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1. Benedetti-Panici P, Zullo MA, Plotti F, Manci N, Muzii L, Angioli R: Long-term bladder function in patients with locally advanced cervical carcinoma treated with neoadjuvant chemotherapy and type 3-4 radical hysterectomy. Cancer; 2004 May 15;100(10):2110-7
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  • [Title] Long-term bladder function in patients with locally advanced cervical carcinoma treated with neoadjuvant chemotherapy and type 3-4 radical hysterectomy.
  • BACKGROUND: The objective of the current study was to evaluate the incidence of long-term bladder dysfunction after type 3-4 radical hysterectomy in patients with locally advanced cervical carcinoma treated with neoadjuvant chemotherapy (NACT).
  • METHODS: A case-control study was conducted to evaluate the occurrence of long-term bladder dysfunction in 76 patients with International Federation of Gynecology and Obstetrics Stage IB-IIA (> 4 cm), Stage IIB, and Stage III cervical carcinoma who underwent type 3-4 radical hysterectomy after NACT.
  • Preoperative assessment included acquisition of a standardized urogynecologic history, evaluation of severity of urinary incontinence symptoms, maintenance of a 3-day voiding diary, pelvic examination, urogynecologic physical examination, urodynamic assessment, and estimation of hydronephrosis.
  • RESULTS: Urinary symptoms (sensory loss, difficult micturition, severe urinary incontinence) were reported by 20 patients (26%).
  • Eighteen patients (24%) had a normal urodynamic profile, 16 patients (21%) had detrusor overactivity, 22 patients (29%) had urodynamic stress incontinence, 2 patients (2%) had aconctractile detrusor, and 18 patients (24%) had mixed urinary incontinence.
  • The length of vagina removed was significantly greater among patients who had detrusor overactivity and mixed urinary incontinence compared with patients who had a normal diagnosis.
  • CONCLUSIONS: The observed rate of bladder dysfunction was higher than the corresponding rate reported in the literature (76%).
  • Three main disturbances were found: detrusor overactivity (21%), mixed urinary incontinence (24%), and de novo stress incontinence (21%).
  • Detrusor overactivity was related to a prevalence of hypertonic bladder.
  • Among patients who underwent type 4 radical hysterectomy, the extent of caudal resection of rectovaginal ligaments and vaginal tissue was found to be more strongly associated with bladder dysfunction than was the extent of lateral parametrial resection.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Hysterectomy. Urinary Bladder / physiopathology. Uterine Cervical Neoplasms / physiopathology. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / surgery. Adult. Aged. Aged, 80 and over. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / surgery. Case-Control Studies. Female. Humans. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging. Prospective Studies. Time Factors. Urinary Incontinence, Stress / etiology

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  • [Copyright] Copyright 2004 American Cancer Society.
  • (PMID = 15139052.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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2. Choong NW, Quevedo JF, Kaur JS: Small cell carcinoma of the urinary bladder. The Mayo Clinic experience. Cancer; 2005 Mar 15;103(6):1172-8
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  • [Title] Small cell carcinoma of the urinary bladder. The Mayo Clinic experience.
  • BACKGROUND: Small cell carcinoma (SCC) of the urinary bladder accounts for 0.35-0.70% of all bladder tumors.
  • There is no standard approach to the management of SCC of the urinary bladder.
  • METHODS: The authors performed a retrospective study at Mayo Clinic (Rochester, MN) to characterize the clinical and pathologic features of patients with SCC of the urinary bladder diagnosed between 1975 and 2003 with emphasis on management.
  • RESULTS: Forty-four patients were identified who had primary bladder SCC, 61.4% of whom had pure SCC.
  • Twelve patients (27.3%) had Stage II disease, 13 patients (29.6%) had Stage III disease, and 19 patients (43.2%) had Stage IV disease.
  • The 5-year survival rates for patients with Stage II, III, and IV disease were 63.6%, 15.4%, and 10.5%, respectively.
  • Six of eight patients with Stage II bladder SCC achieved a cure with radical cystectomy.
  • Five patients with Stage IV disease had obvious metastases and received chemotherapy.
  • Fourteen patients underwent radical cystectomy and were diagnosed later with locally advanced disease (T4b) or lymph node metastasis (N1-N3; Stage IV disease).
