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Beijert IJ, Hentschel AE, Bründl J, Compérat EM, Plass K, Rodríguez O, Subiela Henríquez JD, Hernández V, de la Peña E, Alemany I, Turturica D, Pisano F, Soria F, Čapoun O, Bauerová L, Pešl M, Bruins HM, Runneboom W, Herdegen S, Breyer J, Brisuda A, Calatrava A, Rubio-Briones J, Seles M, Mannweiler S, Bosschieter J, Kusuma VRM, Ashabere D, Huebner N, Cotte J, Contieri R, Mertens LS, Claps F, Masson-Lecomte A, Liedberg F, Cohen D, Lunelli L, Cussenot O, El Sheikh S, Volanis D, Côté JF, Rouprêt M, Haitel A, Shariat SF, Mostafid AH, Nieuwenhuijzen JA, Zigeuner R, Dominguez-Escrig JL, Hacek J, Zlotta AR, Burger M, Evert M, Hulsbergen-van de Kaa CA, van der Heijden AG, Kiemeney LALM, Soukup V, Molinaro L, Gontero P, Llorente C, Algaba F, Palou J, N'Dow J, Ribal MJ, van der Kwast TH, Babjuk M, Sylvester RJ, van Rhijn BWG. Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer: impact on prognosis? Int Urol Nephrol 2024; 56:1323-1333. [PMID: 37980689 DOI: 10.1007/s11255-023-03867-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/23/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE A re-transurethral resection of the bladder (re-TURB) is a well-established approach in managing non-muscle invasive bladder cancer (NMIBC) for various reasons: repeat-TURB is recommended for a macroscopically incomplete initial resection, restaging-TURB is required if the first resection was macroscopically complete but contained no detrusor muscle (DM) and second-TURB is advised for all completely resected T1-tumors with DM in the resection specimen. This study assessed the long-term outcomes after repeat-, second-, and restaging-TURB in T1-NMIBC patients. METHODS Individual patient data with tumor characteristics of 1660 primary T1-patients (muscle-invasion at re-TURB omitted) diagnosed from 1990 to 2018 in 17 hospitals were analyzed. Time to recurrence, progression, death due to bladder cancer (BC), and all causes (OS) were visualized with cumulative incidence functions and analyzed by log-rank tests and multivariable Cox-regression models stratified by institution. RESULTS Median follow-up was 45.3 (IQR 22.7-81.1) months. There were no differences in time to recurrence, progression, or OS between patients undergoing restaging (135 patients), second (644 patients), or repeat-TURB (84 patients), nor between patients who did or who did not undergo second or restaging-TURB. However, patients who underwent repeat-TURB had a shorter time to BC death compared to those who had second- or restaging-TURB (multivariable HR 3.58, P = 0.004). CONCLUSION Prognosis did not significantly differ between patients who underwent restaging- or second-TURB. However, a worse prognosis in terms of death due to bladder cancer was found in patients who underwent repeat-TURB compared to second-TURB and restaging-TURB, highlighting the importance of separately evaluating different indications for re-TURB.
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Affiliation(s)
- Irene J Beijert
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Anouk E Hentschel
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Johannes Bründl
- Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Eva M Compérat
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
- Pathology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
| | - Karin Plass
- European Association of Urology, Guidelines Office Board, Arnhem, The Netherlands
| | - Oscar Rodríguez
- Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Virginia Hernández
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
- Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - Isabel Alemany
- Pathology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Diana Turturica
- Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Turin, Italy
| | - Francesca Pisano
- Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
- Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Turin, Italy
| | - Francesco Soria
- Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Turin, Italy
| | - Otakar Čapoun
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
- Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Lenka Bauerová
- Pathology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Michael Pešl
- Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - H Maxim Bruins
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
- Urology, Radboud University Medical Center, Nijmegen, The Netherlands
- Urology, Zuyderland Medical Center, Sittard/Heerlen, The Netherlands
| | | | - Sonja Herdegen
- Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Johannes Breyer
- Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Antonin Brisuda
- Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Ana Calatrava
- Pathology, Fundación Instituto Valenciano de Oncología (I.V.O.), Valencia, Spain
| | - José Rubio-Briones
- Urology, Fundación Instituto Valenciano de Oncología (I.V.O.), Valencia, Spain
| | | | | | - Judith Bosschieter
- Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Venkata R M Kusuma
- Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - David Ashabere
- Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - Nicolai Huebner
- Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Juliette Cotte
- Urology, Pitié Salpétrière Hospital, AP-HP, GRC no 5, ONCOTYPE-URO, Sorbonne University, 75013, Paris, France
| | - Roberto Contieri
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Laura S Mertens
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Francesco Claps
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Alexandra Masson-Lecomte
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
| | - Fredrik Liedberg
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
| | - Daniel Cohen
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
- Urology, Royal Free London-NHS Foundation Trust, Royal Free Hospital, London, UK
| | - Luca Lunelli
- Urology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
| | - Olivier Cussenot
- Urology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
| | - Soha El Sheikh
- Pathology, Royal Free London-NHS Foundation Trust, Royal Free Hospital, London, UK
| | - Dimitrios Volanis
- Urology, Royal Free London-NHS Foundation Trust, Royal Free Hospital, London, UK
| | - Jean-François Côté
- Pathology, Pierre et Marie Curie Medical School, Pitié Salpétrière Hospital, AP-HP, Sorbonne University, Paris, France
| | - Morgan Rouprêt
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
- Urology, Pitié Salpétrière Hospital, AP-HP, GRC no 5, ONCOTYPE-URO, Sorbonne University, 75013, Paris, France
| | - Andrea Haitel
- Pathology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Shahrokh F Shariat
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
- Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic
- Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - A Hugh Mostafid
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
- Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - Jakko A Nieuwenhuijzen
- Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Richard Zigeuner
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
- Urology, Medical University of Graz, Graz, Austria
| | - Jose L Dominguez-Escrig
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
- Urology, Fundación Instituto Valenciano de Oncología (I.V.O.), Valencia, Spain
| | - Jaromir Hacek
- Pathology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Alexandre R Zlotta
- Surgical Oncology (Urology), University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
| | - Maximilian Burger
- Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
| | - Matthias Evert
- Pathology, University of Regensburg, Regensburg, Germany
| | | | | | | | - Viktor Soukup
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
- Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Luca Molinaro
- Pathology, Città della Salute e della Scienza, University of Torino School of Medicine, Turin, Italy
| | - Paolo Gontero
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
- Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Turin, Italy
| | - Carlos Llorente
- Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Ferran Algaba
- Pathology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Palou
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
- Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - James N'Dow
- European Association of Urology, Guidelines Office Board, Arnhem, The Netherlands
| | - Maria J Ribal
- European Association of Urology, Guidelines Office Board, Arnhem, The Netherlands
| | - Theo H van der Kwast
- Laboratory Medicine Program, University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
| | - Marko Babjuk
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
- Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic
- Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Richard J Sylvester
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
| | - Bas W G van Rhijn
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
- Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany.
- European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.
- Surgical Oncology (Urology), University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada.
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Rezac J, Hanouskova L, Vesely S, Kotaska K, Kantorova A, Linhartova A, Fiala V, Soukup V, Capoun O. Serum Thymidine Kinase 1 - Potential Prostate Cancer Biomarker: A Clinical Study. Anticancer Res 2023; 43:1675-1680. [PMID: 36974824 DOI: 10.21873/anticanres.16319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 01/28/2023] [Accepted: 01/31/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND/AIM Serum thymidine kinase 1 (STK1) is a proliferation biomarker that has been used as a diagnostic marker of several malignant diseases. However, there are limited data for prostate cancer (PCa). PATIENTS AND METHODS In this study, we retrospectively analysed serum samples from 169 patients with biopsy confirmed PCa, who had been indicated for radical prostatectomy (RP) between 2013-2016. The results were compared with those in serum samples from 39 healthy men. We used commercially available enzymatic immunoassay to determine the levels of STK1. The patients were divided into groups according to the Gleason score (GS) and risk factors for adjuvant radiotherapy (aRT), which were defined as GS 8-10, pT3, and a positive surgical margin. RESULTS The median serum level of STK1 in PCa patients was 0.289 pmol/l. In the control group, the median value was 0.0116 pmol/l (p<0.001). By comparing the patients with GS≤6 vs. 7 vs. ≥8 (p=0.01), we found statistically significant differences. In the correlation of STK1 values with risk factors, we found statistically significant differences both in comparison of 0 vs. 1 vs. 2 vs. 3 risk factors (p=0.021), as well as ≤1 vs. 2≥ risk factors (p=0.009). CONCLUSION The levels of STK1 are significantly higher in patients with PCa than those in healthy controls. Furthermore, STK1 values correlate with GS and predefined risk factors for aRT. Therefore, STK1 can be considered as a potential tumour marker of PCa diagnosis and risk stratification.
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Affiliation(s)
- Jakub Rezac
- Department of Urology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Lenka Hanouskova
- Department of Medical Chemistry and Clinical Biochemistry, Motol University Hospital, 2 Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Stepan Vesely
- Department of Urology, Motol University Hospital, 2 Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Karel Kotaska
- Department of Medical Chemistry and Clinical Biochemistry, Motol University Hospital, 2 Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Alzbeta Kantorova
- Department of Urology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Anna Linhartova
- Department of Urology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Vojtech Fiala
- Department of Urology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Viktor Soukup
- Department of Urology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Otakar Capoun
- Department of Urology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic;
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3
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Rouprêt M, Seisen T, Birtle AJ, Capoun O, Compérat EM, Dominguez-Escrig JL, Gürses Andersson I, Liedberg F, Mariappan P, Hugh Mostafid A, Pradere B, van Rhijn BWG, Shariat SF, Rai BP, Soria F, Soukup V, Wood RG, Xylinas EN, Masson-Lecomte A, Gontero P. European Association of Urology Guidelines on Upper Urinary Tract Urothelial Carcinoma: 2023 Update. Eur Urol 2023; 84:S0302-2838(23)02652-0. [PMID: 36967359 DOI: 10.1016/j.eururo.2023.03.013] [Citation(s) in RCA: 85] [Impact Index Per Article: 85.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
CONTEXT The European Association of Urology (EAU) guidelines panel on upper urinary tract urothelial carcinoma (UTUC) has updated the guidelines to aid clinicians in evidence-based management of UTUC. OBJECTIVE To provide an overview of the EAU guidelines on UTUC as an aid to clinicians. EVIDENCE ACQUISITION The recommendations provided in these guidelines are based on a review of the literature via a systematic search of the PubMed, Ovid, EMBASE, and Cochrane databases. Data were searched using the following keywords: urinary tract cancer, urothelial carcinomas, renal pelvis, ureter, bladder cancer, chemotherapy, ureteroscopy, nephroureterectomy, neoplasm, (neo)adjuvant treatment, instillation, recurrence, risk factors, metastatic, immunotherapy, and survival. The results were assessed by a panel of experts. EVIDENCE SYNTHESIS Even though data are accruing, for many areas there is still insufficient high-level evidence to provide strong recommendations. Patient stratification on the basis of histology and clinical examination (including imaging) and assessment of patients at risk of Lynch syndrome will aid management. Kidney-sparing management should be offered as a primary treatment option to patients with low-risk UTUC and two functional kidneys. In particular, for patients with high-risk or metastatic UTUC, new treatment options have become available. In high-risk UTUC, platinum-based chemotherapy after radical nephroureterectomy, and adjuvant nivolumab for unfit or patients who decline chemotherapy, are options. For metastatic disease, gemcitabine/carboplatin chemotherapy is recommended as first-line treatment for cisplatin-ineligible patients. Patients with PD-1/PD-L1-positive tumours should be offered a checkpoint inhibitor (pembrolizumab or atezolizumab). CONCLUSIONS These guidelines contain information on the management of individual patients according to the current best evidence. Urologists should take into account the specific clinical characteristics of each patient when determining the optimal treatment regimen according to the risk stratification of these tumours. PATIENT SUMMARY Cancer of the upper urinary tract is rare, but because 60% of these tumours are invasive at diagnosis, timely and appropriate diagnosis is most important. A number of known risk factors exist.
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Affiliation(s)
- Morgan Rouprêt
- GRC 5 Predictive Onco-Uro, Sorbonne University, AP-HP, Urology, Pitie-Salpetriere Hospital, Paris, France.
| | - Thomas Seisen
- GRC 5 Predictive Onco-Uro, Sorbonne University, AP-HP, Urology, Pitie-Salpetriere Hospital, Paris, France
| | - Alison J Birtle
- Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK; University of Manchester, Manchester, UK
| | - Otakar Capoun
- Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czechia; Department of Pathology, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria
| | - Eva M Compérat
- Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czechia; Department of Pathology, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria; Department of Pathology, Sorbonne University, AP-HP, Hôpital Tenon, Paris
| | | | | | - Fredrik Liedberg
- Department of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Paramananthan Mariappan
- Department of Urology, Edinburgh Bladder Cancer Surgery, Western General Hospital, Edinburgh, UK
| | - A Hugh Mostafid
- Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, La Croix Du Sud Hospital, Quint Fonsegrives, France
| | - Bas W G van Rhijn
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany; Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Shahrokh F Shariat
- Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czechia; Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Bhavan P Rai
- Department of Urology, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Francesco Soria
- Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Viktor Soukup
- Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czechia; Department of Pathology, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria
| | | | - Evanguelos N Xylinas
- Department of Urology, Bichat-Claude Bernard Hospital, AP-HP, Université de Paris, Paris, France
| | | | - Paolo Gontero
- Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
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4
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Sylvester RJ, Rodríguez O, Hernández V, Turturica D, Bauerová L, Max Bruins H, Bründl J, van der Kwast TH, Brisuda A, Rubio-Briones J, Seles M, Hentschel AE, Kusuma VRM, Huebner N, Cotte J, Mertens LS, Volanis D, Cussenot O, Subiela Henríquez JD, de la Peña E, Pisano F, Pešl M, van der Heijden AG, Herdegen S, Zlotta AR, Hacek J, Calatrava A, Mannweiler S, Bosschieter J, Ashabere D, Haitel A, Côté JF, El Sheikh S, Lunelli L, Algaba F, Alemany I, Soria F, Runneboom W, Breyer J, Nieuwenhuijzen JA, Llorente C, Molinaro L, Hulsbergen-van de Kaa CA, Evert M, Kiemeney LALM, N'Dow J, Plass K, Čapoun O, Soukup V, Dominguez-Escrig JL, Cohen D, Palou J, Gontero P, Burger M, Zigeuner R, Mostafid AH, Shariat SF, Rouprêt M, Compérat EM, Babjuk M, van Rhijn BWG. Erratum to "European Association of Urology (EAU) Prognostic Factor Risk Groups for Non-muscle-invasive Bladder Cancer (NMIBC) Incorporating the WHO 2004/2016 and WHO 1973 Classification Systems for Grade: An Update from the EAU NMIBC Guidelines Panel" [Eur. Urol. 79(4) (2021) 480-488]. Eur Urol 2023; 83:e140-e141. [PMID: 36841687 DOI: 10.1016/j.eururo.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Affiliation(s)
- Richard J Sylvester
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.
