Identification of 2,6-Disubstituted 3H-Imidazo[4,5-b]pyridines as Therapeutic Agents for Dysferlinopathies through Phenotypic Screening on Patient-Derived Induced Pluripotent Stem Cells

Dysferlinopathies, which are muscular diseases caused by mutations in the dysferlin gene, remain serious medical problems due to the lack of therapeutic agents. Herein, we report the design, synthesis, and structure-activity relationships of a 2,6-disubstituted 3H-imidazo[4,5-b]pyridine series, which was identified from the phenotypic screening of chemicals that increase the level of dysferlin in myocytes differentiated from patient-derived induced pluripotent stem cells (iPSCs). Optimization studies with cell-based phenotypic assay led to the identification of a highly potent compound, 19, with dysferlin elevation effects at double-digit nanomolar concentrations. In addition, the molecular target of our chemical series was identified as tubulin, through a tubulin polymerization assay and a competitive binding assay using a photoaffinity labeling probe.

Phenotypic Drug Screening for Dysferlinopathy Using Patient-Derived Induced Pluripotent Stem Cells

Dysferlinopathy is a progressive muscle disorder that includes limb‐girdle muscular dystrophy type 2B and Miyoshi myopathy (MM). It is caused by mutations in the dysferlin (DYSF) gene, whose function is to reseal the muscular membrane. Treatment with proteasome inhibitor MG‐132 has been shown to increase misfolded dysferlin in fibroblasts, allowing them to recover their membrane resealing function. Here, we developed a screening system based on myocytes from MM patient‐derived induced pluripotent stem cells. According to the screening, nocodazole was found to effectively increase the level of dysferlin in cells, which, in turn, enhanced membrane resealing following injury by laser irradiation. Moreover, the increase was due to microtubule disorganization and involved autophagy rather than the proteasome degradation pathway. These findings suggest that increasing the amount of misfolded dysferlin using small molecules could represent an effective future clinical treatment for dysferlinopathy. stem cells translational medicine2019;8:1017–1029

Zingiberis Siccatum Rhizoma, the active component of the Kampo formula Daikenchuto, induces anti-inflammatory actions through α7 nicotinic acetylcholine receptor activation

BACKGROUND

We previously reported that Daikenchuto (DKT), a gastrointestinal prokinetic Japanese herbal (Kampo) medicine used for the treatment of postoperative ileus (POI), has characteristic potent anti-inflammatory activity. This effect may be partly mediated by the activation of α7 nicotinic acetylcholine receptor (nAChR). In this study, we identified the specific herbs in DKT that induce anti-inflammatory action.

METHODS

The herbal components of DKT were individually administered orally to each mouse four times before and after intestinal manipulation (IM) was carried out on the distal ileum. The anti-inflammatory activity of each crude drug was subsequently evaluated using immunohistochemical analyses of relevant molecules.

KEY RESULTS

Treatment with Zingiberis Siccatum Rhizoma (ZSR) but not the other components inhibited the infiltration of cluster of differentiation 68 (CD68)-positive macrophages as effectively as DKT treatment. Selective α7nAChR antagonists, such as methyllycaconitine citrate, or transient receptor potential ankyrin 1 (TRPA1) antagonists, such as HC-030031, significantly inhibited the amelioration of macrophage infiltration by ZSR. The inhibition of macrophage infiltration by ZSR was abolished in both α7nAChR and 5-hydroxytryptamine 4 receptor (5-HT₄ R) knockout mice.

CONCLUSIONS & INFERENCES

Daikenchuto-induced anti-inflammatory activity, which was mediated by inhibiting macrophage infiltration in POI, is dependent on the effects of ZSR. Zingiberis Siccatum Rhizoma activates TRPA1 channels possibly in enterochromaffin (EC) cells to release 5-HT, which stimulates 5-HT₄ R in the myenteric plexus neurons to release ACh, which in turn activates α7nAChR on macrophages to inhibit inflammation in POI.