  • Only 2 of 19 patients with Stage IV disease who received adjuvant chemotherapy were alive at 5 years.
  • CONCLUSIONS: Patients with bladder SCC should undergo radical cystectomy except when metastatic disease is present (M1), in which case, systemic chemotherapy is indicated.
  • Adjuvant treatment is not indicated for patients with Stage II disease after radical cystectomy but should be considered for patients with Stage III and IV disease.
  • Chemotherapy should be a platinum-based regimen.
  • [MeSH-major] Carcinoma, Small Cell / pathology. Carcinoma, Small Cell / therapy. Neoplasm Invasiveness / pathology. Neoplasm Recurrence, Local / epidemiology. Urinary Bladder Neoplasms / pathology. Urinary Bladder Neoplasms / therapy
  • [MeSH-minor] Age Distribution. Aged. Aged, 80 and over. Biopsy, Needle. Chemotherapy, Adjuvant. Combined Modality Therapy. Cystectomy / methods. Disease-Free Survival. Female. Humans. Immunohistochemistry. Incidence. Male. Middle Aged. Neoplasm Staging. Prognosis. Retrospective Studies. Risk Assessment. Sex Distribution. Survival Analysis

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  • (PMID = 15700264.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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3. Herchenhorn D, Dienstmann R, Peixoto FA, de Campos FS, Santos VO, Moreira DM, Cardoso H, Small IA, Ferreira CG: Phase II trial of neoadjuvant gemcitabine and cisplatin in patients with resectable bladder carcinoma. Int Braz J Urol; 2007 Sep-Oct;33(5):630-8; discussion 638
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  • [Title] Phase II trial of neoadjuvant gemcitabine and cisplatin in patients with resectable bladder carcinoma.
  • OBJECTIVES: Gemcitabine and cisplatin (GC) is an active combination in the treatment of metastatic bladder cancer.
  • We have prospectively analyzed the efficacy and tolerability of GC as neoadjuvant treatment of invasive bladder cancer.
  • MATERIALS AND METHODS: In this single-institution phase II trial, patients with muscle-invasive transitional cell carcinoma received three cycles of gemcitabine 1200 mg/m2 on days 1 and 8 with cisplatin 75 mg/m2 on day 1 prior to surgery.
  • Radiologic response was evaluated by computed tomography and magnetic resonance imaging.
  • All patients were referred to surgery after chemotherapy completion.
  • Initial stage was II (T2) in 11 and III (T3-4) in 11 patients.
  • One patient was excluded due to sarcomatoid carcinoma at definitive pathologic examination.
  • Grade III/IV toxicity was infrequent, with no deaths due to chemotherapy.
  • CONCLUSIONS: The combination of GC is effective and well-tolerated when used as neoadjuvant therapy in muscle-invasive bladder cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Transitional Cell / drug therapy. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Middle Aged. Prospective Studies. Treatment Outcome

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  • [CommentIn] Int Braz J Urol. 2007 Nov-Dec;33(6):840-1 [18199355.001]
  • (PMID = 17980060.001).
  • [ISSN] 1677-5538
  • [Journal-full-title] International braz j urol : official journal of the Brazilian Society of Urology
  • [ISO-abbreviation] Int Braz J Urol
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Brazil
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine; Q20Q21Q62J / Cisplatin
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4. Donat SM: Integrating perioperative chemotherapy into the treatment of muscle-invasive bladder cancer: strategy versus reality. J Natl Compr Canc Netw; 2009 Jan;7(1):40-7
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  • [Title] Integrating perioperative chemotherapy into the treatment of muscle-invasive bladder cancer: strategy versus reality.
  • Since the initial report in 2003 of the Intergroup-0080 trial confirming benefit of combined neoadjuvant M-VAC (methotrexate, vinblastine, adriablastine, and cisplatin) chemotherapy and cystectomy in the treatment of muscle-invasive bladder cancer, debate has continued in the literature as to the relative risk/benefits of integrating perioperative chemotherapy into the care of patients, especially in those with organ-confined, muscle-invasive, node-negative disease in whom the benefit may be less.