| | - Oscar Rodríguez
- Department of Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Virginia Hernández
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Diana Turturica
- Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Lenka Bauerová
- Department of Pathology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Harman Max Bruins
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Johannes Bründl
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Theo H van der Kwast
- Laboratory Medicine Program, University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
| | - Antonin Brisuda
- Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - José Rubio-Briones
- Department of Urology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Maximilian Seles
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Anouk E Hentschel
- Department of Urology, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands; Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Venkata R M Kusuma
- Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - Nicolai Huebner
- Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Juliette Cotte
- Department of Urology, Pitié Salpétrière Hospital, AP-HP, Sorbonne University, Paris, France
| | - Laura S Mertens
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Dimitrios Volanis
- Department of Urology, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK
| | - Olivier Cussenot
- Department of Urology, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK
| | | | - Enrique de la Peña
- Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Francesca Pisano
- Department of Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Michael Pešl
- Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | | | - Sonja Herdegen
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Alexandre R Zlotta
- Department of Surgical Oncology (Urology), University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
| | - Jaromir Hacek
- Department of Pathology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Ana Calatrava
- Department of Pathology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | | | - Judith Bosschieter
- Department of Urology, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands
| | - David Ashabere
- Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - Andrea Haitel
- Department of Pathology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Jean-François Côté
- Department of Pathology, Pitié Salpétrière Hospital, AP-HP, Pierre et Marie Curie Medical School, Sorbonne University, Paris, France
| | - Soha El Sheikh
- Department of Pathology, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK
| | - Luca Lunelli
- Department of Urology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
| | - Ferran Algaba
- Department of Pathology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Isabel Alemany
- Department of Pathology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Francesco Soria
- Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Willemien Runneboom
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Johannes Breyer
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Jakko A Nieuwenhuijzen
- Department of Urology, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands
| | - Carlos Llorente
- Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Luca Molinaro
- Department of Pathology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | | | - Matthias Evert
- Department of Pathology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | | | - James N'Dow
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | - Karin Plass
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | - Otakar Čapoun
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Viktor Soukup
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Jose L Dominguez-Escrig
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Daniel Cohen
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK
| | - Joan Palou
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Paolo Gontero
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Maximilian Burger
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Richard Zigeuner
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Medical University of Graz, Graz, Austria
| | - Amir Hugh Mostafid
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - Shahrokh F Shariat
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic; Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Morgan Rouprêt
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Pitié Salpétrière Hospital, AP-HP, Sorbonne University, Paris, France
| | - Eva M Compérat
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Pathology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
| | - Marko Babjuk
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic; Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Bas W G van Rhijn
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany; Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Department of Surgical Oncology (Urology), University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
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Gontero P, Soria F, Babjuk M, Burger M, Comperat E, Mostafid H, Palou Redorta J, Roupret M, Van Rhijn B, Zigeuner R, Shariat S, Cohen D, Masson-Lecomte A, Hernandez V, Xylinas E, Capoun O, Thalmann G, Pradere B, Linares E, Soukup V, Seisen T, Dominguez-Escrig J, Liedberg F, Sylvester R. Do current definitions of BCG failure/ BCG unresponsive NMIBCs correlate with disease progression? Results of an individual patient data validation international multi-center retrospective study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01043-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Fiala V, Kocvara R, Drlik M, Sedlacek J, Dite Z, Novakova P, Kalousova M, Soukup V, Zima T. Neoadjuvant hormonal treatment in infants with undescended testis – A prospective case control study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00670-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Beijert IJ, Hentschel AE, Bründl J, Compérat EM, Plass K, Rodríguez O, Subiela Henríquez JD, Hernández V, de la Peña E, Alemany I, Turturica D, Pisano F, Soria F, Čapoun O, Bauerová L, Pešl M, Bruins HM, Runneboom W, Herdegen S, Breyer J, Brisuda A, Calatrava A, Rubio-Briones J, Seles M, Mannweiler S, Bosschieter J, Kusuma VRM, Ashabere D, Huebner N, Cotte J, Mertens LS, Claps F, Masson-Lecomte A, Liedberg F, Cohen D, Lunelli L, Cussenot O, El Sheikh S, Volanis D, Côté JF, Rouprêt M, Haitel A, Shariat SF, Mostafid AH, Nieuwenhuijzen JA, Zigeuner R, Dominguez-Escrig JL, Hacek J, Zlotta AR, Burger M, Evert M, Hulsbergen-van de Kaa CA, van der Heijden AG, Kiemeney LALM, Soukup V, Molinaro L, Gontero P, Llorente C, Algaba F, Palou J, N'Dow J, Ribal MJ, van der Kwast TH, Babjuk M, Sylvester RJ, van Rhijn BWG. Prognosis of Primary Papillary Ta Grade 3 Bladder Cancer in the Non-muscle-invasive Spectrum. Eur Urol Oncol 2023; 6:214-221. [PMID: 36670042 DOI: 10.1016/j.euo.2023.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/05/2022] [Accepted: 01/02/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND Ta grade 3 (G3) non-muscle-invasive bladder cancer (NMIBC) is a relatively rare diagnosis with an ambiguous character owing to the presence of an aggressive G3 component together with the lower malignant potential of the Ta component. The European Association of Urology (EAU) NMIBC guidelines recently changed the risk stratification for Ta G3 from high risk to intermediate, high, or very high risk. However, prognostic studies on Ta G3 carcinomas are limited and inconclusive. OBJECTIVE To evaluate the prognostic value of categorizing Ta G3 compared to Ta G2 and T1 G3 carcinomas. DESIGN, SETTING, AND PARTICIPANTS Individual patient data for 5170 primary Ta-T1 bladder tumors from 17 hospitals were analyzed. Transurethral resection of the tumor was performed between 1990 and 2018. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Time to recurrence and time to progression were analyzed using cumulative incidence functions, log-rank tests, and multivariable Cox-regression models with interaction terms stratified by institution. RESULTS AND LIMITATIONS Ta G3 represented 7.5% (387/5170) of Ta-T1 carcinomas of which 42% were classified as intermediate risk. Time to recurrence did not differ between Ta G3 and Ta G2 (p = 0.9) or T1 G3 (p = 0.4). Progression at 5 yr occurred for 3.6% (95% confidence interval [CI] 2.7-4.8%) of Ta G2, 13% (95% CI 9.3-17%) of Ta G3, and 20% (95% CI 17-23%) of T1 G3 carcinomas. Time to progression for Ta G3 was shorter than for Ta G2 (p < 0.001) and longer than for T1 G3 (p = 0.002). Patients with Ta G3 NMIBC with concomitant carcinoma in situ (CIS) had worse prognosis and a similar time to progression as for patients with T1 G3 NMIBC with CIS (p = 0.5). Multivariable analyses for recurrence and progression showed similar results. CONCLUSIONS The prognosis of Ta G3 tumors in terms of progression appears to be in between that of Ta G2 and T1 G3. However, patients with Ta G3 NMIBC with concomitant CIS have worse prognosis that is comparable to that of T1 G3 with CIS. Our results support the recent EAU NMIBC guideline changes for more refined risk stratification of Ta G3 tumors because many of these patients have better prognosis than previously thought. PATIENT SUMMARY We used data from 17 centers in Europe and Canada to assess the prognosis for patients with stage Ta grade 3 (G3) non-muscle-invasive bladder cancer (NMIBC). Time to cancer progression for Ta G3 cancer differed from both Ta G2 and T1 G3 tumors. Our results support the recent change in the European Association of Urology guidelines for more refined risk stratification of Ta G3 NMIBC because many patients with this tumor have better prognosis than previously thought.
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Affiliation(s)
- Irene J Beijert
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Department of Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Anouk E Hentschel
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Department of Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Johannes Bründl
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Eva M Compérat
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Pathology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
| | - Karin Plass
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | - Oscar Rodríguez
- Department of Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Virginia Hernández
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Enrique de la Peña
- Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Isabel Alemany
- Department of Pathology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Diana Turturica
- Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Francesca Pisano
- Department of Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Francesco Soria
- Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Otakar Čapoun
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czechia
| | - Lenka Bauerová
- Department of Pathology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czechia
| | - Michael Pešl
- Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czechia
| | - H Maxim Bruins
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Willemien Runneboom
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sonja Herdegen
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Johannes Breyer
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Antonin Brisuda
- Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czechia
| | - Ana Calatrava
- Department of Pathology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - José Rubio-Briones
- Department of Urology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Maximilian Seles
- Department of Urology, Medical University of Graz, Graz, Austria
| | | | - Judith Bosschieter
- Department of Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Venkata R M Kusuma
- Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - David Ashabere
- Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - Nicolai Huebner
- Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Juliette Cotte
- Department of Urology, Pitié Salpétrière Hospital, AP-HP, GRC n°5, ONCOTYPE-URO, Sorbonne University, Paris, France
| | - Laura S Mertens
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Francesco Claps
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Alexandra Masson-Lecomte
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
| | - Fredrik Liedberg
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
| | - Daniel Cohen
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
| | - Luca Lunelli
- Department of Urology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
| | - Olivier Cussenot
- Department of Urology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
| | - Soha El Sheikh
- Department of Pathology, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
| | - Dimitrios Volanis
- Department of Urology, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
| | - Jean-François Côté
- Department of Pathology, Pitié Salpétrière Hospital, AP-HP, Pierre et Marie Curie Medical School, Sorbonne University, Paris, France
| | - Morgan Rouprêt
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Pitié Salpétrière Hospital, AP-HP, GRC n°5, ONCOTYPE-URO, Sorbonne University, Paris, France
| | - Andrea Haitel
- Department of Pathology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Shahrokh F Shariat
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czechia; Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - A Hugh Mostafid
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - Jakko A Nieuwenhuijzen
- Department of Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Richard Zigeuner
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Medical University of Graz, Graz, Austria
| | - Jose L Dominguez-Escrig
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Pathology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Jaromir Hacek
- Department of Pathology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czechia
| | - Alexandre R Zlotta
- Department of Surgical Oncology (Urology), University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
| | - Maximilian Burger
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany; European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
| | - Matthias Evert
- Department of Pathology, University of Regensburg, Regensburg, Germany
| | | | | | - Lambertus A L M Kiemeney
- Department of Health Evidence and Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Viktor Soukup
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czechia
| | - Luca Molinaro
- Department of Pathology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Paolo Gontero
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Carlos Llorente
- Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Ferran Algaba
- Deaprtment of Pathology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Palou
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - James N'Dow
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | - Maria J Ribal
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | - Theo H van der Kwast
- Laboratory Medicine Program, University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
| | - Marko Babjuk
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czechia; Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Richard J Sylvester
- European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
| | - Bas W G van Rhijn
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany; European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Surgical Oncology (Urology), University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada.
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Fiala V, Jiraskova Z, Drlik M, Sedlacek J, Dite Z, Novakova P, Kocvara R, Kalousova M, Soukup V. The safety of neoadjuvant hormonal treatment in infants with cryptorchidism. J Pediatr Urol 2022; 18:846.e1-846.e6. [PMID: 35691791 DOI: 10.1016/j.jpurol.2022.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/12/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND/PURPOSE The standard treatment for boys with non-syndromic cryptorchidism is an early orchidopexy. It is unclear if surgical intervention alone is enough for future fertility. Recent studies show benefit of neoadjuvant or adjuvant hormonal treatment with gonadorelin (GnRH) for spermatogonia maturation based on testicular biopsy. The aim of this prospective study was to assess the safety of this treatment in infants with undescended testis at the recommended timing of early gonadorelin administration and timing of orchidopexy. METHODS Unilateral cryptorchid full term boys were initially examined (including hormonal, physical and ultrasound examination) at the age of 2.5-3.5 months. At 6 months of age, cryptorchidism was confirmed. Those with non-syndromic cryptorchidism and palpable or sonographically detected testis were randomly assigned into two groups: with and without intranasal gonadorelin treatment. Inclusion criteria were met by 36 boys (21 in GNRH and 15 in the control groups). The following orchidopexy was performed before 12 months of age with repeated examination at time of surgery. Penile size and testicular volume (using ultrasound) and basal serum levels of LH, FSH, testosterone, Inhibin B and AMH were recorded at age of 3.0 (mean) months and 11.0 (mean) months (date of surgery). The stimulation hormonal levels were checked during GnRH administration. RESULTS Between minipuberty (mean 3 months) and time of orchidopexy (mean 11 months of age) the penile size increased significantly and similarly in both groups. There was no significant difference in the change of the volume of descended testis between the groups nor of the volume of undescended testis. In addition, we did not find any significant difference in the change (drop) of hormonal levels of LH, FSH, Testosterone, Inhibin B and AMH (Table 1a) CONCLUSION: The neoadjuvant gonadorelin stimulation in infants with unilateral undescended testis has not shown any specific effect on the development of penile size, testicular volume and hormonal levels at time of orchidopexy in comparison with boys without stimulation, and in the mid-term, this treatment can be considered safe. Further follow-up is necessary to evaluate the long-term effect of this early treatment.
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Affiliation(s)
- Vojtech Fiala
- Department of Urology, General University Hospital and 1st. Faculty of Medicine of Charles University in Prague, Czech Republic.
| | - Zuzana Jiraskova
- Department of Urology, General University Hospital and 1st. Faculty of Medicine of Charles University in Prague, Czech Republic.
| | - Marcel Drlik
- Department of Urology, General University Hospital and 1st. Faculty of Medicine of Charles University in Prague, Czech Republic.
| | - Josef Sedlacek
- Department of Urology, General University Hospital and 1st. Faculty of Medicine of Charles University in Prague, Czech Republic.
| | - Zdenek Dite
- Department of Urology, General University Hospital and 1st. Faculty of Medicine of Charles University in Prague, Czech Republic.
| | - Petra Novakova
- Department of Urology, General University Hospital and 1st. Faculty of Medicine of Charles University in Prague, Czech Republic.
| | - Radim Kocvara
- Department of Urology, General University Hospital and 1st. Faculty of Medicine of Charles University in Prague, Czech Republic.
| | - Marta Kalousova
- Institute of Medical Biochemistry and Laboratory Diagnostics, General University Hospital and 1st. Faculty of Medicine of Charles University in Prague, Czech Republic.
| | - Viktor Soukup
- Department of Urology, General University Hospital and 1st. Faculty of Medicine of Charles University in Prague, Czech Republic.
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9
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Beijert IJ, Hentschel AE, Bründl J, Compérat EM, Plass K, Rodríguez O, Subiela Henríquez JD, Hernández V, de la Peña E, Alemany I, Turturica D, Pisano F, Soria F, Čapoun O, Bauerová L, Pešl M, Maxim Bruins H, Runneboom W, Herdegen S, Breyer J, Brisuda A, Calatrava A, Rubio-Briones J, Seles M, Mannweiler S, Bosschieter J, Kusuma VRM, Ashabere D, Huebner N, Cotte J, Mertens LS, Masson-Lecomte A, Liedberg F, Cohen D, Lunelli L, Cussenot O, El Sheikh S, Volanis D, Côté JF, Rouprêt M, Haitel A, Shariat SF, Mostafid AH, Nieuwenhuijzen JA, Zigeuner R, Dominguez-Escrig JL, Hacek J, Zlotta AR, Burger M, Evert M, Hulsbergen-van de Kaa CA, van der Heijden AG, A L M Kiemeney L, Soukup V, Molinaro L, Gontero P, Llorente C, Algaba F, Palou J, N'Dow J, Ribal MJ, van der Kwast TH, Babjuk M, Sylvester RJ, van Rhijn BWG. T1G1 Bladder Cancer: Prognosis for this Rare Pathological Diagnosis Within the Non-muscle-invasive Bladder Cancer Spectrum. Eur Urol Focus 2022; 8:1627-1634. [PMID: 35577750 DOI: 10.1016/j.euf.2022.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/13/2022] [Accepted: 04/25/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND The pathological existence and clinical consequence of stage T1 grade 1 (T1G1) bladder cancer are the subject of debate. Even though the diagnosis of T1G1 is controversial, several reports have consistently found a prevalence of 2-6% G1 in their T1 series. However, it remains unclear if T1G1 carcinomas have added value as a separate category to predict prognosis within the non-muscle-invasive bladder cancer (NMIBC) spectrum. OBJECTIVE To evaluate the prognostic value of T1G1 carcinomas compared to TaG1 and T1G2 carcinomas within the NMIBC spectrum. DESIGN, SETTING, AND PARTICIPANTS Individual patient data for 5170 primary Ta and T1 bladder tumors from 17 hospitals in Europe and Canada were analyzed. Transurethral resection (TUR) was performed between 1990 and 2018. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Time to recurrence and progression were analyzed using cumulative incidence functions, log-rank tests, and multivariable Cox regression models stratified by institution. RESULTS AND LIMITATIONS T1G1 represented 1.9% (99/5170) of all carcinomas and 5.3% (99/1859) of T1 carcinomas. According to primary TUR dates, the proportion of T1G1 varied between 0.9% and 3.5% per year, with similar percentages in the early and later calendar years. We found no difference in time to recurrence between T1G1 and TaG1 (p = 0.91) or between T1G1 and T1G2 (p = 0.30). Time to progression significantly differed between TaG1 and T1G1 (p < 0.001) but not between T1G1 and T1G2 (p = 0.30). Multivariable analyses for recurrence and progression showed similar results. CONCLUSIONS The relative prevalence of T1G1 diagnosis was low and remained constant over the past three decades. Time to recurrence of T1G1 NMIBC was comparable to that for other stage/grade NMIBC combinations. Time to progression of T1G1 NMIBC was comparable to that for T1G2 but not for TaG1, suggesting that treatment and surveillance of T1G1 carcinomas should be more like the approaches for T1G2 NMIBC in accordance with the intermediate and/or high risk categories of the European Association of Urology NMIBC guidelines. PATIENT SUMMARY Although rare, stage T1 grade 1 (T1G1) bladder cancer is still diagnosed in daily clinical practice. Using individual patient data from 17 centers in Europe and Canada, we found that time to progression of T1G1 cancer was comparable to that for T1G2 but not TaG1 cancer. Therefore, our results suggest that primary T1G1 bladder cancers should be managed with more aggressive treatment and more frequent follow-up than for low-risk bladder cancer.
