and December 2017. RESULTS The lateral margins showed dysplasia in 16 patients and malignancy in three patients. Local recurrence occurred in 14 (28%) patients. It was noted that 57% of patients with recurrence showed some degree of dysplasia or malignancy in the lateral margin; however, on multivariate logistic regression lateral margins lesions were not significantly associated with recurrence (OR 2.175, 95% CI: 0.430-10.996, P=0.35). CONCLUSIONS ERBT may improve the pathological report of bladder tumor. There was a trend toward increased rate of recurrence in patients with dysplasia or malignancy in their lateral margins; however, this was not statistically significant on multivariate analysis. Further studies with larger sample sizes are required to assess the value of lateral margin analysis.
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Affiliation(s)
- Ahmed Eissa
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy.,Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ahmed Zoeir
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy.,Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Silvia Ciarlariello
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Luca Sarchi
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Maria C Sighinolfi
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Ahmed Ghaith
- Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Stefano Puliatti
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Raffaele Inzillo
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Luca Reggiani Bonetti
- Section of Pathology, Department of Diagnostic Medicine and Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Mino Rizzo
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Bernardo Rocco
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Salvatore Micali
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy -
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