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Upper Urinary Tract Cancer

Min Hyun Cho, Sung Han Kim, Weon Seo Park, Jae Young Joung, Ho Kyung Seo, Jinsoo Chung, Kang Hyun Lee
BACKGROUND: Sarcomatoid urothelial carcinoma (SUC) is a rare malignant neoplasm of the urinary bladder comprising 0.2-0.6 % of all histological bladder tumor subtypes. It presents as a high-stage malignancy and exhibits aggressive biological behavior, regardless of the treatment employed. It is defined as histologically indistinguishable from sarcoma and as a high-grade biphasic neoplasm with malignant epithelial and mesenchymal components. The mean age of patients presenting with SUC is 66 years, and the male-to-female ratio is 3:1...
October 20, 2016: World Journal of Surgical Oncology
Ei-Ichiro Takaoka, Jun Miyazaki, Hitoshi Ishikawa, Koji Kawai, Tomokazu Kimura, Ryutaro Ishitsuka, Takahiro Kojima, Reiko Kanuma, Daichi Takizawa, Toshiyuki Okumura, Hideyuki Sakurai, Hiroyuki Nishiyama
OBJECTIVE: We retrospectively elucidated the oncological outcomes, prognostic factors and toxicities of proton beam therapy in trimodal bladder-preserving therapy for muscle-invasive bladder cancer at our institution. METHODS: From 1990 to 2015, 70 patients with cT2-3N0M0 muscle-invasive bladder cancer underwent trimodal bladder-preserving therapy consisting of maximal transurethral resection of the bladder tumor, small pelvis photon irradiation, intra-arterial chemotherapy and proton beam therapy...
October 13, 2016: Japanese Journal of Clinical Oncology
G J Wirth, A Haitel, M Moschini, F Soria, T Klatte, M R Hassler, K Bensalah, A Briganti, J A Karam, Y Lotan, V Margulis, J D Raman, M Remzi, N Rioux-Leclercq, B D Robinson, M Rouprêt, C G Wood, S F Shariat
PURPOSE: This study aims to determine the significance of androgen receptor (AR) expression in urothelial carcinoma of the upper urinary tract (UTUC). METHODS: AR expression was assessed on tissue microarrays containing specimens of 737 patients with UTUC who underwent radical nephroureterectomy with curative intent. AR expression was correlated with clinical and pathological tumor features as well as recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS)...
October 11, 2016: World Journal of Urology
Jian Cao, Xiaokun Zhao, Zhaohui Zhong, Lei Zhang, Xuan Zhu, Ran Xu
The effect of pre-operative renal insufficiency on urothelial carcinoma (UC) prognosis has been investigated by numerous studies. While the majority report worse UC outcomes in patients with renal insufficiency, the results between the studies differed wildly. To enable us to better estimate the prognostic value of renal insufficiency on UC, we performed a systematic review and meta-analysis based on the published literature. A total of 16 studies which involved 5,232 patients with UC, investigated the relationship between pre-operative renal insufficiency and disease prognosis...
October 11, 2016: Scientific Reports
Gilhyang Kim, Yul Ri Chung, Bohyun Kim, Boram Song, Kyung Chul Moon
Background: Human epidermal growth factor receptor 2 (HER2) is one of the known oncogenes in urothelial carcinoma. However, the association between HER2 and the prognosis of upper urinary tract urothelial carcinoma (UUTUC) has not yet been fully clarified. The aim of this study was to evaluate HER2 expression using the United States Food and Drug Administration (FDA) criteria and American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) criteria and compare their prognostic significance in UUTUC...
October 10, 2016: Journal of Pathology and Translational Medicine
Georgios Gakis, Peter C Black, Bernard H Bochner, Stephen A Boorjian, Arnulf Stenzl, George N Thalmann, Wassim Kassouf
CONTEXT: Urothelial carcinoma is considered a pan-urothelial disease. As such, the remnant urothelium in the upper urinary tract and urethra following radical cystectomy (RC) remains at risk for secondary urothelial tumors (SUTs). OBJECTIVE: To describe the incidence, diagnosis, treatment, and outcomes of patients with SUTs after RC. EVIDENCE ACQUISITION: A systematic search was conducted using PubMed database according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to identify studies between 1970 and 2016 reporting on malignant diseases of the urothelium after RC for bladder cancer...
October 6, 2016: European Urology
Badereddin Mohamad Al-Ali, Stephan Madersbacher, Nadine Zielonke, Ingrid Schauer, Thomas Waldhoer, Gerald Haidinger
BACKGROUND: The aim of this study was to analyze the impact of gender on tumor stage, overall and cancer-specific mortality of upper urinary tract urothelial cancer (UTUC) in a population-based, nationwide analysis. METHODS: All Austrian patients with UTUC diagnosed between 1983 and 2010 were included in this study. Overall mortality was estimated by the Kaplan-Meier method. Cancer-specific (UTUC) mortality was estimated by cumulative incidence with mortality due to other causes as a competing risk...