Accelerated anaerobic release of K, Mg and P from surplus activated sludge for element recovery and struvite formation inhibition

Accelerated release of potassium (K), magnesium (Mg) and phosphorus (P) from surplus activated sludge (SAS) was investigated to develop a new system for the recovery of the elements. Anaerobic cultivation of SAS during 24 h released 78% of K and about 50% of Mg and P from SAS more effectively compared to aerobic cultivation (K: 40%, Mg: 15%, P: 15%). Furthermore, the addition of sodium acetate as an organic carbon source remarkably accelerated the release of K, Mg and P from SAS under anaerobic condition. However, no increase in the maximum release efficiencies was observed. The elements released from SAS could be transferred to separate liquid with the existing mechanical thickener and be recovered as MgKPO₄ by some additional process. Furthermore, the removal of the elements from SAS would inhibit the formation of struvite causing the blockage of sludge transport pipe after anaerobic digestion process of thickened sludge.

ZEB1 induces EPB41L5 in the cancer mesenchymal program that drives ARF6-based invasion, metastasis and drug resistance

Onset of the cancer mesenchymal program is closely associated with cancer malignancy and drug resistance. Among the different epithelial–mesenchymal transition (EMT)-associated transcriptional factors, ZEB1 has a key role in inducing the mesenchymal phenotypes and stem cell-like properties of different breast cancer cells. ARF6 and its effector AMAP1 are frequently overexpressed in breast cancer cells, and promote invasion, metastasis and drug resistance. EPB41L5 is induced during EMT, and mediates the disruption of E-cadherin-based cell–cell adhesion and the promotion of focal adhesion dynamics. Here we show that EPB41L5 is an integral component of the ARF6-based pathway, which is induced by ZEB1. We found that EPB41L5 is expressed at high levels in malignant breast cancer cells and binds to AMAP1. ZEB1 induced EPB41L5 both in cancer cells and normal cells. This relationship was recaptured with The Cancer Genome Atlas RNASeq data set, and correlated with the poor outcome of the patients. In contrast, diversified events, such as tumor growth factor β1 stimulation, expression of SNAI1 and TP53 mutation, can each cause the induction of ZEB1 and EPB41L5, depending on the cellular context. Our results demonstrated that the ZEB1-EPB41L5 axis is at the core of the cancer mesenchymal program that drives ARF6-based invasion, metastasis and drug resistance of significant populations of primary breast cancers, and is tightly correlated with the poor outcomes of patients.

Superovulatory response in Japanese Black cows receiving a single subcutaneous porcine follicle-stimulating hormone treatment or six intramuscular treatments over three days

To reduce labor for superovulation treatment by twice-daily intramuscular (im) administration of FSH for more than 3 to 4 days, we investigated the superovulatory responses of Japanese Black cows to porcine FSH (pFSH) used as a single subcutaneous (sc) administration at two different doses in two different volumes of saline. In experiment 1, 20 Armour units (AU) of pFSH dissolved in either 10 mL (treatment A; n = 14) or 50 mL (treatment B; n = 14) of saline was administered subcutaneously in the neck region. In experiment 2, 30 AU of pFSH dissolved in either 10 mL (treatment C; n = 15) or 50 mL (treatment D; n = 15) of saline was administered subcutaneously in the neck region. The control animals in experiment 1 (n = 14) and experiment 2 (n = 15) received 20 AU of pFSH administered intramuscularly twice daily in decreasing doses for more than 3 days. In experiment 1, mean (±SEM) numbers of CL (15.4 ± 2.5, 18.1 ± 3.4, and 17.2 ± 2.6), total number of ova and embryos (12.9 ± 1.4, 15.9 ± 3.5, and 16.2 ± 2.8), and transferable embryos (7.5 ± 2.0, 10.4 ± 2.8, and 8.0 ± 2.1) did not differ among treatments A, B, and control. In experiment 2, mean (±SEM) numbers of CL (20.5 ± 4.3, 20.4 ± 2.7, and 20.1 ± 3.4), total number of ova and embryos (21.7 ± 4.2, 17.3 ± 3.4, and 16.5 ± 3.2), and transferable embryos (8.1 ± 1.6, 9.3 ± 2.2, and 9.5 ± 1.9) did not differ among treatments C, D, and control. Although there were no differences in serum pFSH concentrations among the three treatments at each of the time points in experiment 1, in experiment 2, the serum pFSH concentration at 6 and 8 hours after pFSH administration in treatment C (3.1 ± 0.8, 2.7 ± 0.5 ng/mL, mean ± SEM) was significantly greater (P < 0.05) than in the control (0.7 ± 0.1, 1.1 ± 0.2 ng/mL). At 10 hours after administration, the pFSH concentration had decreased and there were no differences among the three treatments at subsequent time points. These results suggest that increasing the volume of saline or the dose of pFSH does not affect the absorption pattern of pFSH administered as a single sc administration. In conclusions, single sc administration of pFSH at a dose of 20 or 30 AU dissolved in 10 or 50 mL of saline is able to induce a superovulatory response comparable with that obtained by twice-daily im administration in Japanese Black cows.

