Risk of bladder cancer death in patients younger than 50 with non-muscle-invasive and muscle-invasive bladder cancer

The role of CDK8 gene polymorphisms in bladder cancer susceptibility and prognosis: a study in the Chinese Han population

BACKGROUND

Cyclin-dependent kinase 8 (CDK8) has been implicated in various tumors, with its role differing across tumor types. However, the association between CDK8 polymorphisms and bladder cancer (BC) remains unclear. This study investigated the association between CDK8 polymorphisms and BC susceptibility and prognosis.

METHODS

This case-control study included 271 patients with BC and 381 healthy controls. Two-tag single-nucleotide polymorphisms in the CDK8 gene (rs17083838 and rs7992670) were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Statistical analyses were performed using SNPstats and SPSS software to assess genetic associations.

RESULTS

The AG/AA genotypes of rs17083838 were associated with a significantly reduced risk of BC under the dominant model (P < 0.001, odds ratio [95% confidence interval] = 0.50 [0.33-0.76]). Stratified analysis revealed that the AG genotype of rs17083838 increased the risk of postoperative recurrence in patients with stage IV BC (P = 0.007). For rs7992670, females with the AG/AA genotype exhibited a 2.07-fold higher risk of BC than males, whereas smokers with the same genotype showed a 2.13-fold higher risk than non-smokers. The GG genotype of rs7992670 was associated with better overall survival in patients with stage III BC (P = 0.023). Among patients with recurrent muscle-invasive BC, those with the GG/AA genotype showed significantly improved survival compared with those carrying the AG genotype (P = 0.023).

CONCLUSIONS

CDK8 polymorphisms influence BC susceptibility and prognosis, with rs17083838 showing a protective effect and rs7992670 being associated with increased risk and survival outcomes in specific subgroups.

IMPACT

This study highlights the potential of CDK8 polymorphisms as biomarkers for BC susceptibility and prognosis, emphasizing the need for further research.

Investigation of new autoantibodies in urothelial bladder cancer for biomarker discovery using immunoproteomics

BACKGROUND

Tumor-associated antigens (TAAs) lead to the production of tumor-specific autoantibodies (anti-TAA autoantibodies) by triggering the humoral immune system which can be used as candidate biomarkers. This study aims to investigate TAAs proteins eliciting humoral responses in different stages of urothelial bladder carcinoma (UBC) using an immunoproteomics approach to find novel biomarkers for the clinical management of the disease.

METHODS

Total proteins were obtained from the newly established UBC cell line, JAM-ICR, and separated by two-dimensional gel electrophoresis (2DE). These proteins were then immobilized using pooled serum samples from healthy individuals, autoimmune and UBC patients at different stages. The immunoreactive spots in UBC patient samples were identified by mass spectrometry and verified with several databases such as GEPIA and Enrichr databases.

RESULTS

Through the comparison of the immunoreactivity pattern of serums, we were able to identify eight specific proteins using LC-MS. Patients with muscle invasion showed increased expression of ENO1, VDAC2, AKR1B1, SDF2L1, PRDX6, PSME1, HSPB1 and PHB1 compared to controls. In addition, non-muscle invasive patients showed overexpression of ENO1, VDAC2, AKR1B1, and PRDX6 compared to controls. In addition to their diagnostic function, PRDX6, ENO1, VDAC2, and PHB1 have been demonstrated to possess prognostic capabilities in patients with UBC. Interestingly, these proteins were mainly associated with cellular growth and anti-apoptotic activity.

CONCLUSION

In this study, eight anti-TAA autoantibodies were identified that have the potential to serve as diagnostic and prognostic biomarkers. These could represent a valuable panel of biomarkers for the management of UBC.

Assessing the clinical, humanistic, and economic impact of early cancer diagnosis: a systematic literature review

Introduction

There is a clear consensus among healthcare providers on the advantages of early cancer detection and treatment. However, no in-depth review has yet fully presented the clinical, humanistic, and economic benefits of early cancer diagnosis compared to late detection across a broad range of tumor types.