  • Because of the inaccuracies of clinical staging, the potential morbidity related to M-VAC chemotherapy, a 70% cure rate in pT2No disease with surgery alone, and only a modest (5%) improvement in absolute overall survival with combined therapy, many favor limiting chemotherapy to patients with a pathologic stage of pT3 or greater or node-positive disease.
  • This philosophy was also reflected in the 2008 National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Bladder Cancer, in which neoadjuvant chemotherapy for clinical T2 disease versus adjuvant therapy based on pathologic risks is only "considered."
  • Additionally, a recent study looking at the perioperative integration of chemotherapy for stage III bladder cancer in the United States using the National Cancer Data Base showed that only 11.6% of patients underwent any perioperative chemotherapy, with most in the adjuvant setting.
  • These findings indicate that despite randomized trial data showing survival benefit for perioperative chemotherapy, and the current guidelines for therapy supporting those findings, chemotherapy is not being integrated well into the care of patients with muscle-invasive bladder cancer, even in those who, experts agree, have the most potential for benefit.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Cystectomy. Muscle Neoplasms / drug therapy. Muscle Neoplasms / surgery. Platinum Compounds / administration & dosage. Urinary Bladder Neoplasms / drug therapy. Urinary Bladder Neoplasms / surgery
  • [MeSH-minor] Chemotherapy, Adjuvant. Decision Making. Guideline Adherence. Humans. Multivariate Analysis. Neoadjuvant Therapy. Neoplasm Invasiveness. Randomized Controlled Trials as Topic. Treatment Outcome

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  • (PMID = 19176204.001).
  • [ISSN] 1540-1405
  • [Journal-full-title] Journal of the National Comprehensive Cancer Network : JNCCN
  • [ISO-abbreviation] J Natl Compr Canc Netw
  • [Language] eng
  • [Publication-type] Journal Article; Meta-Analysis; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Platinum Compounds
  • [Number-of-references] 42
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5. Goffin JR, Rajan R, Souhami L: Tolerance of radiotherapy and chemotherapy in elderly patients with bladder cancer. Am J Clin Oncol; 2004 Apr;27(2):172-7
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  • [Title] Tolerance of radiotherapy and chemotherapy in elderly patients with bladder cancer.
  • Bladder-sparing radiotherapy with concurrent chemotherapy may be a reasonable alternative to cystectomy in patients with invasive bladder cancer.
  • The purpose of this study was to determine the tolerance of combined treatment in elderly patients.
  • In this retrospective study, the records of patients 70 or more years of age with stage T2-T4a, N0, M0 disease who were treated with bladder-sparing regimens between 1985 and 2000 were examined for toxicity.
  • Of 149 consecutive patients treated for cancer of the bladder, 14 patients met eligibility criteria.
  • All patients had at least mild toxicity, with 6 of 14 patients having grade III to IV toxicity.
  • Grade III to IV toxicities included one patient with grade IV neutropenia, three with grade III gastrointestinal toxicities, one patient with grade III urinary frequency, one patient with grade IV ureteral obstruction who required stent placement, and one episode of hydration-induced grade III heart failure.
  • Two of 14 patients stopped chemotherapy and 5 patients required dose reductions for toxicity.
  • The observed rates of toxicity compare favorably with studies of bladder-sparing therapy in patients with median ages less than 70 years.
  • Our study shows that bladder-sparing radiotherapy with concurrent chemotherapy is feasible in patients 70 or more years of age, and should be considered for such patients if they are inoperable or strongly wish to avoid cystectomy.
  • [MeSH-major] Urinary Bladder Neoplasms / drug therapy. Urinary Bladder Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Transitional Cell / drug therapy. Carcinoma, Transitional Cell / radiotherapy. Cisplatin / administration & dosage. Combined Modality Therapy. Dose Fractionation. Female. Fluorouracil / administration & dosage. Humans. Male. Methotrexate / administration & dosage. Retrospective Studies. Survival Analysis. Treatment Outcome. Vinblastine / administration & dosage

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  • (PMID = 15057157.001).