18F-FDG PET and intravascular ultrasonography (IVUS) images compared with histology of atherosclerotic plaques: 18F-FDG accumulates in foamy macrophages

PURPOSE

Intravascular ultrasonography (IVUS) and (18)F-FDG PET have been used to evaluate the efficacy of antiatherosclerosis drugs. These two modalities image different characteristics of atherosclerotic plaques, and a comparison of IVUS and PET images with histology has not been performed. The aim of this study was to align IVUS and PET images using anatomic landmarks in Watanabe heritable hyperlipidaemic (WHHL) rabbits, enabling comparison of their depiction of aortic atherosclerosis. Cellular (18)F-FDG localization was evaluated by (3)H-FDG microautoradiography (micro-ARG).

METHODS

A total of 19 WHHL rabbits (7 months of age) were divided into three groups: baseline (n = 6), 3 months (n = 4), and 6 months (n = 9). PET, IVUS and histological images of the same aortic segments were analysed. Infiltration by foamy macrophages was scored from 0 to IV using haematoxylin and eosin (H&E) and antimacrophage immunohistochemical staining, and compared with (3)H-FDG micro-ARG findings in two additional WHHL rabbits.

RESULTS

IVUS images did not identify foamy macrophage deposition but revealed the area of intimal lesions (r = 0.87). (18)F-FDG PET revealed foamy macrophage distribution in the plaques. The intensity of (18)F-FDG uptake was correlated positively with the degree of foamy macrophage infiltration. Micro-ARG showed identical (3)H-FDG accumulation in the foamy macrophages surrounding the lipid core of the plaques.

CONCLUSION

F-FDG PET localized and quantified the degree of infiltration of foamy macrophages in atherosclerotic lesions. IVUS defined the size of lesions. (18)F-FDG PET is a promising imaging technique for evaluating atherosclerosis and for monitoring changes in the composition of atherosclerotic plaques affecting their stability.

Temporal evolution of exposure to mercury in riverside communities in the Tapajós basin, from 1994 to 2010

Our objective was to evaluate the temporal evolution of mercury exposure in two riverside communities, Barreiras and São Luiz do Tapajós, downstream of gold mining areas in the Tapajós basin, Brazilian Amazon. The quantification of mercury in hair sample was made by atomic absorption spectrophotometry in the period between 1994 and 2010. In São Luiz do Tapajós the mercury exposure varied, in log units, from the peak of 1.21 ± 0.03 μg/g in 1996 to 1.16 ± 0.07 μg/g in 2007. Mercury exposure in Barreiras varied, in log units, from 1.25 ± 0.04 μg/g in 1994 to 1 ± 0.03 μg/g in 2010, peaking in 1995 at 1.25 ± 0.06 μg/g. Total mercury concentration found in both communities had no statistical differences across the years (p > 0.05) and they were higher than non-mercury exposed communities in Brazil and in South America. We concluded that the mercury exposure in the Tapajós basin is more than regulatory levels or higher than the general population.

Antidepressant-like Effect of l-perillaldehyde in Stress-induced Depression-like Model Mice through Regulation of the Olfactory Nervous System

Perillae Herba (a leaf of Perilla frutescens) has been prescribed as one of the component herbs in certain Kampo (Japanese herbal) medicines that are used clinically for the improvement of depressive mood. l-Perillaldehyde (PAH) is a major component in the essential oil containing in Perillae Herba, but its antidepressant-like effect has not been reported. To clarify the antidepressant-like effect of PAH, the inhaled effect of PAH on stress-induced depression-like model mice prepared by subjection to a combination of forced swimming and chronic mild stresses was investigated. The degree of the depression-like state was measured by the animal's duration of immobility using a forced swimming test. Inhalation of PAH (0.0965 and 0.965 mg/mouse/day, 9 days) significantly shortened the duration of immobility of the depression-like model mice and did not affect locomotor activity. However, another odor substance, cinnamaldehyde containing in Cinnamomi Cortex, exhibited no reduction in the immobility. The reduction in the immobility induced by the inhalation of PAH was prevented on anosmia-induced mice prepared by intranasal irrigation with zinc sulfate. These results suggest that the inhalation of PAH shows antidepressant-like activity through the olfactory nervous function.