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Affiliation(s)
- Irene J Beijert
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Department of Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Anouk E Hentschel
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Department of Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Johannes Bründl
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Eva M Compérat
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Pathology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
| | - Karin Plass
- European Association of Urology, Guidelines Office Board, Arnhem, The Netherlands
| | - Oscar Rodríguez
- Department of Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Virginia Hernández
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Enrique de la Peña
- Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Isabel Alemany
- Department of Pathology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Diana Turturica
- Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Francesca Pisano
- Department of Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Francesco Soria
- Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Otakar Čapoun
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Lenka Bauerová
- Department of Pathology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Michael Pešl
- Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - H Maxim Bruins
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Willemien Runneboom
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sonja Herdegen
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Johannes Breyer
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Antonin Brisuda
- Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Ana Calatrava
- Department of Pathology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - José Rubio-Briones
- Department of Urology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Maximilian Seles
- Department of Urology, Medical University of Graz, Graz, Austria
| | | | - Judith Bosschieter
- Department of Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Venkata R M Kusuma
- Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - David Ashabere
- Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - Nicolai Huebner
- Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Juliette Cotte
- Department of Urology, Pitié Salpétrière Hospital, AP-HP, GRC no. 5, Oncotype-Uro, Sorbonne University, Paris, France
| | - Laura S Mertens
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Alexandra Masson-Lecomte
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
| | - Fredrik Liedberg
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
| | - Daniel Cohen
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
| | - Luca Lunelli
- Department of Urology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
| | - Olivier Cussenot
- Department of Urology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
| | - Soha El Sheikh
- Department of Pathology, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
| | - Dimitrios Volanis
- Department of Urology, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
| | - Jean-François Côté
- Department of Pathology, Pitié Salpétrière Hospital, AP-HP, Pierre et Marie Curie Medical School, Sorbonne University, Paris, France
| | - Morgan Rouprêt
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Pitié Salpétrière Hospital, AP-HP, GRC no. 5, Oncotype-Uro, Sorbonne University, Paris, France
| | - Andrea Haitel
- Department of Pathology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Shahrokh F Shariat
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic; Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - A Hugh Mostafid
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - Jakko A Nieuwenhuijzen
- Department of Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Richard Zigeuner
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Department of Urology, Medical University of Graz, Graz, Austria
| | - Jose L Dominguez-Escrig
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Department of Urology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Jaromir Hacek
- Department of Pathology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Alexandre R Zlotta
- Department of Surgical Oncology (Urology), University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
| | - Maximilian Burger
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany; European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
| | - Matthias Evert
- Department of Pathology, University of Regensburg, Regensburg, Germany
| | | | | | - Lambertus A L M Kiemeney
- Department of Health Evidence and Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Viktor Soukup
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Luca Molinaro
- Department of Pathology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Paolo Gontero
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Carlos Llorente
- Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Ferran Algaba
- Department of Pathology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Palou
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - James N'Dow
- European Association of Urology, Guidelines Office Board, Arnhem, The Netherlands
| | - Maria J Ribal
- European Association of Urology, Guidelines Office Board, Arnhem, The Netherlands
| | - Theo H van der Kwast
- Laboratory Medicine Program, University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
| | - Marko Babjuk
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic; Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Richard J Sylvester
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
| | - Bas W G van Rhijn
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany; European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Surgical Oncology (Urology), University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada.
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Rai BP, Luis Dominguez Escrig J, Vale L, Kuusk T, Capoun O, Soukup V, Bruins HM, Yuan Y, Violette PD, Santesso N, van Rhijn BWG, Hugh Mostafid A, Imran Omar M. Systematic Review of the Incidence of and Risk Factors for Urothelial Cancers and Renal Cell Carcinoma Among Patients with Haematuria. Eur Urol 2022; 82:182-192. [PMID: 35393159 DOI: 10.1016/j.eururo.2022.03.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/12/2022] [Accepted: 03/17/2022] [Indexed: 12/21/2022]
Abstract
CONTEXT The current impact of haematuria investigations on health care organisations is significant. There is currently no consensus on how to investigate patients with haematuria. OBJECTIVE To evaluate the incidence of bladder cancer, upper tract urothelial carcinoma (UTUC), and renal cell carcinoma (RCC) among patients undergoing investigation for haematuria and identify any risk factors for bladder cancer, UTUC, and RCC (BUR). EVIDENCE ACQUISITION Medline, Embase, and Cochrane controlled trials databases and ClinicalTrials.gov were searched for all relevant publications from January 1, 2000 to June 2021 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Prospective, retrospective, and cross-sectional studies with a minimum population of 50 patients with haematuria were considered for the review. EVIDENCE SYNTHESIS A total of 44 studies were included. The total number of participants was 229701. The pooled incidence rate for urothelial bladder cancer was 17% (95% confidence interval [CI] 14-20%) for visible haematuria (VH) and 3.3% (95% CI 2.45-4.3%) for nonvisible haematuria (NVH). The pooled incidence rate for RCC was 2% (95% CI 1-2%) for VH and 0.58% (95% CI 0.42-0.77%) for NVH. The pooled incidence rate for UTUC was 0.75% (95% CI 0.4-1.2%) for VH and 0.17% (95% CI 0.081-0.299%) for NVH. On sensitivity analysis, the proportions of males (risk ratio [RR] 1.14, 95% CI 1.10-1.17 for VH; 1.54, 95% CI 1.34-1.78 for NVH; p < 0.00001; moderate certainty evidence) and individuals with a smoking history (RR 1.41, 95% CI 1.24-1.61 for VH; 1.53, 95% CI 1.36-1.72 for NVH; p < 0.00001; moderate certainty evidence) appeared to be higher in BUR than in non-BUR groups. CONCLUSIONS Male gender and smoking history are risk factors for BUR cancer in haematuria, with bladder cancer being the commonest cancer. The incidence of RCC and UTUC in NVH is low. The review serves as a reference standard for future policy-making on investigation of haematuria by global organisations. PATIENT SUMMARY Our review shows that male gender and smoking history are risk factors for cancers of the bladder, kidney, and ureter. The review also provides information on the proportion of patients who have cancer when they have blood in their urine (haematuria) and will allow policy-makers to decide on the most appropriate method for investigating haematuria in patients.
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Affiliation(s)
- Bhavan P Rai
- Department of Urology, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
| | | | - Luís Vale
- Department of Urology, Centro Hospital Universitário S. João, Porto, University of Porto, Porto, Portugal
| | - Teele Kuusk
- Department of Urology, Darent Valley Hospital, Dartford and Gravesham NHS Trust, Dartford, UK
| | - Otakar Capoun
- Department of Urology, General University Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Viktor Soukup
- Department of Urology, General University Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Harman M Bruins
- Department of Urology, Zuyderland Medical Center, Sittard-Geleen-Heerlen, The Netherlands
| | - Yuhong Yuan
- Department of Medicine, Health Science Centre, McMaster University, Hamilton, ON, Canada
| | - Philippe D Violette
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Surgery, Division of Urology, McMaster University, Hamilton, ON, Canada
| | - Nancy Santesso
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Michael G. DeGroote Cochrane Canada Centre, McMaster University, Hamilton, ON, Canada
| | - Bas W G van Rhijn
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - A Hugh Mostafid
- Department of Urology, Royal Surrey County Hospital, Guildford, UK
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11
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Gontero P, Dominguez-Escrig J, Van Rhijn B, Mostafid A, Roupret M, Cohen D, Comperat E, Liedberg F, Palou Redorta J, Burger M, Shariat S, Seisen T, Soukup V, Masson-Lecomte A, Capoun O, Babjuk M, Sylvester R. Assessing the impact of BCG on progression of NMIBC in the new EAU high risk and very high-risk groups. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00321-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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12
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Babjuk M, Burger M, Capoun O, Cohen D, Compérat EM, Dominguez Escrig JL, Gontero P, Liedberg F, Masson-Lecomte A, Mostafid AH, Palou J, van Rhijn BWG, Rouprêt M, Shariat SF, Seisen T, Soukup V, Sylvester RJ. European Association of Urology Guidelines on Non-muscle-invasive Bladder Cancer (Ta, T1, and Carcinoma in Situ). Eur Urol 2021; 81:75-94. [PMID: 34511303 DOI: 10.1016/j.eururo.2021.08.010] [Citation(s) in RCA: 475] [Impact Index Per Article: 158.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 08/15/2021] [Indexed: 02/08/2023]
Abstract
CONTEXT The European Association of Urology (EAU) has released an updated version of the guidelines on non-muscle-invasive bladder cancer (NMIBC). OBJECTIVE To present the 2021 EAU guidelines on NMIBC. EVIDENCE ACQUISITION A broad and comprehensive scoping exercise covering all areas of the NMIBC guidelines since the 2020 version was performed. Databases covered by the search included Medline, EMBASE, and the Cochrane Libraries. Previous guidelines were updated, and the level of evidence and grade of recommendation were assigned. EVIDENCE SYNTHESIS Tumours staged as Ta, T1 and carcinoma in situ (CIS) are grouped under the heading of NMIBC. Diagnosis depends on cystoscopy and histological evaluation of tissue obtained via transurethral resection of the bladder (TURB) for papillary tumours or via multiple bladder biopsies for CIS. For papillary lesions, a complete TURB is essential for the patient's prognosis and correct diagnosis. In cases for which the initial resection is incomplete, there is no muscle in the specimen, or a T1 tumour is detected, a second TURB should be performed within 2-6 wk. The risk of progression may be estimated for individual patients using the 2021 EAU scoring model. On the basis of their individual risk of progression, patients are stratified as having low, intermediate, high, or very high risk, which is pivotal to recommending adjuvant treatment. For patients with tumours presumed to be at low risk and for small papillary recurrences detected more than 1 yr after a previous TURB, one immediate chemotherapy instillation is recommended. Patients with an intermediate-risk tumour should receive 1 yr of full-dose intravesical bacillus Calmette-Guérin (BCG) immunotherapy or instillations of chemotherapy for a maximum of 1 yr. For patients with high-risk tumours, full-dose intravesical BCG for 1-3 yr is indicated. For patients at very high risk of tumour progression, immediate radical cystectomy should be considered. Cystectomy is also recommended for BCG-unresponsive tumours. The extended version of the guidelines is available on the EAU website at https://uroweb.org/guideline/non-muscle-invasive-bladder-cancer/. CONCLUSIONS These abridged EAU guidelines present updated information on the diagnosis and treatment of NMIBC for incorporation into clinical practice. PATIENT SUMMARY The European Association of Urology has released updated guidelines on the classification, risk factors, diagnosis, prognostic factors, and treatment of non-muscle-invasive bladder cancer. The recommendations are based on the literature up to 2020, with emphasis on the highest level of evidence. Classification of patients as having low, intermediate, or and high risk is essential in deciding on suitable treatment. Surgical removal of the bladder should be considered for tumours that do not respond to bacillus Calmette-Guérin (BCG) treatment and tumours with the highest risk of progression.
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Affiliation(s)
- Marko Babjuk
- Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic; Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria.
| | - Maximilian Burger
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Otakar Capoun
- Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Daniel Cohen
- Department of Urology, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK
| | - Eva M Compérat
- Department of Pathology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
| | | | - Paolo Gontero
- Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Fredrik Liedberg
- Department of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden
| | | | - A Hugh Mostafid
- Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - Joan Palou
- Department of Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Bas W G van Rhijn
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany; Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Morgan Rouprêt
- GRC 5 Predictive Onco-Uro, Department of Urology, Sorbonne University, AP-HP, Pitié Salpétrière Hospital, Paris, France
| | - Shahrokh F Shariat
- Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic; Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Thomas Seisen
- GRC 5 Predictive Onco-Uro, Department of Urology, Sorbonne University, AP-HP, Pitié Salpétrière Hospital, Paris, France
| | - Viktor Soukup
- Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
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13
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Pisano F, Gontero P, Sylvester R, Joniau S, Serretta V, Larré S, Di Stasi S, van Rhijn B, Witjes A, Grotenhuis A, Colombo R, Briganti A, Babjuk M, Soukup V, Malmstrom PU, Irani J, Malats N, Baniel J, Mano R, Cai T, Cha E, Ardelt P, Varkarakis J, Bartoletti R, Dalbagni G, Shariat SF, Xylinas E, Karnes RJ, Palou J. Risk factors for residual disease at re-TUR in a large cohort of T1G3 patients. Actas Urol Esp 2021; 45:473-478. [PMID: 34147426 DOI: 10.1016/j.acuroe.2020.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/22/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND OBJECTIVES The goals of transurethral resection of a bladder tumor (TUR) are to completely resect the lesions and to make a correct diagnosis in order to adequately stage the patient. It is well known that the presence of detrusor muscle in the specimen is a prerequisite to minimize the risk of under staging. Persistent disease after resection of bladder tumors is not uncommon and is the reason why the European Guidelines recommended a re-TUR for all T1 tumors. It was recently published that when there is muscle in the specimen, re-TUR does not influence progression or cancer specific survival. We present here the patient and tumor factors that may influence the presence of residual disease at re-TUR. MATERIAL AND METHODS In our retrospective cohort of 2451 primary T1G3 patients initially treated with BCG, pathology results for 934 patients (38.1%) who underwent re-TUR are available. 74% had multifocal tumors, 20% of tumors were more than 3 cm in diameter and 26% had concomitant CIS. In this subgroup of patients who underwent re-TUR, there was no residual disease in 267 patients (29%) and residual disease in 667 patients (71%): Ta in 378 (40%) and T1 in 289 (31%) patients. Age, gender, tumor status (primary/recurrent), previous intravesical therapy, tumor size, tumor multi-focality, presence of concomitant CIS, and muscle in the specimen were analyzed in order to evaluate risk factors of residual disease at re-TUR, both in univariate analyses and multivariate logistic regressions. RESULTS The following were not risk factors for residual disease: age, gender, tumor status and previous intravesical chemotherapy. The following were univariate risk factors for presence of residual disease: no muscle in TUR, multiple tumors, tumors > 3 cm, and presence of concomitant CIS. Due to the correlation between tumor multi-focality and tumor size, the multivariate model retained either the number of tumors or the tumor diameter (but not both), p < 0.001. The presence of muscle in the specimen was no longer significant, while the presence of CIS only remained significant in the model with tumor size, p < 0.001. CONCLUSIONS The most significant factors for a higher risk of residual disease at re-TUR in T1G3 patients are multifocal tumors and tumors more than 3 cm. Patients with concomitant CIS and those without muscle in the specimen also have a higher risk of residual disease.