  • [ISSN] 1537-453X
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 5V9KLZ54CY / Vinblastine; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; YL5FZ2Y5U1 / Methotrexate
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6. David KA, Milowsky MI, Ritchey J, Carroll PR, Nanus DM: Low incidence of perioperative chemotherapy for stage III bladder cancer 1998 to 2003: a report from the National Cancer Data Base. J Urol; 2007 Aug;178(2):451-4
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  • [Title] Low incidence of perioperative chemotherapy for stage III bladder cancer 1998 to 2003: a report from the National Cancer Data Base.
  • PURPOSE: Studies of perioperative chemotherapy for muscle invasive bladder cancer have shown a survival benefit with combined modality therapy.
  • We reviewed chemotherapy use in patients with stage III transitional cell carcinoma of the bladder from 1998 to 2003 to evaluate perioperative chemotherapy treatment patterns.
  • MATERIALS AND METHODS: The National Cancer Data Base collected data on approximately 60% of all newly diagnosed bladder cancer cases in the United States from 1998 to 2003.
  • We queried the National Cancer Data Base for all treatment of male and female patients 18 years old or older with bladder transitional cell carcinoma diagnosed between 1998 and 2003.
  • A total of 224,060 bladder transitional cell carcinoma records were reviewed.
  • Perioperative chemotherapy was defined as chemotherapy given within 4 months before and 4 months after surgery.
  • Of 11,339 cases of stage III bladder cancer treatment, analysis was possible for 7,161.
  • RESULTS: Treatment patterns were analyzed in 7,161 patients with stage III bladder transitional cell carcinoma.
  • Perioperative chemotherapy was administered to 11.6% of patients with stage III bladder transitional cell carcinoma with 10.4% receiving adjuvant chemotherapy and 1.2% receiving neoadjuvant chemotherapy.
  • When comparing perioperative chemotherapy use by diagnosis year in 1998 and 2003, a small statistically significant increase was observed using the Pearson's chi-square test with Bonferroni correction (p <0.05) at 11.3% of patients in 1998 vs 16.8% in 2003.
  • CONCLUSIONS: Perioperative chemotherapy is underused in the management of surgically resectable stage III transitional cell carcinoma of the bladder.
  • This finding may reflect a delay in implementing the results of recently reported randomized trials, a low incidence of referrals by urologists for chemotherapy and/or confidence in salvage chemotherapy as an equivalent alternative.
  • Further followup will determine if this treatment pattern changes in the future.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma, Transitional Cell / drug therapy. Chemotherapy, Adjuvant / utilization. Neoadjuvant Therapy / utilization. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Combined Modality Therapy / utilization. Cystectomy. Databases, Factual. Female. Humans. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Retrospective Studies. United States. Urinary Bladder / pathology. Utilization Review

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  • (PMID = 17561135.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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7. Sylvester RJ, Brausi MA, Kirkels WJ, Hoeltl W, Calais Da Silva F, Powell PH, Prescott S, Kirkali Z, van de Beek C, Gorlia T, de Reijke TM, EORTC Genito-Urinary Tract Cancer Group: Long-term efficacy results of EORTC genito-urinary group randomized phase 3 study 30911 comparing intravesical instillations of epirubicin, bacillus Calmette-Guérin, and bacillus Calmette-Guérin plus isoniazid in patients with intermediate- and high-risk stage Ta T1 urothelial carcinoma of the bladder. Eur Urol; 2010 May;57(5):766-73
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  • [Title] Long-term efficacy results of EORTC genito-urinary group randomized phase 3 study 30911 comparing intravesical instillations of epirubicin, bacillus Calmette-Guérin, and bacillus Calmette-Guérin plus isoniazid in patients with intermediate- and high-risk stage Ta T1 urothelial carcinoma of the bladder.
  • BACKGROUND: Intravesical chemotherapy and bacillus Calmette-Guérin (BCG) reduce the recurrence rate in patients with stage Ta T1 urothelial bladder cancer; however, the benefit of BCG relative to chemotherapy for long-term end points is controversial, especially in intermediate-risk patients.
  • DESIGN, SETTING, AND PARTICIPANTS: From January 1992 to February 1997, 957 patients with intermediate- or high-risk stage Ta T1 urothelial bladder cancer were randomized after transurethral resection to one of three treatment groups in the European Organization for Research and Treatment of Cancer Genito-Urinary Group phase 3 trial 30911.
  • MEASUREMENTS: End points were time to recurrence, progression, distant metastases, overall survival, and disease-specific survival.