319 SUPEROVULATORY RESPONSE IN JAPANESE BLACK CATTLE BY A SINGLE SUBCUTANEOUS ADMINISTRATION OF PURE FOLLICLE-STIMULATING HORMONE DISSOLVED IN SALINE

The objective of this study was to evaluate the superovulatory response to a single SC administration of pFSH (Antrin R-10) dissolved in saline in Japanese Black cattle. Forty Japanese Black cows were divided into 5 groups. All cows received a progesterone releasing intravaginal device (PRID) at a random stage of the oestrous cycle except the day of oestrus (Day 0). Superovulatory treatments were initiated on Day 4 with single SC administration of 20 AU pFSH dissolved in 10 mL of saline (Group A) or 50 mL of saline (Group B), or 30 AU pFSH dissolved in 10 mL of saline (Group C) or 50 mL of saline (Group D). Conventional superovulatory treatment (Group E) was also initiated on Day 4 with 20 AU pFSH in decreasing doses in IM administration twice a day for 3 days (5/5, 3/3, and 2/2 in the am/pm). Each administration was carried out in the neck region. For oestrus induction, all animals were treated with prostaglandin F2α (750 μg of cloprostenol) on Day 4, and then the PRID was removed on Day 6 in the morning. The GnRH (10 μg of buserelin) was administrated at 31 h after PRID removal to induce ovulations. The cows were artificially inseminated at 24 h after GnRH treatment, and embryos were recovered 7 days after the insemination. Blood samples were collected at 0, 2, 4, 6, 8, 10, 24, 31, 48, 55, 72, and 79 h after the first pFSH administration, and serum pFSH concentration was measured using time-resolved fluorescence immunoassay. Percentage data were arcsine transformed before analysis, and one-way ANOVA was used for statistical analysis (P < 0.05). There were no significant (P > 0.05) differences among groups in the number of corpus luteum, total number of ova/embryos, number of transferable embryos, and percentage of transferable embryos. The concentrations of pFSH in serum increased in all groups 2 h after each administration and reached a peak at 8 h in Groups A and C, at 10 h in Groups B, D, and E, and then in all groups it decreased gradually. The concentrations of pFSH in serum decreased to the base level (the level at 0 h) in Group A at 55 h and in Group C at 72 h after the first pFSH administration. At 79 h, serum pFSH was still detected in Groups B, D, and E. These results suggest that the single SC administration of 20 AU pFSH that is the same dose as the conventional treatment is able to induce a superovulatory response comparable to that of conventional treatment in Japanese Black cattle. Table 1.Superovulatory responses (mean ± SE) in different treatment groups

Ostwald ripening in nanoalloys: when thermodynamics drives a size-dependent particle composition

Ostwald ripening has been broadly studied because it plays a determinant role in the evolution of cluster size during both chemical and physical synthesis of nanoparticles. This thermoactivated process causes large particles to grow, drawing material from the smaller particles, which shrink. However, this phenomenon becomes more complex when considering the coarsening of metallic alloy clusters. The present experimental and theoretical investigations show that the relative composition of CoPt nanoparticles can be strongly modified during high temperature annealing and displays a size-dependent behavior. This compositional change originates from the higher evaporation rate of Co atoms from the nanoparticles. More importantly, this effect is expected in all alloy clusters containing species with different mobilities.

Size and shape effects on the order-disorder phase transition in CoPt nanoparticles

Chemically ordered bimetallic nanoparticles are promising candidates for magnetic-storage applications. However, the use of sub-10 nm nanomagnets requires further study of possible size effects on their physical properties. Here, the effects of size and morphology on the order-disorder phase transition temperature of CoPt nanoparticles (T(C)(NP)) have been investigated experimentally, using transmission electron microscopy, and theoretically, with canonical Monte Carlo simulations. For 2.4-3-nm particles, T(C)(NP) is found to be 325-175 degrees C lower than the bulk material transition temperature, consistent with our Monte Carlo simulations. Furthermore, we establish that T(C)(NP) is also sensitive to the shape of the nanoparticles, because only one dimension of the particle (that is, in-plane size or thickness) smaller than 3 nm is sufficient to induce a considerable depression of T(C)(NP). This work emphasizes the necessity of taking into account the three-dimensional morphology of nano-objects to understand and control their structural properties.

