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Bladder cancer, cystectomy

Carin Sjöström, Andreas Thorstenson, Viveka Ströck, Abolfazl Hosseini-Aliabad, Firas Aljabery, Fredrik Liedberg, Amir Sherif, Per-Uno Malmström, Johan Rosell, Truls Gårdmark, Staffan Jahnson
OBJECTIVE: The aim of this investigation was to study differences between male and female patients with stage T1 urinary bladder cancer (UBC) regarding intravesical instillation therapy, second resection and survival. MATERIALS AND METHODS: This study included all patients with non-metastatic primary T1 UBC reported to the Swedish National Register of Urinary Bladder Cancer (SNRUBC) from 1997 to 2014, excluding those treated with primary cystectomy. Differences between groups were evaluated using chi-squared tests and logistic regression, and survival was investigated using Kaplan-Meier and log-rank tests and Cox proportional hazards analysis...
April 20, 2018: Scandinavian Journal of Urology
Fan Dong, Yifan Shen, Fengbin Gao, Xiao Shi, Tianyuan Xu, Xianjin Wang, Xiaohua Zhang, Shan Zhong, Minguang Zhang, Shanwen Chen, Zhoujun Shen
Objectives: To develop reliable nomograms to estimate individualized overall survival (OS) and cancer specific survival (CSS) for patients with primary small cell carcinoma of the bladder (SCCB) and compare the predictive value with the AJCC stages. Patients and Methods: 582 eligible SCCB patients identified in the Surveillance, Epidemiology, and End Results (SEER) dataset were randomly divided into training (n=482) and validation (n=100) cohorts. Akaike information criterion was used to select the clinically important variables in multivariate Cox models when establishing nomograms...
2018: Journal of Cancer
Gillian Stearns, Timothy Donahue, Ali Fathollahi, Guido Dalbagni, Jaspreet Sandhu
AIMS: Continent urinary diversion is preferred by some patients and orthotopic urinary diversion (OUD) has become the procedure of choice for most men following cystectomy for invasive bladder cancer. OUD in women, however, is less common, likely due to a high rate of hypercontinence (HC), potentially from lax support of pelvic structures similar to pelvic organ prolapse. As such, we evaluated if abdominal sacrocolpopexy (ASC) at the time of OUD in women led to decreased rates of HC. METHODS: A retrospective review of all female patients receiving OUD by a single surgeon and ASC was performed...
April 17, 2018: Neurourology and Urodynamics
Taku Naiki, Aya Naiki-Ito, Keitaro Iida, Toshiki Etani, Hiroyuki Kato, Shugo Suzuki, Yoriko Yamashita, Noriyasu Kawai, Takahiro Yasui, Satoru Takahashi
Herein, we elucidated the molecular mechanisms and therapeutic potential of glutathione peroxidase 2 (GPX2) in bladder cancer. GPX2 expression gradually increased during progression from normal to papillary or nodular hyperplasia (PNHP) and urothelial carcinoma (UC) in a rat N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN)-induced bladder carcinogenesis model. GPX2 overexpression was more marked in UC with squamous differentiation (SqD) than in pure UC. Clinical intraepithelial lesions of papillary UC and invasive UC with SqD also had strong GPX2 expression in human radical cystectomy specimens...
March 23, 2018: Oncotarget
Usama Jazzar, Shan Yong, Zachary Klaassen, Jinhai Huo, Byron D Hughes, Edgar Esparza, Hemalkumar B Mehta, Simon P Kim, Douglas S Tyler, Stephen J Freedland, Ashish M Kamat, Dwight V Wolf, Stephen B Williams
BACKGROUND: Treatments for muscle-invasive bladder cancer are multimodal, complex, and often carry significant risks of physical and psychological morbidity. The objectives of this study were to define the incidence and types of psychiatric illnesses diagnosed after treatment and to determine their impact on survival outcomes. METHODS: In total, 3709 patients who were diagnosed with clinical stage T2 through T4a bladder cancer from January 1, 2002, to December 31, 2011, from the Surveillance, Epidemiology, and End Results-Medicare were analyzed...