  • RESULTS AND LIMITATIONS: With 837 eligible patients and a median follow-up of 9.2 yr, time to first recurrence (p<0.001), distant metastases (p=0.046), overall survival (p=0.023), and disease-specific survival (p=0.026) were significantly longer in the two BCG arms combined as compared with epirubicin; however, there was no difference for progression.
  • Three hundred twenty-three patients with stage T1 or grade 3 tumors were high risk, and the remaining 497 patients were intermediate risk.
  • The observed treatment benefit was at least as large, if not larger, in the intermediate-risk patients compared with the high-risk patients.
  • CONCLUSIONS: In patients with intermediate- and high-risk stage Ta and T1 urothelial bladder cancer, intravesical BCG with or without INH is superior to intravesical epirubicin not only for time to first recurrence but also for time to distant metastases, overall survival, and disease-specific survival.
  • TRIAL REGISTRATION: This study was registered with the US National Cancer Institute clinical trials database [protocol ID: EORTC-30911]. http://www.cancer.gov/search/ViewClinicalTrials.aspx?cdrid=77075&version=HealthProfessional&protocolsearchid=6540260.

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  • [Copyright] Copyright © 2009 European Association of Urology. Published by Elsevier B.V. All rights reserved.
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  • (PMID = 20034729.001).
  • [ISSN] 1873-7560
  • [Journal-full-title] European urology
  • [ISO-abbreviation] Eur. Urol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / U10 CA011488; United States / NCI NIH HHS / CA / U10 CA011488-39; United States / NCI NIH HHS / CA / CA011488-38; United States / NCI NIH HHS / CA / CA011488-37; United States / NCI NIH HHS / CA / CA011488-39; United States / NCI NIH HHS / CA / U10 CA011488-38; United States / NCI NIH HHS / CA / 5U10 CA011488-37; United States / NCI NIH HHS / CA / 5U10 CA011488-39; United States / NCI NIH HHS / CA / U10 CA011488-37
  • [Publication-type] Clinical Trial, Phase III; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / Antibiotics, Antineoplastic; 0 / BCG Vaccine; 3Z8479ZZ5X / Epirubicin; V83O1VOZ8L / Isoniazid
  • [Other-IDs] NLM/ NIHMS167431; NLM/ PMC2889174
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8. Fakhr I, El-Hossieny H, Salama A: Delayed Cystectomy for T1G3 Transitional Cell Carcinoma (TCC) of the Urinary Bladder, NCI Retrospective Case Series. J Egypt Natl Canc Inst; 2008 Dec;20(4):387-94

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  • [Title] Delayed Cystectomy for T1G3 Transitional Cell Carcinoma (TCC) of the Urinary Bladder, NCI Retrospective Case Series.
  • AIM: We aim to evaluate the National Cancer Institute (NCI) treatment protocol and its outcome regarding recurrence, progression and survival in patients with T1G3 urinary bladder transitional cell carcinoma.
  • PATIENTS AND METHODS: In a retrospective study, between January 2001 and December 2007, all 34 patients with T1G3 bladder transitional cell carcinoma (TCC), after complete transurethral resection (TURBT), received intravesical BCG as adjuvant therapy.
  • Final analysis was made at median follow-up of 15 months (Range of 3-68 months, mean 18 months) for survival.
  • Two (20.0%) of them, were staged as TNM stage II, 6 (60.0%) as TNM stage III and 2 (20.0%) patients were TNM stage IV.
  • Eight (72.7%) of these 11 patients had post-cystectomy radiotherapy alone; while the 2 (6.0%) other patients with stage IV had adjuvant concomitant Cisplatin and Gemcitabine chemotherapy.
  • CONCLUSION: Adjuvant intravesical therapy with BCG with repeated cystoscopies, and delayed radical cystectomy until progression to the invasive disease carries a significant risk of mortality from invasive disease.
  • This treatment policy may be acceptable for T1G3 bladder TCC, without concomitant carcinoma in situ (CIS), who don't recur after intravesical BCG, however, patients who progress to invasive disease may skip stage II disease and present with stage III or IV, with consequent poor survival.