Methods

A systematic literature review was conducted to determine the clinical, humanistic, and economic benefits of early cancer diagnosis, as opposed to late diagnosis, as reported in non-interventional studies conducted worldwide. Searches were conducted using electronic databases (MEDLINE and Embase), conference repositories and grey literature. Observational studies in adults diagnosed with bladder cancer, gastric cancer, head and neck cancer (HNC), melanoma, non-small cell lung cancer (NSCLC), renal-cell carcinoma (RCC), and triple negative breast cancer (TNBC) were eligible for inclusion if they reported survival, health-related quality of life (HRQoL), healthcare resource utilization and/or costs, according to stage at diagnosis. Identified records were screened and extracted by two independent reviewers, and discrepancies were resolved by a third reviewer. The quality of studies was assessed using the Newcastle-Ottawa scale and the Larg and Moss adapted checklist.

Results

Of the 3,159 records identified, 103 studies were included in this review. The general trend showed worse clinical, humanistic, and economic outcomes when patients were diagnosed at a later stage compared to an earlier stage. Patients diagnosed at an earlier stage, had on average, substantially higher survival rates and lower mortality rates across all cancer types and incurred lower resource utilization and costs (with available evidence for patients with NSCLC, TNBC, and HNC), compared to those diagnosed at a more advanced/later stage. Limited evidence on the humanistic burden suggested that with a more advanced stage at diagnosis, patients with bladder cancer experienced reduced HRQoL.

Conclusion

Early cancer diagnosis (i.e., cancer diagnosed at earlier stages or with lower grades) was associated with longer survival, improved quality of life and lower healthcare costs and resource utilization compared to diagnosis of cancer at later stages or higher grades, as reported by overall survival (OS) and HRQoL outcomes. These findings emphasize the importance of screening and early detection of cancer to improve outcomes among patients diagnosed with cancer.

Long-term outcomes of penile squamous cell carcinoma in men age ≤50 years old compared with men >50 years old from a single tertiary referral centre: a propensity score matched analysis

Penile cancer (PeCa) is rare, and the oncological outcomes in younger men are unclear. We aimed to analyse and compare oncological outcomes of men age ≤50 years (y) and >50 years with PeCa. A retrospective analysis of men ≤50 y with penile squamous cell carcinoma managed at a tertiary centre was performed. A propensity score matched cohort of men >50 y was identified for comparison. Matching was according to tumour, nodal stage and the types of primary surgery. Overall survival (OS), disease-specific survival (DSS), recurrence-free survival (RFS), and metastasis-free survivals (MFS) were estimated using Kaplan-Meier plots and compared using log-rank tests. Between 2005-2020, 100 men ≤50 y (median (IQR) age, 46 y (40-49)) were identified and matched with 100 men >50 y (median (IQR) age, 65 y (59-73)). 10, 24, 32, 34 men age ≤50 y were diagnosed in 2005-2007, 2008-2012, 2013-2016 and 2017-2020 respectively. Median (IQR) follow-up was 53.5 (18-96) months. OS at 2 years: ≤50 y, 86%>50 y, 80.6%; 5 years: ≤50 y, 78.1%, >50 y, 63.1%; 10 years: ≤50 y, 72.3%, >50 y, 45.6% (p = 0.01). DSS at 2 years: ≤50 y, 87.2%>50 y, 87.8%; 5 years: ≤50 y, 80.9%>50 y, 78.2%; 10 years: ≤50 y, 78%, >50 y, 70.9% (p = 0.74). RFS was 93.1% in the ≤50 y group (vs. >50 y, 96.5%) at 2 year, and 90% (vs. >50 y, 88.5%) at 5 years, p = 0.81. Within the ≤50 y group, 2 years and 5 years MFS was 93% (vs. >50 y, 96.5%), and 89.5% (vs. >50 y, 92.7%) respectively, (p = 0.40). There were no statistical significance in DFS, RFS and MFS in men age ≤50 y and >50 y. PeCa in younger patients is fatal, public awareness and patient education are crucial for early detection and management.