September 26, 2016: Wiener Klinische Wochenschrift
Nozomu Kishimoto, Tetsuya Takao, Sohei Kuribayashi, Gaku Yamamichi, Kosuke Nakano, Masataka Kawamura, Koichi Tsutahara, Go Tanigawa, Seiji Yamaguchi
BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation associated with recurrence and poor prognosis in numerous cancer types. The aim of this study was to evaluate the use of the NLR as a biomarker for intravesical recurrence (IVR) in patients undergoing radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UTUC) for the first time. METHODS: We retrospectively analyzed the records of 100 patients with UTUC who had undergone RNU between 1999 and 2015 at our institution...
September 10, 2016: International Journal of Clinical Oncology
Koichiro Nandate, Bryan B Voelzke
Indigo carmine (also known as 5,5'-indigodisulfonic acid sodium salt or indigotine) is a blue dye that is administered intravenously to examine the urinary tract and usually is biologically safe and inert. Indigo carmine rarely may cause adverse reactions. We treated a 66-year-old man who had general anesthesia and radical retropubic prostatectomy for prostate cancer. He had a previous history of allergy to bee sting with nausea, vomiting, and dizziness. Within 1 minute after injection of indigo carmine for evaluation of the ureters, the patient developed hypotension to 40 mmHg, severe hypoxia (the value of SpO2 (peripheral capillary oxygen saturation) was 75% on 40% inspired oxygen concentration), poor air movement and bilateral diffuse wheezing on auscultation, and marked subcutaneous erythema at the upper extremities...
2016: Case Reports in Urology
Alexandre A Barros, Shane Browne, Carlos Oliveira, Estevão Lima, Ana Rita C Duarte, Kevin E Healy, Rui L Reis
Upper urinary tract urothelial carcinoma (UTUC) accounts for 5-10% of urothelial carcinomas and is a disease that has not been widely studied as carcinoma of the bladder. To avoid the problems of conventional therapies, such as the need for frequent drug instillation due to poor drug retention, we developed a biodegradable ureteral stent (BUS) impregnated by supercritical fluid CO2 (scCO2) with the most commonly used anti-cancer drugs, namely paclitaxel, epirubicin, doxorubicin, and gemcitabine. The release kinetics of anti-cancer therapeutics from drug-eluting stents was measured in artificial urine solution (AUS)...
August 31, 2016: International Journal of Pharmaceutics
C Hernández-Fernández, F Herranz-Amo, M Moralejo-Gárate, D Subirá-Ríos, J Caño-Velasco, G Barbas-Bernardos
CONTEXT: Bladder cancer is the cause of more than 150,000 deaths per year. The overall rate of survival is approximately 45%, with a 10-year recurrence-free rate of 50-59%, with no changes in the last decade. OBJECTIVE: Due to a lack of agreement on the follow-up of cystectomy or on a uniform treatment when faced with the various types of recurrence, we have analysed the most recent literature in an attempt to unify the criteria for the diagnosis and treatment of bladder cancer...
August 22, 2016: Actas Urologicas Españolas
Margaret L Hoang, Chung-Hsin Chen, Pau-Chung Chen, Nicholas J Roberts, Kathleen G Dickman, Byeong Hwa Yun, Robert J Turesky, Yeong-Shiau Pu, Bert Vogelstein, Nickolas Papadopoulos, Arthur P Grollman, Kenneth W Kinzler, Thomas Rosenquist
BACKGROUND: Aristolochia species used in the practice of traditional herbal medicine contain aristolochic acid (AA), an established human carcinogen contributing to urothelial carcinomas of the upper urinary tract. AA binds covalently to genomic DNA, forming aristolactam (AL)-DNA adducts. We here investigated whether AA is also an etiologic factor in clear cell renal cell carcinoma (ccRCC). METHODS: We conducted a population-based case-control study to investigate the linkage between Aristolochia prescription history, cumulative AA consumption, and ccRCC incidence in Taiwan (5,709 cases and 22,836 matched controls)...
August 23, 2016: Cancer Epidemiology, Biomarkers & Prevention
Sławomir G Kata, Omar Aboumarzouk
INTRODUCTION: There is observed increase in detection rate of upper urinary tract urothelial cancer worldwide. This is a result of improved imaging as well as implementation of novel technologies of direct visualization of upper urinary tract. Standard techniques still remain insufficient to diagnose flat urothelial lesions. Carcinoma in situ is characterized by flat disordered proliferation of urothelial cells with marked cytologic abnormality, which occur within one cell layer as well as full thickness urothelium and therefore requires a better technology to pick up early and subtle mucosal changes...
2016: Central European Journal of Urology
Benjamin Pradere, Yair Lotan, Morgan Roupret
PURPOSE OF REVIEW: Lynch syndrome is a genetic syndrome that integrates a large spectrum of cancers caused by germline mutations in mismatch repair genes. Its incidence is underestimated due to a lack of systematic screening in the population. Because upper tract urothelial carcinoma is the third-most common cancer associated with the syndrome, urologists should be aware of the diagnostic pathway. RECENT FINDINGS: Lynch syndrome can be positively diagnosed after the three following distinct steps: meeting the clinical criteria, tissue and genetic testing, and familial genetic counseling...