Genetic parameters for preweaning and early growth traits in Berkshire pigs when creep feeding is used

The objective of this study was to find optimal traits for inclusion in selection criteria by estimating genetic parameters for direct genetic, maternal genetic, and common environmental effects for growth traits before 60 d of age and for the number of teats under an open breeding population, and to evaluate genetic relationships for traits at 60 d of age. Records of 2,344 male and 2,204 female purebred Berkshire pigs were analyzed. For BW at 14 d of age and for weaning weight, the heritabilities of a direct genetic effect were greater than those of a maternal genetic effect. This result is contrary to previous results showing a gradual decrease in the maternal genetic effect and an increase in the direct genetic effect up to weaning. The positive genetic correlations between direct and maternal genetic effects for BW at 14 d of age and weaning weight are clearly contrary to other reports. This phenomenon seems to be caused by creep feeding begun just after the birth of the piglets and maintained throughout the preweaning period in this Berkshire population.

Sensitivity and specificity of photopic negative response of focal electoretinogram to detect glaucomatous eyes

AIMS

To determine the sensitivity and specificity of the photopic negative response (PhNR) of the focal electroretinograms (ERG; focal PhNR) to detect glaucomatous eyes with different degrees of visual field defects.

METHODS

One-hundred and fourteen eyes of 114 patients with open angle glaucoma and 42 eyes of 42 normal controls were studied. The focal ERGs were elicited by a 15 degrees stimulus spot centred on the macula, and on the supero-temporal and on the infero-temporal areas of the macula. The receiver operating characteristic curves were determined to obtain optimal cut-off values. Eyes were classified as being glaucomatous when their focal PhNRs were less than the cut-off values in either retinal area (combined criterion).

RESULTS

The focal PhNR amplitudes were significantly reduced with an advance in the stage of glaucoma. In early glaucoma, the sensitivities of the PhNR measured for each retinal area ranged from 58.1% to 80.7%. The sensitivities were significantly increased to 90.6% and 96.9% for the focal PhNR amplitude and the focal PhNR/b-wave amplitude ratio, respectively, when the combined criterion was employed. The specificity was >90%.

CONCLUSIONS

Focal PhNRs have diagnostic ability in detecting early glaucoma with high sensitivity and specificity, especially when the combined criterion is used.

Influence of early postweaning traits on genetic improvement of meat productivity in purebred Berkshire pigs

The objective of this study was to estimate genetic parameters for growth and body composition traits at 60 d of age and at finish in a population of Berkshire pigs and to evaluate the effectiveness of selection at 60 d of age for meat productivity. A total of 4,548 purebred Berkshire (2,344 males and 2,204 females) pigs born between December 1994 and January 2005 were used in this study. The traits analyzed were BW at 60 d of age; daily BW gain from birth to finish, from weaning to 60 d, from weaning to finish, and from 60 d to finish; age at finish; backfat thickness at 60 d of age and at finish; loin eye area at 60 d of age (LEA60) and at finish; and the number of teats. The heritability estimates for BW at 60 d of age, daily BW gain from weaning to 60 d, backfat thickness at 60 d of age, and LEA60 were 0.22, 0.25, 0.49, and 0.22, respectively. The estimated common environmental effect for BW at 60 d of age, daily BW gain from weaning to 60 d, backfat thickness at 60 d of age, and LEA60 were 0.12, 0.13, 0.18, and 0.21, respectively. Therefore, the common environmental effect should be included in the model to analyze traits at 60 d of age. The positive genetic correlation between LEA60 and loin eye area at finish and the negative genetic correlation between LEA60 and backfat thickness at finish indicated that improvement of the ultrasonic loin eye area at 60 d of age may result in favorable correlated responses to the traits at finish, an increase in loin eye area, and a decrease in backfat thickness. In addition, genetic correlations of backfat thickness at 60 d of age with backfat thickness at finish and loin eye area at finish were found to be favorable, indicating that improvement of ultrasonic backfat thickness at 60 d of age may result in greater correlated responses to the traits at finish: an increase in loin eye area and a decrease in backfat thickness. Therefore, constructing a selection scheme that includes body composition traits at 60 d and traits at finish is practical for gaining a greater selection response.