April 16, 2018: Cancer
Brian R Winters, Funda Vakar-Lopez, Lisha Brown, Bruce Montgomery, Roland Seiler, Peter C Black, Joost L Boormans, Marc Dall Era, Elai Davincioni, James Douglas, Ewan A Gibb, Bas W G van Rhijn, Michiel S van der Heijden, Andrew C Hsieh, Jonathan L Wright, Hung-Ming Lam
BACKGROUND: The mechanistic target of rapamycin (mTOR) has been implicated in driving tumor biology in multiple malignancies, including urothelial carcinoma (UC). We investigate how mTOR and phosphorylated mTOR (pmTOR) protein expression correlate with chemoresponsiveness in the tumor and its microenvironment at final pathologic staging after neoadjuvant chemotherapy (NAC). METHODS: A single-institution retrospective analysis was performed on 62 patients with cT2-4Nany UC undergoing NAC followed by radical cystectomy...
April 12, 2018: Urologic Oncology
N Tselis, F J Prott, O Ott, C Weiss, C Rödel
BACKGROUND: The standard treatment for muscle-invasive bladder cancer is radical cystectomy with pelvic lymphadenectomy. Primary organ-preservation by means of multimodal therapy, however, can be a viable alternative to radical surgery. OBJECTIVES: The concept and results of multimodal therapy, consisting of initial transurethral resection of the bladder tumor (TUR-B), followed by simultaneous radiochemotherapy (RCT), are presented. MATERIALS AND METHODS: Evaluation of retrospective cohorts and prospective therapy optimization studies on organ-preservation treatment regimens...
April 12, 2018: Der Urologe. Ausg. A
Mark D Tyson, Daniel A Barocas
Approximately 1 in 5 new cases of clinically localized bladder cancer is muscle invasive and requires the patient to choose from 1 of 2 prevailing options for treatment: radical cystectomy or radiation to the bladder. However, these treatments are associated with detrimental effects on patient well-being and quality of life, particularly with respect to functional independence, urinary and sexual function, social and emotional health, body image, and psychosocial stress. Compared with the literature on other malignancies like breast or prostate cancer, high-quality studies evaluating the effects of bladder cancer treatment on quality of life are lacking...
May 2018: Urologic Clinics of North America
Madhumitha Reddy, Karim Kader
Bladder cancer is the sixth leading cancer in the United States. Radical cystectomy is a lifesaving procedure for bladder cancer with or without muscle invasion. Radical cystectomy is performed on 39% of these patients, and 35% will have a life-threatening recurrence. Distant metastases are the most common; local, upper tract, and urethral recurrence can also occur. Surveillance after cystectomy is critical to diagnosing recurrence early. Functional complications after urinary diversion include bowel dysfunction, vitamin B12 deficiency, acidosis, electrolyte abnormalities, osteopenia, nephrolithiasis, urinary tract infections, renal functional decline, and urinary obstruction, which can be reversed when diagnosed early...
May 2018: Urologic Clinics of North America
Daniel Zainfeld, Ankeet Shah, Siamak Daneshmand
Radical cystectomy remains the gold standard therapy for the treatment of muscle-invasive urothelial carcinoma, yet is accompanied by significant rates of perioperative complications and readmission. Enhanced recovery protocols aim to apply evidence-based principles of care to ameliorate the morbidity of this procedure by enabling better tolerance of and recovery from radical cystectomy. Multiple patient series have demonstrated the capacity for enhanced-recovery-after-surgery (ERAS) principles to improve outcomes among patients undergoing radical cystectomy through decreased incidence of gastrointestinal complications and decreased length of hospitalization without increased readmissions or overall morbidity...
May 2018: Urologic Clinics of North America
William Tabayoyong, Roger Li, Jianjun Gao, Ashish Kamat
Radical cystectomy with bilateral pelvic lymph node dissection is the standard of care for patients with clinically localized muscle-invasive bladder cancer. Survival after radical cystectomy is associated with final pathologic staging. Survival decreases with increasing pT stage because of the presence of occult micrometastases, indicating the need for systemic chemotherapy. Systemic chemotherapy is delivered as either neoadjuvant therapy preoperatively, or as adjuvant therapy postoperatively. This article reviews the evidence for neoadjuvant and adjuvant chemotherapy for the treatment of muscle-invasive bladder and upper tract urothelial cancer and offers recommendations based on these data and recently updated clinical guidelines...
May 2018: Urologic Clinics of North America
Massimiliano Creta, Nicola Longo, Ciro Imbimbo, Vittorio Imperatore, Vincenzo Mirone, Ferdinando Fusco
No abstract text is available yet for this article.
March 2018: Translational Andrology and Urology
Valérie Fonteyne, Elke Rammant, Karel Decaestecker
No abstract text is available yet for this article.