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Affiliation(s)
- F Pisano
- Città della Salute e della Scienza di Torino, University of Studies of Turin; Department of Urology, Fundacio Puigvert, University of Barcelona, Barcelona, Spain.
| | - P Gontero
- Città della Salute e della Scienza di Torino, University of Studies of Turin
| | - R Sylvester
- Formerly Department of Biostatistics, EORTC Headquarters
| | - S Joniau
- Oncologic and Reconstructive Urology, Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - V Serretta
- Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - S Larré
- Department of Surgical Science, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - S Di Stasi
- Policlinico Tor Vergata-University of Rome, Rome, Italy
| | - B van Rhijn
- Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - A Witjes
- Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - A Grotenhuis
- Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - R Colombo
- Dipartimento di Urologia, Università Vita-Salute, Ospedale S. Raffaele, Milan, Italy
| | - A Briganti
- Dipartimento di Urologia, Università Vita-Salute, Ospedale S. Raffaele, Milan, Italy
| | - M Babjuk
- Department of Urology, Motol Hospital, University of Praha, Praha, Czech Republic
| | - V Soukup
- Department of Urology, Motol Hospital, University of Praha, Praha, Czech Republic
| | - P U Malmstrom
- Department of Urology, Academic Hospital, Uppsala University, Uppsala, Sweden
| | - J Irani
- Department of Urology, Hospital Bicetre, France
| | - N Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO)
| | - J Baniel
- Department of Urology, Rabin Medical Centre, Tel Aviv, Israel
| | - R Mano
- Department of Urology, Rabin Medical Centre, Tel Aviv, Israel
| | - T Cai
- Department of Urology, Santa Chiara Hospital, Trento, Italy
| | - E Cha
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - P Ardelt
- University Hospital Basel, Urological University Clinic Basel-Liestal, Basel, Switzerland
| | - J Varkarakis
- Department of Urology, Sismanoglio Hospital, University of Athens, Athens, Greece
| | - R Bartoletti
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - G Dalbagni
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - S F Shariat
- Department of Urology, Medical University of Vienna, Vienna, 1190, Austria; Department of Urology, Cochin Hospital, Paris, France
| | - E Xylinas
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - R J Karnes
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - J Palou
- Department of Urology, Fundacio Puigvert, University of Barcelona, Barcelona, Spain
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14
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Sylvester RJ, Rodríguez O, Hernández V, Turturica D, Bauerová L, Bruins HM, Bründl J, van der Kwast TH, Brisuda A, Rubio-Briones J, Seles M, Hentschel AE, Kusuma VRM, Huebner N, Cotte J, Mertens LS, Volanis D, Cussenot O, Subiela Henríquez JD, de la Peña E, Pisano F, Pešl M, van der Heijden AG, Herdegen S, Zlotta AR, Hacek J, Calatrava A, Mannweiler S, Bosschieter J, Ashabere D, Haitel A, Côté JF, El Sheikh S, Lunelli L, Algaba F, Alemany I, Soria F, Runneboom W, Breyer J, Nieuwenhuijzen JA, Llorente C, Molinaro L, Hulsbergen-van de Kaa CA, Evert M, Kiemeney LALM, N'Dow J, Plass K, Čapoun O, Soukup V, Dominguez-Escrig JL, Cohen D, Palou J, Gontero P, Burger M, Zigeuner R, Mostafid AH, Shariat SF, Rouprêt M, Compérat EM, Babjuk M, van Rhijn BWG. European Association of Urology (EAU) Prognostic Factor Risk Groups for Non-muscle-invasive Bladder Cancer (NMIBC) Incorporating the WHO 2004/2016 and WHO 1973 Classification Systems for Grade: An Update from the EAU NMIBC Guidelines Panel. Eur Urol 2021; 79:480-488. [PMID: 33419683 DOI: 10.1016/j.eururo.2020.12.033] [Citation(s) in RCA: 174] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/17/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The European Association of Urology (EAU) prognostic factor risk groups for non-muscle-invasive bladder cancer (NMIBC) are used to provide recommendations for patient treatment after transurethral resection of bladder tumor (TURBT). They do not, however, take into account the widely used World Health Organization (WHO) 2004/2016 grading classification and are based on patients treated in the 1980s. OBJECTIVE To update EAU prognostic factor risk groups using the WHO 1973 and 2004/2016 grading classifications and identify patients with the lowest and highest probabilities of progression. DESIGN, SETTING, AND PARTICIPANTS Individual patient data for primary NMIBC patients were collected from the institutions of the members of the EAU NMIBC guidelines panel. INTERVENTION Patients underwent TURBT followed by intravesical instillations at the physician's discretion. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Multivariable Cox proportional-hazards regression models were fitted to the primary endpoint, the time to progression to muscle-invasive disease or distant metastases. Patients were divided into four risk groups: low-, intermediate-, high-, and a new, very high-risk group. The probabilities of progression were estimated using Kaplan-Meier curves. RESULTS AND LIMITATIONS A total of 3401 patients treated with TURBT ± intravesical chemotherapy were included. From the multivariable analyses, tumor stage, WHO 1973/2004-2016 grade, concomitant carcinoma in situ, number of tumors, tumor size, and age were used to form four risk groups for which the probability of progression at 5 yr varied from <1% to >40%. Limitations include the retrospective collection of data and the lack of central pathology review. CONCLUSIONS This study provides updated EAU prognostic factor risk groups that can be used to inform patient treatment and follow-up. Incorporating the WHO 2004/2016 and 1973 grading classifications, a new, very high-risk group has been identified for which urologists should be prompt to assess and adapt their therapeutic strategy when necessary. PATIENT SUMMARY The newly updated European Association of Urology prognostic factor risk groups for non-muscle-invasive bladder cancer provide an improved basis for recommending a patient's treatment and follow-up schedule.
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Affiliation(s)
- Richard J Sylvester
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.
| | - Oscar Rodríguez
- Department of Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Virginia Hernández
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Diana Turturica
- Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Lenka Bauerová
- Department of Pathology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Harman Max Bruins
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Johannes Bründl
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Theo H van der Kwast
- Laboratory Medicine Program, University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
| | - Antonin Brisuda
- Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - José Rubio-Briones
- Department of Urology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Maximilian Seles
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Anouk E Hentschel
- Department of Urology, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands; Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Venkata R M Kusuma
- Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - Nicolai Huebner
- Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Juliette Cotte
- Department of Urology, Pitié Salpétrière Hospital, AP-HP, Sorbonne University, Paris, France
| | - Laura S Mertens
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Dimitrios Volanis
- Department of Urology, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK
| | - Olivier Cussenot
- Department of Urology, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK
| | | | - Enrique de la Peña
- Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Francesca Pisano
- Department of Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Michael Pešl
- Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | | | - Sonja Herdegen
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Alexandre R Zlotta
- Department of Surgical Oncology (Urology), University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
| | - Jaromir Hacek
- Department of Pathology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Ana Calatrava
- Department of Pathology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | | | - Judith Bosschieter
- Department of Urology, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands
| | - David Ashabere
- Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - Andrea Haitel
- Department of Pathology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Jean-François Côté
- Department of Pathology, Pitié Salpétrière Hospital, AP-HP, Pierre et Marie Curie Medical School, Sorbonne University, Paris, France
| | - Soha El Sheikh
- Department of Pathology, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK
| | - Luca Lunelli
- Department of Urology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
| | - Ferran Algaba
- Department of Pathology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Isabel Alemany
- Department of Pathology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Francesco Soria
- Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Willemien Runneboom
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Johannes Breyer
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Jakko A Nieuwenhuijzen
- Department of Urology, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands
| | - Carlos Llorente
- Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Luca Molinaro
- Department of Pathology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | | | - Matthias Evert
- Department of Pathology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | | | - James N'Dow
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | - Karin Plass
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | - Otakar Čapoun
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Viktor Soukup
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Jose L Dominguez-Escrig
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Daniel Cohen
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK
| | - Joan Palou
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Paolo Gontero
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Maximilian Burger
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Richard Zigeuner
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Medical University of Graz, Graz, Austria
| | - Amir Hugh Mostafid
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - Shahrokh F Shariat
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic; Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Morgan Rouprêt
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Pitié Salpétrière Hospital, AP-HP, Sorbonne University, Paris, France
| | - Eva M Compérat
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Pathology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
| | - Marko Babjuk
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic; Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Bas W G van Rhijn
- European Association of Urology Non-Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Department of Surgical Oncology (Urology), University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
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van Rhijn BWG, Hentschel AE, Bründl J, Compérat EM, Hernández V, Čapoun O, Bruins HM, Cohen D, Rouprêt M, Shariat SF, Mostafid AH, Zigeuner R, Dominguez-Escrig JL, Burger M, Soukup V, Gontero P, Palou J, van der Kwast TH, Babjuk M, Sylvester RJ. Prognostic Value of the WHO1973 and WHO2004/2016 Classification Systems for Grade in Primary Ta/T1 Non-muscle-invasive Bladder Cancer: A Multicenter European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel Study. Eur Urol Oncol 2021; 4:182-191. [PMID: 33423944 DOI: 10.1016/j.euo.2020.12.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND In the current European Association of Urology (EAU) non-muscle-invasive bladder cancer (NMIBC) guideline, two classification systems for grade are advocated: WHO1973 and WHO2004/2016. OBJECTIVE To compare the prognostic value of these WHO systems. DESIGN, SETTING, AND PARTICIPANTS Individual patient data for 5145 primary Ta/T1 NMIBC patients from 17 centers were collected between 1990 and 2019. The median follow-up was 3.9 yr. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Univariate and multivariable analyses of WHO1973 and WHO2004/2016 stratified by center were performed for time to recurrence, progression (primary endpoint), cystectomy, and duration of survival, taking into account age, concomitant carcinoma in situ, gender, multiplicity, tumor size, initial treatment, and tumor stage. Harrell's concordance (C-index) was used for prognostic accuracy of classification systems. RESULTS AND LIMITATIONS The median age was 68 yr; 3292 (64%) patients had Ta tumors. Neither classification system was prognostic for recurrence. For a four-tier combination of both WHO systems, progression at 5-yr follow-up was 1.4% in low-grade (LG)/G1, 3.8% in LG/G2, 7.7% in high grade (HG)/G2, and 18.8% in HG/G3 (log-rank, p < 0.001). In multivariable analyses with WHO1973 and WHO2004/2016 as independent variables, WHO1973 was a significant prognosticator of progression (p < 0.001), whereas WHO2004/2016 was not anymore (p = 0.067). C-indices for WHO1973, WHO2004, and the WHO systems combined for progression were 0.71, 0.67, and 0.73, respectively. Prognostic analyses for cystectomy and survival showed results similar to those for progression. CONCLUSIONS In this large prognostic factor study, both classification systems were prognostic for progression but not for recurrence. For progression, the prognostic value of WHO1973 was higher than that of WHO 2004/2016. The four-tier combination (LG/G1, LG/G2, HG/G2, and HG/G3) of both WHO systems proved to be superior, as it divides G2 patients into two subgroups (LG and HG) with different prognoses. Hence, the current EAU-NMIBC guideline recommendation to use both WHO classification systems remains correct. PATIENT SUMMARY At present, two classification systems are used in parallel to grade non-muscle-invasive bladder tumors. Our data on a large number of patients showed that the older classification system (WHO1973) performed better in terms of assessing progression than the more recent (WHO2004/2016) one. Nevertheless, we conclude that the current guideline recommendation for the use of both classification systems remains correct, since this has the advantage of dividing the large group of WHO1973 G2 patients into two subgroups (low and high grade) with different prognoses.
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Affiliation(s)
- Bas W G van Rhijn
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Surgical Oncology (Urology), Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany; Surgical Oncology (Urology), University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada.
| | - Anouk E Hentschel
- Surgical Oncology (Urology), Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Johannes Bründl
- Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Eva M Compérat
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Pathology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
| | - Virginia Hernández
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Otakar Čapoun
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - H Maxim Bruins
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Daniel Cohen
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Urology, Royal Free London - NHS Foundation Trust, Royal Free Hospital, London, UK
| | - Morgan Rouprêt
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Urology, Pitié Salpétrière Hospital, AP-HP, GRC n°5, ONCOTYPE-URO, Sorbonne University, Paris, France
| | - Shahrokh F Shariat
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic; Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - A Hugh Mostafid
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK
| | - Richard Zigeuner
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Urology, Medical University of Graz, Graz, Austria
| | - Jose L Dominguez-Escrig
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Urology, Fundación Instituto Valenciano de Oncología (I.V.O.), Valencia, Spain
| | - Maximilian Burger
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Viktor Soukup
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic
| | - Paolo Gontero
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
| | - Joan Palou
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Theo H van der Kwast
- Laboratory Medicine Program, University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
| | - Marko Babjuk
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands; Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic; Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Richard J Sylvester
- European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands
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Hentschel AE, van Rhijn BW, Bründl J, Compérat EM, Plass K, Rodríguez O, Henríquez JDS, Hernández V, de la Peña E, Alemany I, Turturica D, Pisano F, Soria F, Čapoun O, Bauerová L, Pešl M, Bruins HM, Runneboom W, Herdegen S, Breyer J, Brisuda A, Scavarda-Lamberti A, Calatrava A, Rubio-Briones J, Seles M, Mannweiler S, Bosschieter J, Kusuma VR, Ashabere D, Huebner N, Cotte J, Mertens LS, Cohen D, Lunelli L, Cussenot O, Sheikh SE, Volanis D, Coté JF, Rouprêt M, Haitel A, Shariat SF, Mostafid AH, Nieuwenhuijzen JA, Zigeuner R, Dominguez-Escrig JL, Hacek J, Zlotta AR, Burger M, Evert M, Hulsbergen-van de Kaa CA, van der Heijden AG, Kiemeney LA, Soukup V, Molinaro L, Gontero P, Llorente C, Algaba F, Palou J, N'Dow J, Babjuk M, van der Kwast TH, Sylvester RJ. Papillary urothelial neoplasm of low malignant potential (PUN-LMP): Still a meaningful histo-pathological grade category for Ta, noninvasive bladder tumors in 2019? Urol Oncol 2020; 38:440-448. [DOI: 10.1016/j.urolonc.2019.10.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/23/2019] [Accepted: 10/02/2019] [Indexed: 12/21/2022]
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Soukup V, Capoun O, Pesl M, Vavrova L, Sobotka R, Levova K, Hanus T, Zima T, Kalousova M. The significance of calprotectin, CD147, APOA4 and DJ-1 in non-invasive detection of urinary bladder carcinoma. Neoplasma 2019; 66:1019-1023. [PMID: 31607136 DOI: 10.4149/neo_2019_190124n74] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 05/22/2019] [Indexed: 11/08/2022]
Abstract
Aim of the study is to define the diagnostic accuracy of selected urinary protein biomarkers in the non-invasive detection of primary and recurrent urothelial carcinoma of the urinary bladder. The urinary levels of calprotectin, CD147, APOA4 and protein deglycase DJ-1 were examined in 255 individuals, including 60 controls with non-malignant urological disease, 61 patients with a history of urinary bladder cancer with negative cytology and negative cystoscopy and 134 patients with urinary bladder cancer. Urinary concentrations of biomarkers were determined by Enzyme-Linked Immunosorbent Assay (ELISA). During the follow-up of patients with non-muscle invasive bladder cancer (NMIBC), a group of 44 patients with cancer recurrence was compared to the group of 61 patients with a history of NMIBC but with no evidence of disease. Urinary concentrations of the evaluated markers did not reveal any significant difference between these groups. During the primary diagnosis, a group of 90 patients with primary bladder cancer and 60 subjects with benign disease were compared. Urinary levels of CD147 were not significantly higher in patients with tumors. The greatest diagnostic accuracy was observed in APOA4 (sensitivity 55.6, specificity 83.3, AUC 0.75), and lesser in calprotectin (sensitivity 39.4, specificity 87.7, AUC 0.66) and in DJ-1 (sensitivity 61.1, specificity 66.7, AUC 0.64), respectively. Apolipoprotein A4 may be used potentially as a supplemental urinary marker in the diagnosis of primary bladder cancer.