  • Therefore, due to the aggressive biologic behavior of T1G3 cancer, a determination of a cutoff number for recurrence(s) or better evaluation parameters are needed, to proceed with cystectomy without awaiting muscle invasion.
  • KEY WORDS: Superficial bladder cancer - T1G3 TCC - Delayed cystectomy - BCG.

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  • (PMID = 20571597.001).
  • [ISSN] 1110-0362
  • [Journal-full-title] Journal of the Egyptian National Cancer Institute
  • [ISO-abbreviation] J Egypt Natl Canc Inst
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Egypt
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9. Altay B, Girgin C, Kefi A, Cikili N: The best management of superficial bladder tumours: comparing TUR alone versus TUR combined with intravesical chemotherapy modalities? Int Urol Nephrol; 2000;32(1):53-8
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  • [Title] The best management of superficial bladder tumours: comparing TUR alone versus TUR combined with intravesical chemotherapy modalities?
  • To compare retrospectively the recurrence rates of TUR alone versus different intravesical chemotherapy modalities in superficial bladder cancer cases, 187 patients with stage Ta and T1 bladder tumours were treated with transurethral resection followed by adjuvant intravesical chemotherapy with mitomycin, BCG or epirubicin or by transurethral resection alone.
  • All patients in this study had historically proven transurethrally resectable primary, category Ta and T1 transitional cell carcinoma (TCC) of the bladder.
  • Group I included transurethral resection alone, and the other groups included intravesical mitomycin-C (Group II), BCG (Group III) and epirubicin (Group IV) therapies after transurethral resection.
  • 146 male and 41 female patients (78% male and 22% female patients) in this study were diagnosed as primary TCC bladder tumours.
  • Only 52 of them were stage Ta and 135 of them were stage T1 bladder tumours.
  • Examining the histological grade of the bladder tumours, 88 (47%) of the patients had grade I, 53 (28%) had grade IIa, 30 (16%) had grade IIb and remaining 16 (9%) had grade III bladder cancers.
  • The recurrence rates were 25% for Group I, 23.8% for Group II, 26.2% for Group III and 22.7% for Group IV.
  • These values were given with disregarding the grade and volume of the bladder tumours.
  • For solitary, less than 3 cm low grade tumours (grade I, IIa) recurrence rates were 16% for Group I, 15.4% for Group II, 17.8% for Group III, 17.2% for Group IV (p > 0.05).
  • As a result of this retrospective study, for patients with low grade, stage Ta and T1 tumours TUR alone may be the best treatment modality.
  • Although intravesical chemotherapy is effective in decreasing short-term incidences of tumour recurrence, it has not decreased long-term incidences of tumour recurrence.
  • The high cost and adverse side effects of intravesical chemotherapy should also be taken into consideration in superficial, single, low grade tumours of bladder.
  • [MeSH-major] Carcinoma, Transitional Cell / drug therapy. Carcinoma, Transitional Cell / surgery. Urinary Bladder Neoplasms / drug therapy. Urinary Bladder Neoplasms / surgery
  • [MeSH-minor] Administration, Intravesical. Adult. Aged. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / epidemiology. Neoplasm Staging. Retrospective Studies

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  • [Cites] J Urol. 1983 Dec;130(6):1083-6 [6644886.001]
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  • (PMID = 11057773.001).
  • [ISSN] 0301-1623
  • [Journal-full-title] International urology and nephrology
  • [ISO-abbreviation] Int Urol Nephrol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Netherlands
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10. Kobayashi K, Furukawa A, Takahashi M, Murata K: Neoadjuvant intra-arterial chemotherapy for locally advanced uterine cervical cancer: clinical efficacy and factors influencing response. Cardiovasc Intervent Radiol; 2003 May-Jun;26(3):234-41
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  • [Title] Neoadjuvant intra-arterial chemotherapy for locally advanced uterine cervical cancer: clinical efficacy and factors influencing response.
  • PURPOSE: To evaluate the effects of neoadjuvant intra-arterial chemotherapy (NAIC) for locally advanced uterine cervical cancer, and to analyze factors influencing the response to the chemotherapy.
  • METHODS: Thirty-four patients with invasive cervical cancer more than 4 cm in diameter were enrolled in this study.
  • Six of the 14 stage III patients became operable.