Biological differences underlying sex and gender disparities in bladder cancer: current synopsis and future directions

Sex and gender disparities in bladder cancer have long been a subject of interest to the cancer research community, wherein men have a 4 times higher incidence rate than women, and female patients often present with higher-grade disease and experience worse outcomes. Despite the known differences in disease incidence and clinical outcomes between male and female bladder cancer patients, clinical management remains the same. In this review, we critically analyze studies that report on the biological differences between men and women and evaluate how these differences contribute to sex and gender disparities in bladder cancer. Distinct characteristics of the male and female immune systems, differences in circulating hormone levels and hormone receptor expression, and different genetic and epigenetic alterations are major biological factors that all likely contribute to disparate incidence rates and outcomes for male and female bladder cancer patients. Future preclinical and clinical studies in this area should employ experimental approaches that account for and consider sex and gender disparities in bladder cancer, thereby facilitating the development of precision medicine for the effective treatment of bladder cancer in all patients.

Prognostic factors and nomogram for the overall survival of bladder cancer bone metastasis: A SEER-based study

Bone metastasis has a poor prognosis in patients with bladder cancer (BC). This study aimed to construct a prognostic nomogram for predicting the overall survival of patients with bone-metastatic BC (BMBC). The Surveillance, Epidemiology, and End Results database was used to recruit patients with BMBC between 2010 and 2018. Univariate and multivariate analyses were performed to screen for prognostic factors and construct a nomogram. Harrell concordance index, receiver operating characteristic curve, and calibration curve were used to verify the prognostic nomograms. All statistical analyses and chart formation were performed using SPSS 23.0 and R software 4.1.2. A total of 1361 patients diagnosed with BMBC were identified in the Surveillance, Epidemiology, and End Results database. Six independent prognostic factors, including marital status, histological type, T stage, other metastases, surgery, and chemotherapy, were identified and included in the nomogram construction. Among them, chemotherapy contributed the most to the prognosis in the nomogram. The concordance index of the nomogram was 0.745 and 0.753 in the training and validation groups, respectively, and all values of the area under the curve were >0.77. The calibration curves showed perfect consistency between the observed and predicted survival rates. The prognostic nomogram developed in this study is expected to become an accurate and individualized tool for predicting overall survival in patients with BMBC and providing guidance for appropriate treatment or care.

Incidence, mortality and relative survival of patients with cancer of the bladder and upper urothelial tract in the Nordic countries between 1990 and 2019

PURPOSE

To understand the potential impact of new treatment options for urinary tract cancer, recent population trends in incidence, mortality and survival should be elucidated. This study estimated changes in the incidence, mortality and relative survival of urinary tract cancer in the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) between 1990 and 2019.

METHODS

Annual counts of incident cases and deaths due to urinary tract cancer (International Classification of Diseases, Tenth Revision, Clinical Modification codes C65-C68, D09.0-D09.1, D30.1-D30.9 and D41.1-D41.9) in Nordic countries were retrieved in 5-year age categories by sex during the study period. Country-specific time trends (annual rate ratios [RRs]) were estimated using Poisson regression, and RRs were compared between sexes.

RESULTS

The incidence rate of bladder and upper urothelial tract cancer was >3-times lower in women than men in all countries across all age groups (incidence RR for women to men ranging from 0.219 [95% CI = 0.213-0.224] in Finland to 0.291 [95% CI = 0.286-0.296] in Denmark). Incidence rates were lowest in Finland and highest in Norway and Denmark. Age-adjusted mortality decreased in Finland, Denmark and Norway and in Swedish men, with the greatest decrease seen in Danish men (annual RR = 0.976; 95% CI = 0.975-0.978). In all countries and age groups, women had a lower relative survival rate than men.

CONCLUSION

Between 1990 and 2019, the incidence of urinary tract cancer was stable in the Nordic countries, while mortality rates declined and relative survival increased. This could be due to earlier diagnosis and better treatment.