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Affiliation(s)
- V Soukup
- Department of Urology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - O Capoun
- Department of Urology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - M Pesl
- Department of Urology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - L Vavrova
- Department of Urology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - R Sobotka
- Department of Urology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - K Levova
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - T Hanus
- Department of Urology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - T Zima
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - M Kalousova
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
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Babjuk M, Burger M, Compérat EM, Gontero P, Mostafid AH, Palou J, van Rhijn BWG, Rouprêt M, Shariat SF, Sylvester R, Zigeuner R, Capoun O, Cohen D, Escrig JLD, Hernández V, Peyronnet B, Seisen T, Soukup V. European Association of Urology Guidelines on Non-muscle-invasive Bladder Cancer (TaT1 and Carcinoma In Situ) - 2019 Update. Eur Urol 2019; 76:639-657. [PMID: 31443960 DOI: 10.1016/j.eururo.2019.08.016] [Citation(s) in RCA: 809] [Impact Index Per Article: 161.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 08/08/2019] [Indexed: 12/31/2022]
Abstract
CONTEXT This overview presents the updated European Association of Urology (EAU) guidelines for non-muscle-invasive bladder cancer (NMIBC), TaT1, and carcinoma in situ (CIS). OBJECTIVE To provide practical recommendations on the clinical management of NMIBC with a focus on clinical presentation and recommendations. EVIDENCE ACQUISITION A broad and comprehensive scoping exercise covering all areas of the NMIBC guidelines has been performed annually since the last published version in 2017. Databases covered by the search included Medline, EMBASE, and the Cochrane Libraries. Previous guidelines were updated, and the level of evidence and grade of recommendation were assigned. EVIDENCE SYNTHESIS Tumours staged as Ta, T1, and/or CIS are grouped under the heading of NMIBC. Diagnosis depends on cystoscopy and histological evaluation of the tissue obtained by transurethral resection (TURB) in papillary tumours or by multiple bladder biopsies in CIS. In papillary lesions, a complete TURB is essential for the patient's prognosis and correct diagnosis. Where the initial resection is incomplete, where there is no muscle in the specimen, or where a T1 tumour is detected, a second TURB should be performed within 2-6 wk. The risks of both recurrence and progression may be estimated for individual patients using the European Organisation for Research and Treatment of Cancer (EORTC) scoring system. Stratification of patients into low-, intermediate-, and high-risk groups is pivotal to the recommendation of adjuvant treatment. In patients with tumours presumed to be at a low risk and in those presumed to be at an intermediate risk with a low previous recurrence rate and an expected EORTC recurrence score of <5, one immediate chemotherapy instillation is recommended. Patients with intermediate-risk tumours should receive 1 yr of full-dose bacillus Calmette-Guérin (BCG) intravesical immunotherapy or instillations of chemotherapy for a maximum of 1 yr. In patients with high-risk tumours, full-dose intravesical BCG for 1-3 yr is indicated. In patients at the highest risk of tumour progression, immediate radical cystectomy should be considered. Cystectomy is recommended in BCG-unresponsive tumours. The extended version of the guidelines is available at the EAU website: https://uroweb.org/guideline/non-muscle-invasive-bladder-cancer/. CONCLUSIONS These abridged EAU guidelines present updated information on the diagnosis and treatment of NMIBC for incorporation into clinical practice. PATIENT SUMMARY The European Association of Urology Non-muscle-invasive Bladder Cancer (NMIBC) Panel has released an updated version of their guidelines, which contains information on classification, risk factors, diagnosis, prognostic factors, and treatment of NMIBC. The recommendations are based on the current literature (until the end of 2018), with emphasis on high-level data from randomised clinical trials and meta-analyses. Stratification of patients into low-, intermediate-, and high-risk groups is essential for deciding appropriate use of adjuvant intravesical chemotherapy or bacillus Calmette-Guérin (BCG) instillations. Surgical removal of the bladder should be considered in case of BCG-unresponsive tumours or in NMIBCs with the highest risk of progression.
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Affiliation(s)
- Marko Babjuk
- Department of Urology, 2nd Faculty of Medicine, Hospital Motol, Charles University, Prague, Czech Republic; Department of Urology, Medical University of Vienna, Vienna, Austria.
| | - Maximilian Burger
- Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany
| | - Eva M Compérat
- Department of Pathology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, UPMC Paris VI, Paris, France
| | - Paolo Gontero
- Division of Urology, Molinette Hospital, University of Studies of Torino, Torino, Italy
| | - A Hugh Mostafid
- Department of Urology, Royal Surrey County Hospital, Guildford, Surrey, UK
| | - Joan Palou
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Bas W G van Rhijn
- Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany; Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Morgan Rouprêt
- Urology Department, Sorbonne Université, GRC n°5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Shahrokh F Shariat
- Department of Urology, 2nd Faculty of Medicine, Hospital Motol, Charles University, Prague, Czech Republic; Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Richard Sylvester
- European Association of Urology Guidelines Office, Brussels, Belgium
| | - Richard Zigeuner
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Otakar Capoun
- Department of Urology, General University Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Daniel Cohen
- Department of Urology, Royal Free London NHS Foundation Trust, London, UK
| | | | - Virginia Hernández
- Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - Thomas Seisen
- Urology Department, Sorbonne Université, GRC n°5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Viktor Soukup
- Department of Urology, General University Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic
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Pospisilova S, Pazourkova E, Horinek A, Brisuda A, Svobodova I, Soukup V, Hrbacek J, Capoun O, Hanus T, Mares J, Korabecna M, Babjuk M. MicroRNAs in urine supernatant as potential non-invasive markers for bladder cancer detection. Neoplasma 2019; 63:799-808. [PMID: 27468885 DOI: 10.4149/neo_2016_518] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Urinary bladder carcinoma contributes to 4% of newly diagnosed oncological diseases in the Czech Republic. Biomarkers for its early non-invasive detection are therefore highly desirable. Urine seems to be an ideal source of such biomarkers due to the content of cell-free nucleic acids, especially microRNAs (miRNAs).To find potential biomarkers among miRNAs in urine supernatant, we examined in total 109 individuals (36 controls and 73 bladder cancer patients) in three phases. In the first - discovery - phase, microarray cards with 381 miRNAs were used for miRNA analysis of 13 controls and 46 bladder cancer patients. In the second - verification - phase, the results of this first phase were verified on the same groups of subjects by single-target qPCR assays for the selected miRNAs. For the third - validation - phase, new independent samples of urine supernatant (23 controls and 27 bladder cancer patients) were analyzed using single-target qPCR assays for 13 verified in the previous phase. The results of all phases were normalized to miR-191, miR-28-3p, and miR-200b, which were selected as suitable for our study by the qBase+®.We found that miR-125b, miR-30b, miR-204, miR-99a, and miR-532-3p are significantly down-regulated in patients' urine supernatant. In our experiments, the analysis of miR-125 levels provided the highest AUC (0.801) with 95.65% specificity and 59.26% sensitivity, the analysis of miR-99a lead to AUC (0.738) with 82.61% specificity and 74.07% sensitivity. We demonstrate that levels of these miRNAs could potentially serve as promising diagnostic markers for the non-invasive diagnostics of bladder cancer.
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Soukup V, Čapoun O, Cohen D, Hernández V, Burger M, Compérat E, Gontero P, Lam T, Mostafid AH, Palou J, van Rhijn BWG, Rouprêt M, Shariat SF, Sylvester R, Yuan Y, Zigeuner R, Babjuk M. Risk Stratification Tools and Prognostic Models in Non-muscle-invasive Bladder Cancer: A Critical Assessment from the European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel. Eur Urol Focus 2018; 6:479-489. [PMID: 30470647 DOI: 10.1016/j.euf.2018.11.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 10/28/2018] [Accepted: 11/10/2018] [Indexed: 02/08/2023]
Abstract
CONTEXT This review focuses on the most widely used risk stratification and prediction tools for non-muscle-invasive bladder cancer (NMIBC). OBJECTIVE To assess the clinical use and relevance of risk stratification and prediction tools to enhance clinical decision making and counselling of patients with NMIBC. EVIDENCE ACQUISITION The most frequent, currently used risk stratification tools and prognostic models for NMIBC patients were identified by the members of the European Association of Urology (EAU) Guidelines Panel on NMIBC. EVIDENCE SYNTHESIS The 2006 European Organization for Research and Treatment of Cancer (EORTC) risk tables are the most widely used and validated tools for risk stratification and prognosis prediction in NMIBC patients. The EAU risk categories constitute a simple alternative to the EORTC risk tables and can be used for comparable risk stratification. In the subgroup of NMIBC patients treated with a short maintenance schedule of bacillus Calmette-Guerin (BCG), the Club Urológico Español de Tratamiento Oncológico (CUETO) scoring model is more accurate than the EORTC risk tables. Both the EORTC risk tables and the CUETO scoring model overestimate the recurrence and progression risks in patients treated according to current guidelines. The new concept of conditional recurrence and progression estimates is very promising during follow-up but should be validated. CONCLUSIONS Risk stratification and prognostic models enable outcome comparisons and standardisation of treatment and follow-up. At present, none of the available risk stratification and prognostic models reflects current standards of treatment. The EORTC risk tables and CUETO scoring model should be updated with previously unavailable data and recalculated. PATIENT SUMMARY Non-muscle-invasive bladder cancer is a heterogeneous disease. A risk-based therapeutic approach is recommended. We present available risk stratification and prediction tools and the degree of their validation with the aim to increase their use in everyday clinical practice.
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Affiliation(s)
- Viktor Soukup
- Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
| | - Otakar Čapoun
- Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Daniel Cohen
- Department of Urology, Royal Free London NHS Foundation Trust, London, UK
| | - Virginia Hernández
- Department of Urology, Hospital Universitario Fundación de Alcorcón, Madrid, Spain
| | - Maximilian Burger
- Department of Urology and Paediatric Urology, Julius-Maximilians-University Würzburg, Würzburg, Germany
| | - Eva Compérat
- Department of Pathology, Hôpital Tenon, Assistance Publique Hopitaux de Paris, Institut Universitaire de Cancérologie GRC5, Sorbonne University, Paris, France
| | - Paolo Gontero
- Department of Surgical Sciences, Urology, University of Turin, Turin, Italy
| | - Thomas Lam
- Academic Urology Unit, University of Aberdeen, Scotland, UK
| | - A Hugh Mostafid
- Department of Urology, Royal Surrey County Hospital, Guildford, UK
| | - Joan Palou
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Bas W G van Rhijn
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Morgan Rouprêt
- Department of Urology, Hopital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, Institut Universitaire de Cancérologie GRC5, Sorbonne University, Paris, France
| | - Shahrokh F Shariat
- Department of Urology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Richard Sylvester
- EAU Guidelines Office Board, European Association of Urology, Arnhem, The Netherlands
| | - Yuhong Yuan
- Department of Medicine, Health Science Centre, McMaster University, Hamilton, Ontario, Canada
| | - Richard Zigeuner
- Department of Urology, Medizinische Universität Graz, Graz, Austria
| | - Marek Babjuk
- Department of Urology, Motol University Hospital and Second Faculty of Medicine, Charles University, Prague, Czech Republic
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Sobotka R, Capoun O, Hanus T, Zima T, Kalousova M, Soukup V. The importance of serum osteopontin and stanniocalcin-1 in renal cell carcinoma. Neoplasma 2018; 65:958-964. [PMID: 29940774 DOI: 10.4149/neo_2018_171123n759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 03/21/2018] [Indexed: 11/08/2022]
Abstract
A total of 56 RCC patients with staging ≥ pT1b were enrolled in a prospective study to assess the prognostic importance of serum levels of osteopontin (OP), stanniocalcin-1 (SC), FGF-23, alpha Klotho and 25-OH-D at the time of diagnosis in renal cell carcinoma (RCC) patients. The relationship between the serum level of the analyzed parameters and recurrence-free survival (RFS), overall survival (OS) and cancer-specific survival (CSS) was examined, and our control group consisted of 20 patients without cancer. The levels of osteopontin, stanniocalcin-1, FGF-23 and alpha Klotho were determined by Enzyme-Linked Immunosorbent Assay (ELISA) and 25-OH-D by chemiluminiscence immunoanalysis (CLIA). The follow-up period median was 46 months. Renal cell carcinoma recurred in 9 patients and 20 patients died during follow-up; 12 of them from RCC. The level of osteopontin and stanniocalcin-1 varied between the control group and RCC patients (at p=0.02 and p=0.0003). Higher levels of stanniocalcin-1 were detected in the metastatic RCC group than in the localized RCC group (p=0.003). Only the stanniocalcin-1 level at the time of surgery was associated with RFS (p=0.0004). Both OS and CCS were associated with the osteopontin, stanniocalcin-1 and FGF preoperative level. Patients with stanniocalcin-1 level over 1,277 pg/ml and osteopontin level over 100 ng/ml had 17.8 times higher and 7.9 times higher risk of dying from RCC progression, respectively (p<0.001 and p=0.002). High levels of osteopontin, stanniocalcin-1 and FGF 23 at the time of surgery are important prognostic factors related to CSS and OS. Patients with high stanniocalcin-1 level were at risk of tumor recurrence.
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Affiliation(s)
- R Sobotka
- Department of Urology, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - O Capoun
- Department of Urology, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - T Hanus
- Department of Urology, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - T Zima
- Institute of Medical Biochemistry and Laboratory Diagnostics, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - M Kalousova
- Institute of Medical Biochemistry and Laboratory Diagnostics, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - V Soukup
- Department of Urology, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
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Soria F, Pisano F, Gontero P, Palou J, Joniau S, Serretta V, Larré S, Di Stasi S, van Rhijn B, Witjes JA, Grotenhuis A, Colombo R, Briganti A, Babjuk M, Soukup V, Malmstrom PU, Irani J, Malats N, Baniel J, Mano R, Cai T, Cha E, Ardelt P, Varkarakis J, Bartoletti R, Dalbagni G, Shariat SF, Xylinas E, Karnes RJ, Sylvester R. Predictors of oncological outcomes in T1G3 patients treated with BCG who undergo radical cystectomy. World J Urol 2018; 36:1775-1781. [PMID: 30171454 DOI: 10.1007/s00345-018-2450-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 08/13/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE To evaluate the oncological impact of postponing radical cystectomy (RC) to allow further conservative therapies prior to progression in a large multicentre retrospective cohort of T1-HG/G3 patients initially treated with BCG. METHODS According to the time of RC, the population was divided into 3 groups: patients who did not progress to muscle-invasive disease, patients who progressed before radical cystectomy and patients who experienced progression at the time of radical cystectomy. Clinical and pathological outcomes were compared across the three groups. RESULTS Of 2451 patients, 509 (20.8%) underwent RC. Patients with tumors > 3 cm or with CIS had earlier cystectomies (HR = 1.79, p = 0.001 and HR = 1.53, p = 0.02, respectively). Patients with tumors > 3 cm, multiple tumors or CIS had earlier T3/T4 or N + cystectomies. In patients who progressed, the timing of cystectomy did not affect the risk of T3/T4 or N + disease at RC. Patients with T3/T4 or N + disease at RC had a shorter disease-specific survival (HR = 4.38, p < 0.001), as did patients with CIS at cystectomy (HR = 2.39, p < 0.001). Patients who progressed prior to cystectomy had a shorter disease-specific survival than patients for whom progression was only detected at cystectomy (HR = 0.58, p = 0.024) CONCLUSIONS: Patients treated with RC before experiencing progression to muscle-invasive disease harbor better oncological and survival outcomes compared to those who progressed before RC and to those upstaged at surgery. Tumor size and concomitant CIS at diagnosis are the main predictors of surgical treatment while tumor size, CIS and tumor multiplicity are associated with extravesical disease at surgery.
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Affiliation(s)
- Francesco Soria
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Francesca Pisano
- Città della Salute e della Scienza di Torino, University of Studies of Turin, Turin, Italy. .,Department of Urology, Fundacio Puigvert, University of Barcelona, Barcelona, Spain.
| | - Paolo Gontero
- Città della Salute e della Scienza di Torino, University of Studies of Turin, Turin, Italy
| | - J Palou
- Department of Urology, Fundacio Puigvert, University of Barcelona, Barcelona, Spain
| | - S Joniau
- Oncologic and Reconstructive Urology, Department of Urology, University Hospitals Leuven, Louvain, Belgium
| | - V Serretta
- Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - S Larré
- Department of Surgical Science, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - S Di Stasi
- Policlinico Tor Vergata-University of Rome, Rome, Italy
| | - B van Rhijn
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - J A Witjes
- Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - A Grotenhuis
- Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - R Colombo
- Dipartimento di Urologia, Università Vita-Salute. Ospedale S. Raffaele, Milan, Italy
| | - A Briganti
- Dipartimento di Urologia, Università Vita-Salute. Ospedale S. Raffaele, Milan, Italy
| | - M Babjuk
- Department of Urology, Motol Hospital, University of Praha, Prague, Czech Republic
| | - V Soukup
- Department of Urology, Motol Hospital, University of Praha, Prague, Czech Republic
| | - P U Malmstrom
- Department of Urology, Academic Hospital, Uppsala University, Uppsala, Sweden
| | - J Irani
- Department of Urology, CHU de Bicêtre, 78, rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France
| | - N Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - J Baniel
- Department of Urology, Rabin Medical Centre, Tel Aviv, Israel
| | - R Mano
- Department of Urology, Rabin Medical Centre, Tel Aviv, Israel
| | - T Cai
- Department of Urology, Santa Chiara Hospital, Trento, Italy
| | - E Cha
- Department of Urology, Weill Medical College of Cornell University in New York City, New York, NY, USA
| | - P Ardelt
- Facharzt fur Urologie, Abteilung fur Urologie, Chirurgische Universitats klinik, Freiburg, Germany
| | - J Varkarakis
- Department of Urology, Sismanoglio Hospital, University of Athens, Athens, Greece
| | - R Bartoletti
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - G Dalbagni
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - S F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - E Xylinas
- Department of Urology, Cochin Hospital, Paris, France
| | - R J Karnes
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - R Sylvester
- Formerly Department of Biostatistics, EORTC Headquarters, Brussels, Belgium
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Babjuk M, Burger M, Compérat EM, Gontero P, Mostafid HA, Palou J, van Rhijn BWG, Rouprêt M, Shariat SF, Sylvester R, Zigeuner R, Capoun O, Cohen D, Dominguez-Escrig JL, Hernández V, Peyronnet B, Seisen T, Soukup V. Indication for a Single Postoperative Instillation of Chemotherapy in Non-muscle-invasive Bladder Cancer: What Factors Should Be Considered? Eur Urol Focus 2018; 4:525-528. [PMID: 30061076 DOI: 10.1016/j.euf.2018.07.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 07/08/2018] [Accepted: 07/13/2018] [Indexed: 10/28/2022]
Abstract
An early single instillation of intravesical chemotherapy (SICI) used immediately after transurethral resection of the bladder (TURB) can significantly reduce the recurrence rate in selected patients with non-muscle-invasive bladder cancer (NMIBC). SICI should be used in patients with low-risk and with selected intermediate-risk tumours, in particular for multiple primary small papillary tumours, single primary papillary tumours >3cm, and single recurrent papillary tumours recurring >1yr after the previous resection. The available data do not support any recommendation to reduce the role of SICI in patients after fluorescence cystoscopy-guided TURB or en bloc TURB. SICI can even provide some benefit in patients with intermediate-risk tumours subsequently treated with further instillations. During instillation, contraindications should be taken into account and safety measures should be applied. PATIENT SUMMARY: An early single instillation of intravesical chemotherapy immediately after transurethral resection of the bladder can significantly reduce the recurrence rate in selected patients with non-muscle-invasive bladder cancer. It should be used in patients with low-risk and selected intermediate-risk tumours.