March 2018: Translational Andrology and Urology
Stephen Odunayo Ikuerowo, Olufemi O Ojewuyi, Muftau Jimoh Bioku, Abimbola Ayodeji Abolarinwa, Olufunmilade Akinfolarin Omisanjo
Introduction: Mainz II pouch urinary diversion in patients with muscle-invasive bladder cancer is one of the options of continent urinary diversion following radical cystectomy (RC). We aim to report our experience and the outcome of our patients who had this procedure. Patients and Methods: Patients who had RC and Mainz II pouch urinary diversion for muscle-invasive bladder cancer in our institution from 2007 to 2016 were evaluated. Variables analyzed included age, gender, stage of the disease, pathological grade and tumor types, complications, and survival status...
January 2018: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
Kyle Scarberry, Nicholas G Berger, Kelly B Scarberry, Shree Agrawal, John J Francis, Jessica M Yih, Christopher M Gonzalez, Robert Abouassaly
OBJECTIVES: Positive surgical margins (PSM) and lymph node yield (LNY) following radical cystectomy (RC) for urothelial carcinoma of the bladder affect survival. Variations in PSM or LNY at different care facilities are poorly described. We evaluated the relationship between hospital surgical volume and academic hospital status with these surgical outcomes and overall survival (OS). METHODS AND MATERIALS: Patients with nonmetastatic urothelial carcinoma of the bladder who underwent RC were identified from the National Cancer Database (2004-2013)...
April 5, 2018: Urologic Oncology
Moshe C Ornstein, Claudia Marcela Diaz-Montero, Patricia Rayman, Paul Elson, Samuel Haywood, James H Finke, Jin S Kim, Paul G Pavicic, Marcelo Lamenza, Sarah Devonshire, Priscilla Dann, Kim Schach, Andrew Stephenson, Steven Campbell, Hamid Emamekhoo, Marc S Ernstoff, Christopher J Hoimes, Timothy D Gilligan, Brian I Rini, Jorge A Garcia, Petros Grivas
BACKGROUND: Myeloid derived suppressor cells (MDSC) are heterogeneous immunosuppressive cells with potential predictive and prognostic roles in cancer. The association between MDSC, clinicopathologic factors, and pathologic response in patients with bladder urothelial carcinoma (UC) was explored. METHODS: Peripheral blood or tissue were collected from patients with UC undergoing definitive surgery. MDSCs levels were measured in peripheral blood mononuclear cells and fresh tumor tissue...
March 29, 2018: Urologic Oncology
Qiaqia Li, Chao Li, Jinbo Chen, Peihua Liu, Yu Cui, Xinyi Zhou, Huihuang Li, Xiongbing Zu
PURPOSE: To explore the function of NORAD in bladder cancer (BC), and to verify whether NORAD could be used as a biomarker to determine preoperative presence of progression and lymph node metastasis. To our knowledge, it is the first study investigating NORAD and its implications in BC. METHODS: BC specimens of 90 patients underwent bladder cystectomy or transurethral resection between January 2012 to December 2016 were tested by fluorescence in situ hybridization...
March 28, 2018: Urologic Oncology
Yair Lotan, Solomon L Woldu, Oner Sanli, Peter Black, Matthew I Milowsky
OBJECTIVES: To model the cost-effectiveness (CE) of a biomarker-based approach to select patients for neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC) in muscle-invasive bladder cancer (MIBC). MATERIALS AND METHODS: We obtained most recently clinical studies on locally-advanced bladder cancer treated by RC, including stage distributions, overall survival (OS) estimates, associated costs, and utilization/response to NAC. Additionally, we estimated the putative efficacy of 3 biomarkers to select patients for NAC: DNA repair gene panel [ATM, RB1, and FANCC], ERCC2, and RNA subtypes...
March 31, 2018: BJU International
Marco Moschini, Emilio Arbelaez, Julian Cornelius, Agostino Mattei, Shahrokh F Shariat, Paolo Dell Oglio, Emanuele Zaffuto, Andrea Salonia, Francesco Montorsi, Alberto Briganti, Renzo Colombo, Andrea Gallina
BACKGROUND: Pelvic lymph node dissection (PLND) has a diagnostic and therapeutic role during radical cystectomy in bladder cancer patients. However, at the time, no prospective data supports the value of extended PLND in improving survival expectances. We sought to describe incidence and location of node metastases in patients treated with extended and superextended PLND. METHODS: We evaluated 653 contemporary patients with clinically nonmetastatic high risk nonmuscle invasive or muscle-invasive bladder cancer treated with radical cystectomy and extended or superextended PLND without neoadjuvant chemotherapy at a single tertiary referral center between 1990 and 2013...
March 27, 2018: Urologic Oncology
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