Magnetic fluctuation profile measurement using optics of motional Stark effect diagnostics in JT-60U

Motional Stark effect (MSE) diagnostics in JT-60U works as polarimeter to measure the pitch angle of magnetic field as well as beam-emission-spectroscopy (BES) monochromator simultaneously at 30 spatial channels. Fluctuation in the BES signal using MSE optics (MSE/BES) contains fluctuations in not only the density but also the pitch angle (or the magnetic field). Correlation analysis of the magnetic fluctuation between two spatial channels is applied to high-beta plasma with a magnetohydrodynamic activity at frequency of about 0.9 kHz. It has been found that the magnetic fluctuation measured by the MSE/BES is spatially localized near the magnetic flux surface having safety factor and that the phase of the fluctuation is inverted at about the surface, suggesting magnetic island structure by tearing mode. The phase of the magnetic fluctuation measured by the MSE/BES at outside of the q=2 surface is consistent with that by the pickup coil placed outside the plasma.

Mercury exposure and antioxidant defenses in women: a comparative study in the Amazon

Mercury is a hazardous metal that has become an important issue of environmental contamination in Amazon areas. Human intoxication by mercury causes sensory deficits, motor dysfunction, delayed psychomotor development, genotoxicity, and several other health problems. One of the major cellular mechanisms of mercury toxicity is the oxidative stress which may lead to membrane peroxidation and generation of reactive oxygen species. The antioxidant defense, which includes scavenger compounds such as glutathione and antioxidant enzymes such as catalase, might prevent these injuries to occur. Thus, the objective of this work was to evaluate hair mercury levels and the strength of antioxidant defenses, evaluated by glutathione levels and catalase activity in the blood of exposed and non-exposed women living in Amazon populations. For each location, no statistically significant difference (P<0.05) was detected for age versus mercury content. However, women from populations under the influence of gold mining activity exhibit high mercury levels in hair samples, above the tolerance limit accepted by the World Health Organization. In addition, a significant correlation was found between high mercury content, high glutathione level, and lower catalase activity. These data suggest that chronic mercury intoxication may deplete antioxidant enzymatic activity, which can be used as an important peripheral marker. Knowledge originated by this monitoring will better assist the development of preventive strategies and governmental actions against the problem of mercury contamination.

Breast cancer resistance protein (BCRP) affected acquired resistance to gefitinib in a "never-smoked" female patient with advanced non-small cell lung cancer

Development of acquired resistance to gefitinib after an initial good response is common. Recently, it was reported that this acquired resistance is related to a secondary mutation associated with a substitution of threonine by methionine at codon 790 (T790M) of the epidermal growth factor receptor (EGFR) gene. In this report, we present a "never smoking" woman with advanced lung cancer who showed acquired resistance to gefitinib, and analysis of autopsy samples revealed no evidence of EGFR mutations in either exons 18-21 or codon 790, and positive immunostaining for breast cancer resistance protein (BCRP). We describe, for the first time, a case in which expression of BCRP was associated with acquired resistance to gefitinib, independent of EGFR mutations.

Background variables for the patients with invasive bladder cancer suitable for bladder-preserving therapy

15610

Background: The present study was undertaken to identify the patients suitable for bladder preservation by analysis of our previous studies. Methods: The subjects of this study were all 72 patients with T2–3N0M0 bladder cancer who underwent bladder- preserving therapy in our institute. The therapy involved intra-arterial chemotherapy with MTX and CDDP and concomitant radiotherapy. Results: Of the evaluable 70 cases, complete response was confirmed in 57 cases (81.4%). The median follow-up was 45.3 months. The 5-year cause-specific survival rate was 81 % and the 5-year overall survival rate was 66%. Based on the results of univariate analysis, variables contributing to complete response were selected. In T2 cases, tumor size of 3 cm or less was scored 0 and tumor larger than 3 cm was scored 1, while single tumor was scored 0 and multiple tumors were scored 1. In T3 cases, tumor size of 3 cm or less was scored 0 and tumor larger than 3 cm was scored 1, while G2 was scored 0 and G3 scored 1. The CR rates were 93.8% and 92.6% for total scores of 0 and 1, respectively, and 62.9% for a total score of 2 (P = 0.003; score 0 or 1 vs 2). The overall survival rate was significantly higher in the former group (P = 0.003). Conclusion: Bladder-preserving therapy can be acceptable for cases of single T2N0M0 tumor with a size of =3 cm and for T3N0M0 cases with a tumor size of =3 cm.

No significant financial relationships to disclose.