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Affiliation(s)
- Marko Babjuk
- Department of Urology, Hospital Motol, Second Faculty of Medicine, Charles University, Praha, Czech Republic; Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
| | - Maximilian Burger
- Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany
| | - Eva M Compérat
- Department of Pathology, Hôpital Tenon, AP-HP, Sorbonne University, Paris, France
| | - Paolo Gontero
- Department of Urology, San Giovanni Battista Hospital, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Hugh A Mostafid
- Department of Urology, Royal Surrey County Hospital, Guildford, UK
| | - Joan Palou
- Department of Urology, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Bas W G van Rhijn
- Department of Urology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Morgan Rouprêt
- Department of Urology, Hôpital La Pitié-Salpétrière, AP-HP, Sorbonne University, Paris, France
| | - Shahrokh F Shariat
- Department of Urology, Hospital Motol, Second Faculty of Medicine, Charles University, Praha, Czech Republic; Medical University of Vienna, Vienna General Hospital, Vienna, Austria; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, Weill Cornell Medical College, New York, NY, USA
| | - Richard Sylvester
- European Association of Urology Guidelines Office, Brussels, Belgium
| | - Richard Zigeuner
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Otakar Capoun
- Department of Urology, General University Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Daniel Cohen
- Department of Surgery and Cancer, Imperial College London, London, UK; Department of Urology, Lister Hospital, East and North Hertfordshire NHS Trust, Stevenage, UK
| | | | - Virginia Hernández
- Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - Thomas Seisen
- Department of Urology, Hôpital La Pitié-Salpétrière, AP-HP, Sorbonne University, Paris, France
| | - Viktor Soukup
- Department of Urology, General University Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic
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Soukup V, Čapoun O, Pešl M, Sobotka R, Vávřová L, Hanuš T, Zima T, Kalousová M. Placental Growth Factor in Bladder Cancer Compared to the Diagnostic Accuracy and Prognostic Performance of Vascular Endothelial Growth Factor A. Anticancer Res 2018; 38:239-246. [PMID: 29277778 DOI: 10.21873/anticanres.12213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 11/08/2017] [Accepted: 11/09/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM To evaluate the diagnostic accuracy and prognostic performance of urinary and plasma levels of placental growth factor (PLGF) and provide their comparison with the results of vascular endothelial growth factor A (VEGF-A) in patients with primary and recurrent urinary bladder cancer. MATERIALS AND METHODS The enzyme-linked immunosorbent assay (ELISA) was used to assess urinary and plasma concentrations of PLGF and VEGF-A in 240 individuals. RESULTS PLGF levels in urine and plasma were significantly higher in patients with primary bladder cancer than in healthy individuals (p=0.003, p=0.005, respectively). Area under the curve (AUC) of urinary PLGF was 0.68; AUC of plasma PLGF levels was 0.65. Patients with the urine levels of PLGF higher than 82.33 pg/ml had three times higher risk of recurrence. In patients with recurrent bladder cancer, the urinary concentrations of PLGF did not significantly differ from the concentrations in patients without current disease (p=0.61). However, plasma PLGF levels were significantly higher in patients diagnosed with tumor recurrence (p=0.001); AUC of plasma PLGF levels was 0.69. Moreover, patients with plasma levels higher than 10.09 pg/ml had a five-times higher risk of future tumor recurrence. The diagnostic accuracy of PLGF was comparable with VEGF-A. CONCLUSION From a clinical point of view, PLGF could be considered a valid diagnostic test for the detection of primary and recurrent bladder cancer. In patients with recurrent bladder cancer, plasma PLGF levels can differentiate individuals at risk of tumor recurrence.
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Affiliation(s)
- Viktor Soukup
- Department of Urology, the First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Otakar Čapoun
- Department of Urology, the First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Michael Pešl
- Department of Urology, the First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Roman Sobotka
- Department of Urology, the First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Lucie Vávřová
- Department of Urology, the First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Tomáš Hanuš
- Department of Urology, the First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Tomáš Zima
- Institute of Medical Biochemistry and Laboratory Diagnostics, the First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Marta Kalousová
- Institute of Medical Biochemistry and Laboratory Diagnostics, the First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
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Sobotka R, Čapoun O, Kalousová M, Hanuš T, Zima T, Koštířová M, Soukup V. Prognostic Importance of Vitamins A, E and Retinol-binding Protein 4 in Renal Cell Carcinoma Patients. Anticancer Res 2017; 37:3801-3806. [PMID: 28668878 DOI: 10.21873/anticanres.11757] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 06/10/2017] [Accepted: 06/12/2017] [Indexed: 11/10/2022]
Abstract
AIM To assess the prognostic importance of serum levels of retinol, retinol-binding protein 4 (RBP4) and vitamin E at the time of diagnosis in patients with renal cell carcinoma (RCC). PATIENTS AND METHODS In this prospective study, in a cohort of 102 renal cell carcinoma patients, relationships between serum levels of the aforementioned markers and recurrence-free survival (RFS), overall survival (OS), as well as cancer-specific survival (CSS), were evaluated. The vitamin A and vitamin E levels were determined by high-performance liquid chromatography (HPLC), while the RBP4 level by enzyme-linked immunosorbent assay (ELISA). RESULTS The median follow-up period was 39 months. Renal cell carcinoma recurred in 9 patients; 23 patients died with 12 of them from RCC. The preoperative vitamin E level was associated to RFS (p=0.02). We found a significant relationship between OS and the level of RBP4 (p=0.002), retinol (p=0.037) and vitamin E (p=0.007). The CSS period was significantly associated with the level of RBP4 (p=0.0001) and retinol (p=0.0003). Patients with an RBP4 level less than 21.0 mg/l at the time of diagnosis had a 13.5-times higher risk of death due to RCC progression; this risk was up to 7.7-times higher with vitamin A levels under 0.52 mg/l. CONCLUSION Low levels of vitamin A, E and RBP4 at the time of RCC diagnosis are associated with a poorer prognosis after surgery.
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Affiliation(s)
- Roman Sobotka
- Department of Urology, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Otakar Čapoun
- Department of Urology, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marta Kalousová
- Institute of Medical Biochemistry and Laboratory Diagnostics, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Tomáš Hanuš
- Department of Urology, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Tomáš Zima
- Institute of Medical Biochemistry and Laboratory Diagnostics, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Milada Koštířová
- Institute of Medical Biochemistry and Laboratory Diagnostics, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Viktor Soukup
- Department of Urology, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
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Babjuk M, Böhle A, Burger M, Capoun O, Cohen D, Compérat EM, Hernández V, Kaasinen E, Palou J, Rouprêt M, van Rhijn BW, Shariat SF, Soukup V, Sylvester RJ, Zigeuner R. EAU Guidelines on Non–Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur Urol 2017; 71:447-461. [DOI: 10.1016/j.eururo.2016.05.041] [Citation(s) in RCA: 1330] [Impact Index Per Article: 190.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 05/30/2016] [Indexed: 12/15/2022]
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Čapoun O, Mikulová V, Jančíková M, Honová H, Kološtová K, Sobotka R, Michael P, Zima T, Hanuš T, Soukup V. Prognosis of Castration-resistant Prostate Cancer Patients - Use of the AdnaTest® System for Detection of Circulating Tumor Cells. Anticancer Res 2016; 36:2019-2026. [PMID: 27069196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 03/03/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Detection of circulating tumor cells (CTC) in patients with castration-resistant prostate cancer (CRPC) may improve the estimate of chemotherapy response. We evaluated the AdnaTest® system in patients receiving docetaxel. PATIENTS AND METHODS CTC analysis was carried out in 37 patients by immunomagnetic separation. Correlation between serum prostate-specific antigen (sPSA) change and CTC presence and the influence of each parameter on the overall survival (OS) were evaluated. RESULTS We detected CTCs in 32 and 16 patients before and after three docetaxel cycles, respectively. The sPSA level correlated with CTC positivity during docetaxel therapy (p=0.0031). The longest OS was in patients negative for CTCs in both samples (p=0.0228). Change in sPSA levels was associated with treatment response (p=0.033). CONCLUSION We detected CTCs in a considerable number of patients with CRPC. The absolute change of sPSA level correlated with OS. CTC presence during docetaxel therapy was associated with shorter OS.
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Affiliation(s)
- Otakar Čapoun
- Department of Urology, General University Hospital and of The First Faculty of Medicine of Charles University
| | - Veronika Mikulová
- Institute of Medical Biochemistry and Laboratory Diagnostics, General University Hospital and of The First Faculty of Medicine of Charles University
| | - Markéta Jančíková
- Institute of Medical Biochemistry and Laboratory Diagnostics, General University Hospital and of The First Faculty of Medicine of Charles University
| | - Hana Honová
- Department of Oncology, General University Hospital and of The First Faculty of Medicine of Charles University
| | - Katarína Kološtová
- Department of Tumor Biology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Roman Sobotka
- Department of Urology, General University Hospital and of The First Faculty of Medicine of Charles University
| | - Pešl Michael
- Department of Urology, General University Hospital and of The First Faculty of Medicine of Charles University
| | - Tomáš Zima
- Institute of Medical Biochemistry and Laboratory Diagnostics, General University Hospital and of The First Faculty of Medicine of Charles University
| | - Tomáš Hanuš
- Department of Urology, General University Hospital and of The First Faculty of Medicine of Charles University
| | - Viktor Soukup
- Department of Urology, General University Hospital and of The First Faculty of Medicine of Charles University
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Gontero P, Sylvester R, Pisano F, Joniau S, Oderda M, Serretta V, Larré S, Di Stasi S, Van Rhijn B, Witjes AJ, Grotenhuis AJ, Colombo R, Briganti A, Babjuk M, Soukup V, Malmström PU, Irani J, Malats N, Baniel J, Mano R, Cai T, Cha EK, Ardelt P, Vakarakis J, Bartoletti R, Dalbagni G, Shariat SF, Xylinas E, Karnes RJ, Palou J. The impact of re-transurethral resection on clinical outcomes in a large multicentre cohort of patients with T1 high-grade/Grade 3 bladder cancer treated with bacille Calmette-Guérin. BJU Int 2015; 118:44-52. [PMID: 26469362 DOI: 10.1111/bju.13354] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine if a re-transurethral resection (TUR), in the presence or absence of muscle at the first TUR in patients with T1-high grade (HG)/Grade 3 (G3) bladder cancer, makes a difference in recurrence, progression, cancer specific (CSS) and overall survival (OS). PATIENTS AND METHODS In a large retrospective multicentre cohort of 2451 patients with T1-HG/G3 initially treated with bacille Calmette-Guérin, 935 (38%) had a re-TUR. According to the presence or absence of muscle in the specimen of the primary TUR, patients were divided in four groups: group 1 (no muscle, no re-TUR), group 2 (no muscle, re-TUR), group 3 (muscle, no re-TUR) and group 4 (muscle, re-TUR). Clinical outcomes were compared across the four groups. RESULTS Re-TUR had a positive impact on recurrence, progression, CSS and OS only if muscle was not present in the primary TUR specimen. Adjusting for the most important prognostic factors, re-TUR in the absence of muscle had a borderline significant effect on time to recurrence [hazard ratio (HR) 0.67, P = 0.08], progression (HR 0.46, P = 0.06), CSS (HR 0.31, P = 0.07) and OS (HR 0.48, P = 0.05). Re-TUR in the presence of muscle in the primary TUR specimen did not improve the outcome for any of the endpoints. CONCLUSIONS Our retrospective analysis suggests that re-TUR may not be necessary in patients with T1-HG/G3, if muscle is present in the specimen of the primary TUR.
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Affiliation(s)
- Paolo Gontero
- Urology Clinic, Città della Salute e della Scienza di Torino, University of Studies of Turin, Turin, Italy
| | - Richard Sylvester
- Formerly Department of Biostatistics, EORTC Headquarters, Brussels, Belgium
| | - Francesca Pisano
- Urology Clinic, Città della Salute e della Scienza di Torino, University of Studies of Turin, Turin, Italy
| | - Steven Joniau
- Oncologic and Reconstructive Urology, Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Marco Oderda
- Urology Clinic, Città della Salute e della Scienza di Torino, University of Studies of Turin, Turin, Italy
| | - Vincenzo Serretta
- Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - Stéphane Larré
- Department of Surgical Science, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | | | - Bas Van Rhijn
- Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Alfred J Witjes
- Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Anne J Grotenhuis
- Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Renzo Colombo
- Dipartimento di Urologia, Università Vita-Salute. Ospedale S. Raffaele, Milan, Italy
| | - Alberto Briganti
- Dipartimento di Urologia, Università Vita-Salute. Ospedale S. Raffaele, Milan, Italy
| | - Marek Babjuk
- Department of Urology, Motol Hospital, University of Praha, Praha, Czech Republic
| | - Viktor Soukup
- Department of Urology, Motol Hospital, University of Praha, Praha, Czech Republic
| | - Per-Uno Malmström
- Department of Urology, Academic Hospital, Uppsala University, Uppsala, Sweden
| | - Jacques Irani
- Department of Urology, Centre Hospitalier Universitaire La Milétrie, University of Poitiers, Poitiers, France
| | - Nuria Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Jack Baniel
- Department of Urology, Rabin Medical Centre, Tel Aviv, Israel
| | - Roy Mano
- Department of Urology, Rabin Medical Centre, Tel Aviv, Israel
| | - Tommaso Cai
- Department of Urology, Santa Chiara Hospital, Trento, Italy
| | - Eugene K Cha
- Department of Urology, Weill Medical College of Cornell University in New York City, New York, NY, USA
| | - Peter Ardelt
- Facharzt fur Urologie, Abteilung fur Urologie. Chirurgische Universitats klinik, Freiburg, Germany
| | - John Vakarakis
- Department of Urology, Sismanoglio Hospital, University of Athens, Athens, Greece
| | - Riccardo Bartoletti
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Guido Dalbagni
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Shahrokh F Shariat
- Department of Urology, Weill Medical College of Cornell University in New York City, New York, NY, USA
| | - Evanguelos Xylinas
- Department of Urology, Weill Medical College of Cornell University in New York City, New York, NY, USA
| | | | - Joan Palou
- Department of Urology, Fundacio Puigvert, University of Barcelona, Barcelona, Spain
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Brisuda A, Pazourkova E, Soukup V, Horinek A, Hrbáček J, Capoun O, Svobodova I, Pospisilova S, Korabecna M, Mares J, Hanuš T, Babjuk M. Urinary Cell-Free DNA Quantification as Non-Invasive Biomarker in Patients with Bladder Cancer. Urol Int 2015; 96:25-31. [PMID: 26338254 DOI: 10.1159/000438828] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 07/16/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Concentration of urinary cell-free DNA (ucfDNA) belongs to potential bladder cancer markers, but the reported results are inconsistent due to the use of various non-standardised methodologies. The aim of the study was to standardise the methodology for ucfDNA quantification as a potential non-invasive tumour biomarker. MATERIAL AND METHODS In total, 66 patients and 34 controls were enrolled into the study. Volumes of each urine portion (V) were recorded and ucfDNA concentrations (c) were measured using real-time PCR. Total amounts (TA) of ucfDNA were calculated and compared between patients and controls. Diagnostic accuracy of the TA of ucfDNA was determined. RESULTS The calculation of TA of ucfDNA in the second urine portion was the most appropriate approach to ucfDNA quantification, as there was logarithmic dependence between the volume and the concentration of a urine portion (p = 0.0001). Using this methodology, we were able to discriminate between bladder cancer patients and subjects without bladder tumours (p = 0.0002) with area under the ROC curve of 0.725. Positive and negative predictive value of the test was 90 and 45%, respectively. CONCLUSION Quantification of ucf DNA according to our modified method could provide a potential non-invasive biomarker for diagnosis of patients with bladder cancer.