August 16, 2016: Current Opinion in Urology
Masakazu Washio, Mitsuru Mori, Kazuya Mikami, Tsuneharu Miki, Yoshiyuki Watanabe, Masahiro Nakao, Tatsuhiko Kubo, Koji Suzuki, Kotaro Ozasa, Kenji Wakai, Akiko Tamakoshi
BACKGROUND: The incidence of bladder cancer is lower in Asian than in Western countries. However, the crude incidence and mortality of bladder cancer have recently increased in Japan because of the increased number of senior citizens. We have already reported risk factors for urothelial cancer in a large populationbased cohort study in Japan (JACC study). However, we did not evaluate the cancer risk in the upper and lower urinary tract separately in our previous study. MATERIALS AND METHODS: Here we evaluated the risk of cancer death in the upper and lower urinary tracts, separately, using the database of the JACC study...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
Hyung Suk Kim, Chang Wook Jeong, Cheol Kwak, Hyeon Hoe Kim, Ja Hyeon Ku
We aimed to assess the prognostic significance of demographic factors, including age, sex, performance status, smoking status, obesity, and race in upper urinary tract urothelial carcinoma (UTUC) patients treated with radical nephroureterectomy through a systematic review and meta-analysis. We conducted PubMed search for all articles published until December 2014 according to Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Survival outcomes of interest were intravesical recurrence (IVR) free survival, progression free survival (PFS), cancer-specific survival (CSS), and overall survival (OS)...
July 19, 2016: Oncotarget
Hiroki Ishihara, Tsunenori Kondo, Kenji Omae, Toshio Takagi, Junpei Iizuka, Hirohito Kobayashi, Yasunobu Hashimoto, Kazunari Tanabe
BACKGROUND: We aimed to evaluate the effect of sarcopenia, a condition of low muscle mass, on the survival among patients who were undergoing radical nephroureterectomy (RNU) for urothelial carcinoma of the upper urinary tract (UCUT). METHODS: We retrospectively reviewed consecutive patients with UCUT (cT[any]N0M0) who underwent RNU between 2003 and 2013 at our department and its affiliated institutions. Preoperative computed tomography images were used to calculate each patient's skeletal muscle index, an indicator of whole-body muscle mass...
July 15, 2016: International Journal of Clinical Oncology
Seth P Lerner, Dean F Bajorin, Colin P Dinney, Jason A Efstathiou, Susan Groshen, Noah M Hahn, Donna Hansel, David Kwiatkowski, Michael O'Donnell, Jonathan Rosenberg, Robert Svatek, Jeffrey S Abrams, Hikmat Al-Ahmadie, Andrea B Apolo, Joaquim Bellmunt, Margaret Callahan, Eugene K Cha, Charles Drake, Jonathan Jarow, Ashish Kamat, William Kim, Margaret Knowles, Bhupinder Mann, Luigi Marchionni, David McConkey, Lisa McShane, Nilsa Ramirez, Andrew Sharabi, Arlene H Sharpe, David Solit, Catherine M Tangen, Abdul Tawab Amiri, Eliezer Van Allen, Pamela J West, J A Witjes, Diane Zipursky Quale
The NCI Bladder Cancer Task Force convened a Clinical Trials Planning Meeting (CTPM) Workshop focused on Novel Therapeutics for Non-Muscle Invasive Bladder Cancer (NMIBC). Meeting attendees included a broad and multi-disciplinary group of clinical and research stakeholders and included leaders from NCI, FDA, National Clinical Trials Network (NCTN), advocacy and the pharmaceutical and biotech industry. The meeting goals and objectives were to: 1) create a collaborative environment in which the greater bladder research community can pursue future optimally designed novel clinical trials focused on the theme of molecular targeted and immune-based therapies in NMIBC; 2) frame the clinical and translational questions that are of highest priority; and 3) develop two clinical trial designs focusing on immunotherapy and molecular targeted therapy...
2016: Bladder Cancer
Wassim Kassouf, Samer L Traboulsi, Bernd Schmitz-Dräger, Joan Palou, Johannes Alfred Witjes, Bas W G van Rhijn, Herbert Barton Grossman, Lambertus A Kiemeney, Peter J Goebell, Ashish M Kamat
OBJECTIVE: Non-muscle-invasive bladder cancer (NMIBC) comprises a wide spectrum of tumors with different behaviors and prognoses. It follows that the surveillance for these tumors should be adapted according to the risks of recurrence and progression and should be dynamic in design. METHODS AND MATERIALS: Medline search was conducted from 1980 to 2016 using a combination of MeSH and keyword terms. The highest available evidence was reviewed to define different risk groups in NMIBC...
October 2016: Urologic Oncology
Yimin Wang, Baiye Jin, Xiaolin Yao
Numerous studies have reported an association between end-stage renal disease (ESRD) and malignancy. The predominant malignant tumor that occurs in patients with ESRD in Asian countries is urothelial carcinoma (UC). According to recent research, cases of UC in dialysis-dependent patients are associated with higher recurrence rates and more aggressive biological behavior compared with patients without ESRD. The necessity of 1-step total urinary tract exenteration for dialysis-dependent patients with UC is advocated by certain studies...
June 2016: Oncology Letters
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