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Affiliation(s)
- Antonin Brisuda
- Department of Urology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
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Čapoun O, Soukup V, Kalousová M, Sobotka R, Pešl M, Zima T, Hanuš T. Diagnostic Importance of Selected Protein Serum Markers in the Primary Diagnostics of Prostate Cancer. Urol Int 2015; 95:429-35. [DOI: 10.1159/000431364] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 05/12/2015] [Indexed: 11/19/2022]
Abstract
Objective: To determine a predictive model for the primary diagnosis of prostate cancer (PC) based on a multiple serum biomarker assay. Material and Methods: Between August 2011 and February 2013, a total of 387 prostate biopsies were performed. Serum or plasma concentrations of 22 biomarkers (neopterin, IGF-1, IGFBP-2, IGFBP-3, sarcosine, endoglin, TGF-β1, periostin, sPLA2-IIa, chromogranin A, ZAG2, clusterin, PSP94, PSP94bp, leptin, cathepsin D, hepsin, KLK11, PSMA, AMACR, CRISP3 and A1AT) were determined. Biomarker levels were correlated with the prostate biopsy results. Several statistical models for PC detection were created. Results: A total of 167 of the 373 evaluated patients (44.8%) were diagnosed with PC. None of the tested biomarkers reached statistical significance using the univariate analysis. However, the level of serum clusterin was not associated with any other tested parameter. Several basic models showed a higher positive predictive value than individual parameters. Addition of serum clusterin to the base model with prostate-specific antigen, digital rectal exam and prostate size significantly improved the area under curve value (0.723 vs. 0.716). Conclusion: Our findings suggested that multiple serum assays based on some promising markers may only have a limited practical benefit for the prediction of PC in the prostate biopsy.
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Soukup V, Kalousová M, Capoun O, Sobotka R, Breyl Z, Pešl M, Zima T, Hanuš T. Panel of Urinary Diagnostic Markers for Non-Invasive Detection of Primary and Recurrent Urothelial Urinary Bladder Carcinoma. Urol Int 2015; 95:56-64. [PMID: 25662337 DOI: 10.1159/000368166] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/04/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To determine the combination of urinary protein markers for noninvasive detection of primary and recurrent urothelial bladder carcinomas. METHODS Urinary concentrations of 27 biomarkers (NSE, ATT, AFABP, Resistin, Midkine, Clusterin, Uromodulin, ZAG2, HSP27, HSP 60, NCAM1/CD56, Angiogenin, Calreticulin, Chromogranin A, CEACAM1, CXCL1, IL13Ra2, Progranulin, VEGFA, CarbAnhydIX, Annexin-V, TIM4, Galectin1, Cystatin B, Synuclein G, ApoA1 and ApoA2) were assessed by enzyme-linked immunosorbent assay or by electrochemiluminiscence immunoassay. RESULTS During the primary diagnostics, a group of 70 patients with primary occurrence of bladder cancer and 49 healthy control subjects were compared. For this clinical situation, the most accurate combination proved to be the combination of cytology with markers Midkine and Synuclein G (sensitivity 91.8%, specificity 97.5%). During the monitoring of patients with non-muscle invasive bladder cancer (NMIBC), a group of 44 patients with cancer recurrence was compared with the group of 61 patients with a history of NMIBC without current disease. For this clinical situation, the most accurate combination proved to be the combination of cytology and erythrocytes count in urine sediment with markers Midkine, ZAG2, CEACAM1, and Synuclein G (sensitivity 92.68%, specificity 90.16%). A lower accuracy of the diagnostic panel and the necessity to use more markers in the case of recurrence was connected with a different structure of patients. CONCLUSIONS Multi-marker test can significantly improve the bladder cancer detection both during the primary diagnostics and monitoring of patients with NMIBC. This outcome should result in other, larger studies.
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Affiliation(s)
- Viktor Soukup
- Department of Urology, General University Hospital and The First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
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Gontero P, Sylvester R, Pisano F, Joniau S, Vander Eeckt K, Serretta V, Larré S, Di Stasi S, Van Rhijn B, Witjes AJ, Grotenhuis AJ, Kiemeney LA, Colombo R, Briganti A, Babjuk M, Malmström PU, Oderda M, Irani J, Malats N, Baniel J, Mano R, Cai T, Cha EK, Ardelt P, Varkarakis J, Bartoletti R, Spahn M, Johansson R, Frea B, Soukup V, Xylinas E, Dalbagni G, Karnes RJ, Shariat SF, Palou J. Prognostic Factors and Risk Groups in T1G3 Non–Muscle-invasive Bladder Cancer Patients Initially Treated with Bacillus Calmette-Guérin: Results of a Retrospective Multicenter Study of 2451 Patients. Eur Urol 2015; 67:74-82. [PMID: 25043942 DOI: 10.1016/j.eururo.2014.06.040] [Citation(s) in RCA: 171] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 06/23/2014] [Indexed: 11/19/2022]
Affiliation(s)
- Paolo Gontero
- Department of Surgical Sciences, Molinette Hospital, University of Studies of Turin, Turin, Italy.
| | | | - Francesca Pisano
- Department of Surgical Sciences, Molinette Hospital, University of Studies of Turin, Turin, Italy
| | - Steven Joniau
- Oncologic and Reconstructive Urology, Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Kathy Vander Eeckt
- Oncologic and Reconstructive Urology, Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Vincenzo Serretta
- Department of Urology, Paolo Giaccone General Hospital, Palermo, Italy
| | - Stéphane Larré
- Department of Surgical Science, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | | | - Bas Van Rhijn
- Department of Urology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Alfred J Witjes
- Department of Urology and Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Anne J Grotenhuis
- Department of Urology and Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Lambertus A Kiemeney
- Department of Urology and Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Renzo Colombo
- Dipartimento di Urologia, Università Vita-Salute, Ospedale S. Raffaele, Milan, Italy
| | - Alberto Briganti
- Dipartimento di Urologia, Università Vita-Salute, Ospedale S. Raffaele, Milan, Italy
| | - Marek Babjuk
- Department of Urology, Motol Hospital, 2nd Faculty of Medicine, Charles, University of Prague, Prague, Czech Republic
| | - Per-Uno Malmström
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Marco Oderda
- Department of Surgical Sciences, Molinette Hospital, University of Studies of Turin, Turin, Italy
| | - Jacques Irani
- Department of Urology, Centre Hospitalier Universitaire La Milétrie, University of Poitiers, Poitiers, France
| | - Nuria Malats
- Department of Urology, Spanish National Cancer Research Centre-Madrid, Madrid, Spain
| | - Jack Baniel
- Institute of Urology, Rabin Medical Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roy Mano
- Institute of Urology, Rabin Medical Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tommaso Cai
- Department of Urology, Santa Chiara Hospital, Trento, Italy
| | - Eugene K Cha
- Department of Urology, Weill Medical College of Cornell University, New York, NY, USA, and Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Peter Ardelt
- Facharzt fur Urologie, Abteilung fur Urologie, Chirurgische Universitatsklinik, Freiburg, Germany
| | - John Varkarakis
- Department of Urology, Sismanoglio Hospital, University of Athens, Athens, Greece
| | - Riccardo Bartoletti
- Urology Unit, S. Maria Annunziata Hospital, University of Florence, Florence, Italy
| | - Martin Spahn
- Department of Urology, University Hospital of Wuerzburg, Wuertzburg, Germany
| | - Robert Johansson
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Bruno Frea
- Department of Surgical Sciences, Molinette Hospital, University of Studies of Turin, Turin, Italy
| | - Viktor Soukup
- Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University in Praha, Praha, Czech Republic
| | | | - Guido Dalbagni
- Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | | | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center Medical University Vienna, Vienna, Austria
| | - Joan Palou
- Department of Urology, Fundacio Puigvert, University of Barcelona, Barcelona, Spain
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Soukup V, Duková J, Pel M, Capoun O, Feherová Z, Zámecník L, Hanu T, Babjuk M. The Prognostic Value of T1 Bladder Cancer Substaging: A Single Institution Retrospective Study. Urol Int 2014; 92:150-6. [DOI: 10.1159/000355358] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 08/28/2013] [Indexed: 11/19/2022]
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Capoun O, Soukup V, Mikulová V, Jančíková M, Honová H, Kološtová K, Zima T, Hanuš T. [Circulating tumor cells and prostate cancer prognosis]. Cas Lek Cesk 2014; 153:72-77. [PMID: 24797777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Prostate cancer (PC) is the most common malignant disease in men. Prognosis of patients with metastatic PC is generally unfavourable; however there are significant differences in survival at this stage of the disease. The definition of prognosis is essential for the selection of therapy, respecting an individual risk. In recent years, the association between circulating tumor cells (CTC) detection and response to PC treatment has been widely investigated. Detection of CTC is based on a metastatic process theory and uses well-known tumor-specific antigens on the cell surface. Individual methods assess CTC with different sensitivity and are not yet efficient at the localised PC stage. Only the method of immunomagnetic separation and semi-automatic visualisation (CellSearchTM) has been validated and approved for the use in the PC management. Assessment of the CTC count directly correlates with the prognosis of patients with castration-resistant PC. Change in the CTC count during the therapy also considerably improves risk estimation and represents a marker of overall survival. New methods of CTC cultivation and gene profiling may contribute to individualisation of the treatment similarly to breast cancer. The authors present a review article about theory, methods of detection and clinical use of CTC in castration-resistant PC.
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Mares J, Szakacsova M, Soukup V, Duskova J, Horinek A, Babjuk M. Prediction of recurrence in low and intermediate risk non-muscle invasive bladder cancer by real-time quantitative PCR analysis: cDNA microarray results. Neoplasma 2013; 60:295-301. [PMID: 23452234 DOI: 10.4149/neo_2013_0391] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of the study was to define specific genetic profile in Ta and T1 urinary bladder carcinoma patients with and without recurrence by gene expression microarrays. Eleven patients with the time to recurrence shorter than one year (patients with recurrence) and 11 patients with time to recurrence longer than 4 years (patients without recurrence) were enrolled. Data from microarrays were subjected to a panel of statistical analyses to identify bladder cancer recurrence-associated gene signatures. Initial screening using the GeneSpring and Bioconductor software tools revealed a putative set 47 genes differing in gene expression in both groups. After the validation, 33 genes manifested significant differences between both groups. The significant expression was observed in the group of patients without recurrence by 30 genes of which the highest differences were detected by ANXA1, ARHGEF4, FLJ32252, GNE, NINJ1, PRICKLE1, PSAT1, RNASE1, SPTAN1, SYNGR1, TNFSF15, TSPAN1, and WDR34. These genes code for signal transduction, vascular remodeling and vascular endothelial growth inhibition mainly. In the group with recurrence, 3 genes had significant differences, the highest differences were identified by two genes (PLOD2 and WDR72). Loci of genes with significant changes of gene expression were located on characteristic chromosomes for bladder cancer: 7 loci on chromosome 9, 8 loci on chromosomes 1, 2, 3, 12,14,15,16, and 22. We have selected and validated 15 genes that are differentially expressed in superficial bladder cancer. We hope that this cohort of genes will serve as a promising pool of candidate biomarkers for early stage bladder cancer. Our results indicate that it may be possible to identify patients with a low and high risk of disease recurrence at an early stage using a molecular profile.
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Affiliation(s)
- J Mares
- Charles University, Prague, Czech Republic.
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Zapletal R, Kubes J, Dedeckova K, Soukup V. 7127 POSTER Radical Radiotherapy of Bladder Cancer 64-74 Gy. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72042-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cauberg EC, Kloen S, Visser M, de la Rosette JJ, Babjuk M, Soukup V, Pesl M, Duskova J, de Reijke TM. Narrow Band Imaging Cystoscopy Improves the Detection of Non–muscle-invasive Bladder Cancer. Urology 2010; 76:658-63. [DOI: 10.1016/j.urology.2009.11.075] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Revised: 10/28/2009] [Accepted: 11/06/2009] [Indexed: 11/27/2022]
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Soukup V, Babjuk M, Pesl M, Szakácsová M, Mares J, Zamecnik L, Hanus T. MP-20.15: Prognostic Value of Gene Pax5 Expression in the TA, T1 Urothelial Urinary Bladder Carcinoma. Urology 2009. [DOI: 10.1016/j.urology.2009.07.776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dundr P, Pesl M, Povýsil C, Bauerová L, Soukup V. Primary large cell neuroendocrine carcinoma of the kidney. Pathol Oncol Res 2009; 16:139-42. [PMID: 19579058 DOI: 10.1007/s12253-009-9180-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Accepted: 06/16/2009] [Indexed: 12/20/2022]
Abstract
We report a case of a 56-year-old male with a primary large cell neuroendocrine renal carcinoma. Grossly, the left kidney was enlarged by a solid tumor that measured 145 x 125 x 100 mm. Histologically, the tumor consisted of large cells with a moderate to abundant amount of eosinophilic cytoplasm. The nuclei were irregular, some of them with finely or coarsely granular chromatin, others with vesicular chromatin and prominent nucleoli. The tumor cells showed multiple mitotic figures (up to 32 mitoses/10 HPF). In some areas, the tumor cells were arranged in solid sheets; however, the predominant pattern was solid-alveolar, trabecular and cribriform. Large areas of tumor necrosis were found. Immunohistochemically, the tumor cells were positive for synaptophysin, CD56 and CD57. Cytokeratin AE1/AE3, vimentin and CD10 were positive only focally. Chromogranin showed weak cytoplasmic positivity in rare tumor cells. Cytokeratin CAM5.2, cytokeratin 34betaE12, BerEP 4, EMA, TTF-1, cytokeratin 7, cytokeratin 20, calretinin, serotonin, somatostatin, gastrin, calcitonin, glukagon and insulin were negative. Primary large cell neuroendocrine carcinoma of the kidney is a rare tumor. To the best of our knowledge, only 3 cases of a tumor of this type have been reported to date.
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Affiliation(s)
- Pavel Dundr
- Department of Pathology, 1st Faculty of Medicine and General Teaching Hospital, Charles University, Studnickova 2, Prague, 128 00, Czech Republic.
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Soukup V, Babjuk M, Dusková J, Pesl M, Szakáczová M, Zámecník L, Dvorácek J. Does the expression of fascin-1 and tumor subclassification help to assess the risk of recurrence and progression in t1 urothelial urinary bladder carcinoma? Urol Int 2008; 80:413-8. [PMID: 18587253 DOI: 10.1159/000132700] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2007] [Accepted: 05/30/2007] [Indexed: 11/19/2022]
Abstract
INTRODUCTION To evaluate the prognostic value of T1 subclassification and fascin-1 expression in T1 human urothelial cell carcinoma of the bladder. MATERIALS AND METHODS In a prospective study with 105 consecutive patients, T1 tumors were subclassified into 2 groups according to the depth of tumor invasion. The tunica muscularis mucosae was used as a landmark. The expression of fascin-1 was examined by using an anti-fascin-1 mouse monoclonal antibody and was evaluated semiquantitatively for both intensity and distribution. The patients were followed up for 27.3 +/- 13.7 months. RESULTS The T1 tumor subclassification was feasible in 99 patients (94%). T1a tumor was detected in 77 patients (73%), T1b tumor in 22 patients (21%). An invasive tumor was found in 5 patients (4.8%) during the restaging transurethral resection of the bladder. The risk of understaging in patients with T1b tumor was 18%. There was not a significant difference in time to the recurrence in the T1a and the T1b group. The progression-free survival rates were significantly different between both groups (p = 0.0034). No correlation was found between fascin-1 positivity and the depth of tumor invasion. Fascin-1 positivity did not correlate with recurrence or the progression-free intervals. In the multivariate analysis, only the extent of lamina propria invasion was an independent predictor of the tumor progression. The fascin positivity was not an independent prognostic factor relating to the risk of recurrence or progression. CONCLUSION The finding of T1b tumor was connected with a significantly higher risk of progression and understaging. The fascin-1 expression did not correlate with the depth of tumor invasion or with the tumor recurrence or progression.
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Affiliation(s)
- V Soukup
- Department of Urology, General Teaching Hospital, 1st Medical Faculty, Charles University, Prague, Czech Republic.
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Babjuk M, Soukup V, Pešl M, Koštířová M, Drncová E, Smolová H, Szakacsová M, Getzenberg R, Pavlík I, Dvořáček J. Urinary Cytology and Quantitative BTA and UBC Tests in Surveillance of Patients with pTapT1 Bladder Urothelial Carcinoma. Urology 2008; 71:718-22. [DOI: 10.1016/j.urology.2007.12.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2007] [Revised: 11/25/2007] [Accepted: 12/04/2007] [Indexed: 01/25/2023]
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Dusková J, Babjuk M, Soukup V. [Difficulties in routine diagnostics of urothelium lesions]. Cesk Patol 2008; 44:29-34. [PMID: 18819323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Facing the increasing frequency of urothelial neoplasms and stratified therapeutic strategy pathologists have to meet the demands of urologists for constantly increasing preciseness of the histopathology reports influencing the application of tailored therapeutic schemes. The WHO/ISUP consensus conference in 1998 resulted into adoption of a new classification of the urothelial lesions. Its employment requires considering of features that can be difficult to find in the material provided. MATERIAL AND METHODS parallel typing of more than 200 urothelial neoplasms from the daily routine biopsy samples provided by the faculty of medicine urology clinic according to the previous Mostofi 1973 and the new WHO/ISUP 1998 classification. RESULTS Realizing the consultation demands we have identified some repetitive problems in the urothelium lesions diagnostics considering typing, grading, and staging of the lesions. Typing was a less frequent source of problems. It appeared in classifying lesions with inverted growth, and mucin producing urothelial neoplasms vs. adenocarcinomas. Less important typing problems are represented by uncommon rare diagnoses, as they manifest from the beginning as a specialty solvable mostly with the help of immunohistochemistry. Grading was experienced as troublesome in the following items: papillary hyperplasia vs. LG papillary ca, PUNLMP vs. LG papillary ca, HG papillary ca with a majority of LG material, monotonous types of HG flat lesions, and combined lesions. Staging difficulties applied mostly in identification of the initial unequivocal invasion and the substaging of pT1 into pT1a and pT1b with learning to find the decisive mucosa structures described in detail as late as 1983 (2). We have implemented reporting the presence/absence of the detrusor muscle in the material as a marker describing the representativness of the sample provided; we consider this approach less confusing than introduction of clinical staging terminology Ta, T1 instead of pTa, pT1. To help the practising pathologists accustomed to the previous classification system we have organized postgraduate courses dealing with the application of the new diagnostic criteria adopted by the new version WHO 2004 urothelial neoplasms classification. A slide collection from the routine biopsy material comparing the previous and the new classification and a reference image database with commented reference images are being developed in the LUCIA Net image archiving system. Free access for study is available at http://www.laboratory-imaging.com. Recently, it includes over 80 images. CONCLUSION adopting the new system of urothelial lesions classification requires consideration of formerly not employed features. The learning can be simplified with both classical slide collection & e-learning image database.
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Affiliation(s)
- J Dusková
- Ustav patologie, LF UK a VFN, Katedra patologie IPVZ a Vysoká skola zdravotní, Praha.
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Dundr P, Pesl M, Povýsil C, Tvrdík D, Pavlík I, Soukup V, Dvorácek J. Pigmented microcystic chromophobe renal cell carcinoma. Pathol Res Pract 2007; 203:593-7. [PMID: 17658700 DOI: 10.1016/j.prp.2007.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2007] [Revised: 04/23/2007] [Accepted: 05/02/2007] [Indexed: 11/21/2022]
Abstract
We report a case of a 60-year-old female with a pigmented microcystic chromophobe renal cell carcinoma (PMCRCC). The tumor was 4.5 cm in diameter, and was located in the right kidney. Grossly, on cross section, the tumor was light gray with multiple small brown to black pigmented foci up to 0.2 cm in diameter. Histologically, the tumor showed a microcystic arrangement with cribriform areas and formation of adenomatous structures. The microcystic and cribriform areas were composed of larger pale cells and smaller eosinophilic cells, with cytological features of conventional chromophobe renal cell carcinoma (CRCC). The cytological features of the cells within the adenomatous structures were different. These cells were mostly columnar with nuclei at the base, and had a variable amount of pale to eosinophilic cytoplasm. There were foci of ample brown pigmentation located in the cytoplasm of the tumor cells and extracellularly. In addition, microscopic calcifications were present. Immunohistochemically, the tumor cells were positive for EMA, E-cadherin, cytokeratin CAM5.2, and cytokeratin AE1/AE3. Cytokeratin 7 was positive only focally. S-100 protein, melan A, HMB 45, vimentin, and CD117 were negative. PMCRCC is a rare tumor. To the best of our knowledge, only one series containing 20 cases of this variant of CRCC has been described to date. The important feature is that PMCRCC seems to have a relatively benign biological behavior, and distant metastases and sarcomatoid transformation are absent.
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Affiliation(s)
- Pavel Dundr
- Institute of Pathology, 1st Medical Faculty and General Faculty Hospital, Charles University, Studnickova 2, Prague 128 00, Czech Republic.
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Dundr P, Pesl M, Povýsil C, Prokopová P, Pavlík I, Soukup V, Dvorácek J. Anaplastic variant of spermatocytic seminoma. Pathol Res Pract 2007; 203:621-4. [PMID: 17651911 DOI: 10.1016/j.prp.2007.04.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2007] [Revised: 04/14/2007] [Accepted: 04/25/2007] [Indexed: 10/23/2022]
Abstract
We report a case of a 56-year-old male with an anaplastic variant of spermatocytic seminoma of the left testis. Grossly, the tumor measured 10 x 7.5 x 6.5 cm and consisted of soft grayish-white tissue, which varied from fleshy to gelatinous with formation of some pseudocysts. Histologically, the tumor was composed of the areas of typical spermatocytic seminoma; however, in some areas, the intermediate and large tumor cells showed prominent nucleoli. In another part of the tumor, we noted anaplastic areas composed of sheets of tumor cells with large vesicular nuclei and prominent nucleoli. Tunical and vascular invasion as well as growth into the epididymis were noted. Immunohistochemically, the tumor cells showed only weak positivity for CD117, the other markers examined were negative.
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Affiliation(s)
- Pavel Dundr
- Institute of Pathology, 1st Faculty of Medicine and General Faculty Hospital, Charles University, Studnickova 2, Prague 128 00, Czech Republic.
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Babjuk M, Hanus T, Safarík L, Dvorácek J, Pavlík I, Soukup V, Pesl M, Szakacsová M, Dusková J. [Cystectomy in the treatment of bladder cancer]. Cas Lek Cesk 2007; 146:751-757. [PMID: 18020006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Radical cystectomy with pelvic lymphadenectomy and urinary diversion is an important component in the treatment of bladder cancer. It is considered the most important method in the therapy for muscle invasive and selected high-risk non-muscle invasive tumours with excellent local control and high complete remission rate. It consists of complete removal of tumour tissue in the bladder, small pelvis and regional lymph nodes. In males, urinary bladder and prostate are routinely removed; in females, bladder, uterus and anterior vaginal wall are removed. Urethrectomy is indicated only in selected situations. An integral part of the operation is the bilateral pelvic lymphadenectomy. Extravesical disease extension and lymph node positivity are unfavourable prognostic factors. Better prognosis is expected in patients with less than 5 positive nodes. Important prognostic factor is also the number of removed lymph nodes, which is a strong argument for meticulous bilateral pelvic lymphadenectomy. Lymph node density (number of positive nodes/ number of removed nodes) is considered as very important prognostic factor. Better prognosis can be expected in patients with less positive and more removed nodes.
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Affiliation(s)
- M Babjuk
- Urologická klinika 1, LF UK a VFN a Katedra urologie IPVZ, Praha.
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Soukup V, Babjuk M, Dusková J, Pesl M, Szakácsova M, Zámefnik L, Dvorácek J. [The p53 positivity in non-tumor mucosa in patients with superficial urinary bladder cancer]. Cas Lek Cesk 2007; 146:63-7. [PMID: 17310587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND The aim of the study is to assess the prognostic value of p53 positivity in the non-tumor mucosa of urinary bladder in patients with superficial urinary bladder carcinoma. METHODS AND RESULTS In 45 patients cold cup non-tumor mucosa samples were taken at the same time with the TUR of superficial urinary bladder carcinoma prospectively. Monoclonal antibody BP53-12-1 was used for the detection of p53 protein. When identifying positive colouring only the nuclear immunoreactivity was being evaluated. 200 nuclei at minimum were examined in several representative fields. The McCarthy method in Bacus modification was used to analyse the findings. It is a semiquantitative method which detects not only the percentage of p53 positive cells but also the intensity of positivity classified into four degrees (0 - negative, 1 - slightly positive, 2 - distinctly positive, 3 - strongly positive). The intensity of p53 positivity was quantified as HSCORE, where HSCORE = 7Pi (i + 1), in which i is one of the four see above degrees and Pi fluctuates from 0 % to 100 %. The result is a numerical figure from 100-400. A negative finding is of HSCORE 100, HSCORE of 400 is the highest possible. The samples were analysed in the analytical system LUCIA. The borderline value was quantified to HSCORE 200. All patients were carefully followed up and treated using usual schemes. The results were evaluated by the use of SAS system (Cary, USA). Thirty patients recurred during the follow-up and 7 of them progressed. The average HSCORE in those who did not recur was 130.2, in patients with the recurrence of tumor it was 162.5 and in patients with progression it was 169.2. We have found a correlation between the HSCORE and the risk of recurrence, which was statistically significant. CONCLUSIONS The p53 positivity in non-tumor mucosa of urinary bladder in patients with superficial bladder cancer may bring additional information when predicting the risk of recurrence. More extensive studies need to be carried out.
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Affiliation(s)
- V Soukup
- Urologická klinika 1. LF UK a VFN, Praha.
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Macek P, Novák K, Hanus T, Babjuk M, Pesl M, Safarík L, Fógel K, Soukup V, Dvorácek J, Sedlácek J, Stolz J, Capoun O. [Analysis of results of percutaneous nephrolithotomies]. Cas Lek Cesk 2007; 146:809-812. [PMID: 18020017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Percutaneous nephrolithotomy is an effective less invasive method for the treatment of nephrolithiasis. Authors retrospectively analysed results of this procedure performed in a single centre (Department of Urology, General University Hospital, Prague) from January 2005 till June 2007. METHODS AND RESULTS Patients were acquired by an analysis of operating reports performed over a period January 2005 till June 2007 and subsequently a retrospective analysis of electronic and paper patient's records was carried out. Percutaneous nephrolithotomy was performed in 150 patients. Of those, 117 (78%) patients underwent primary and 33 (21.3%) secondary procedure. Analysed group consisted of 85 (56.7%) men and 65 (43.3%) women. Right-sided procedure was performed in 46% (69 times) and left-sided in 54% (81 times) of cases. Mean patient's age was 52.9 years (SD +/- 16.3). Mean stone size was 18.3 (SD +/- 9.5) mm. Staghorn calculi were present in 19 (12.7%) patients and 77 (51.3%) patients had more than 1 stone. Intracorporeal lithotripsy was necessary in 82 (54.7%) cases. Seventy eight (52.9%) patients were stone free after the procedure. There were 24 (16%) patients with an anatomic abnormality of upper urinary tract. The most common (in 64.3%) component in analysed stones was a calcium oxalate. CONCLUSIONS The amount of stone free patients is rather lower compared to the literature results. However, definitive results are always affected by auxiliary procedures (mainly extracorporeal shock wave lithotripsy), which are not included in the analysis.
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Affiliation(s)
- P Macek
- Urologická klinika 1. LF UK a VFN, Praha.
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Babjuk M, Soukup V, Pesl M, Kostirova M, Tejckova J, Dvoracek J, Pavlik I. MP-12.13. Urology 2006. [DOI: 10.1016/j.urology.2006.08.418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Babjuk M, Soukup V, Mares J, Dusková J, Pecen L, Pesl M, Pavlík I, DvorRcek J. Association of PAX5 expression with clinical outcome in patients with TaT1 transitional cell carcinoma of the bladder. Urology 2006; 67:756-61. [PMID: 16566978 DOI: 10.1016/j.urology.2005.10.053] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2005] [Revised: 10/03/2005] [Accepted: 10/28/2005] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess the frequency and intensity of PAX5 gene messenger ribonucleic acid (mRNA) expression in TaT1 bladder cancer tissue, as well as its correlation with clinicopathologic variables and patient outcome. METHODS The RNA expression of PAX5 was evaluated with reverse transcriptase polymerase chain reaction in the tumor tissue of 75 patients with stage TaT1 bladder cancer treated with transurethral resection. Patients were observed with cystoscopy and urinary cytologic evaluation. The association between PAX5 expression and clinicopathologic variables and patient outcome was evaluated. Benign urothelium from 8 patients with benign prostatic hyperplasia was obtained. These patients were used as a control group. RESULTS PAX5 expression was found in 62 patients with bladder cancer (82.7%) but in no patient from the control group. High PAX5 expression (greater than 0.2) was confirmed in 19 patients (25.3%). No significant relationship was observed between quantity of PAX5 expression and clinicopathologic variables. The 3-year recurrence-free and progression-free survival rates in highly positive patients were 13.2% and 71.6%, compared with 40.6% and 92.8%, respectively, in patients with weak or negative expression (log-rank test, P = 0.0075, P = 0.022). Multivariate Cox proportional hazard model analysis identified PAX5 expression as an independent predictor of tumor recurrence. CONCLUSIONS PAX5 gene expression is a frequent finding in superficial transitional cell carcinoma of the bladder. High levels of PAX5 are associated with poorer recurrence-free and progression-free survival rates. Moreover, PAX5 expression was found to be an independent prognostic factor for recurrence-free survival by a multivariate analysis.
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Affiliation(s)
- M Babjuk
- Department of Urology, General Faculty Hospital, 1st Medical Faculty, Charles University, Postgraduate Institute, Praha, Czech Republic.
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Trkova M, Babjuk M, Duskova J, Benesova-Minarikova L, Soukup V, Mares J, Minarik M, Sedlacek Z. Analysis of genetic events in 17p13 and 9p21 regions supports predominant monoclonal origin of multifocal and recurrent bladder cancer. Cancer Lett 2005; 242:68-76. [PMID: 16343743 DOI: 10.1016/j.canlet.2005.10.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2005] [Revised: 10/25/2005] [Accepted: 10/25/2005] [Indexed: 01/06/2023]
Abstract
Clonality was tested in 86 tumours from 25 patients with recurrent and multifocal superficial bladder transitional cell carcinomas (TCCs) using the analysis of TP53 mutations and of LOH in the 17p13 and 9p21 regions. Tumours from the majority of individuals showed either absence or presence of the same TP53 mutation and/or an identical LOH pattern, with the same allele lost in all tumours. Only two pairs of tumours from two patients had discordant findings, which were incompatible with monoclonality. Therefore, our results rather support the monoclonal model of development of highly recurrent superficial bladder TCCs.
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Affiliation(s)
- Marie Trkova
- Institute of Biology and Medical Genetics, Charles University Second Medical School, V uvalu 84, 15006 Prague, Czech Republic.
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