  • Twenty-eight of the 38 parametrial halves were free from cancer.
  • CONCLUSION: NAIC for locally advanced cervical cancer is useful for preoperative tumor reduction.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Infusions, Intra-Arterial. Neoadjuvant Therapy. Uterine Cervical Neoplasms / drug therapy. Uterine Neoplasms / drug therapy
  • [MeSH-minor] Adenocarcinoma / diagnosis. Adenocarcinoma / drug therapy. Adenocarcinoma / epidemiology. Adult. Aged. Antineoplastic Agents / administration & dosage. Carcinoma, Small Cell / diagnosis. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / epidemiology. Cisplatin / administration & dosage. Disease-Free Survival. Etoposide / administration & dosage. Female. Femoral Artery / radiography. Femoral Artery / surgery. Humans. Iliac Artery / radiography. Iliac Artery / surgery. Japan. Magnetic Resonance Imaging. Middle Aged. Necrosis. Neoplasm Staging. Retrospective Studies. Risk Factors. Treatment Outcome. Urinary Bladder / pathology. Women's Health


11. Andreadis C, Touloupidis S, Galaktidou G, Kortsaris AH, Boutis A, Mouratidou D: Serum CYFRA 21-1 in patients with invasive bladder cancer and its relevance as a tumor marker during chemotherapy. J Urol; 2005 Nov;174(5):1771-5; discussion 1775-6
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  • [Title] Serum CYFRA 21-1 in patients with invasive bladder cancer and its relevance as a tumor marker during chemotherapy.
  • PURPOSE: Previous studies have shown that serum levels of the degradation products of cytokeratins could be used as surrogate markers in the diagnosis and followup of patients with solid tumors, including tumors of the bladder.
  • MATERIALS AND METHODS: The soluble cytokeratin 19 fragment CYFRA 21-1 was measured by solid phase radioimmunoassay in the serum of 142 patients with invasive transitional cell cancer of the bladder.
  • Of the patients 56 had clinical stage I to III locally confined disease (T1-4aN0M0) and 86 had stage IV metastatic disease with lymph node and/or distant metastases.
  • In a subgroup of 49 patients with metastatic disease receiving combined platinum based chemotherapy serum CYFRA 21-1 was determined prior to the initiation of therapy and after the documentation of response.
  • Moreover, in the subgroup of patients with metastatic disease receiving chemotherapy CYFRA 21-1 levels correlated with the response to treatment.
  • CONCLUSIONS: Patients with transitional cell cancer of the bladder with evidence of distant metastases showed a significant increase in serum CYFRA 21-1.
  • During chemotherapy CYFRA 21-1 appears to be a potentially sensitive and useful indicator for monitoring treatment response.
  • [MeSH-major] Antigens, Neoplasm / blood. Biomarkers, Tumor / blood. Carcinoma, Transitional Cell / drug therapy. Neoplasm Invasiveness / pathology. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Aged. Analysis of Variance. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Case-Control Studies. Cohort Studies. Female. Humans. Keratin-19. Keratins. Male. Middle Aged. Monitoring, Physiologic / methods. Neoplasm Staging. Prognosis. Reference Values. Risk Assessment. Sensitivity and Specificity. Statistics, Nonparametric. Survival Analysis. Treatment Outcome

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  • (PMID = 16217281.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / Keratin-19; 0 / antigen CYFRA21.1; 68238-35-7 / Keratins
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12. Kommoss F, Kommoss S, Schmidt D, Trunk MJ, Pfisterer J, du Bois A, Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom: Survival benefit for patients with advanced-stage transitional cell carcinomas vs. other subtypes of ovarian carcinoma after chemotherapy with platinum and paclitaxel. Gynecol Oncol; 2005 Apr;97(1):195-9
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  • [Title] Survival benefit for patients with advanced-stage transitional cell carcinomas vs. other subtypes of ovarian carcinoma after chemotherapy with platinum and paclitaxel.
  • OBJECTIVE: Transitional cell carcinoma (TCC) of the ovary is a less well recognized histological type of ovarian carcinoma resembling TCC of the urinary bladder.
  • It was the aim of the present retrospective study to compare incidence and outcome of patients with TCCs and other subtypes of ovarian carcinoma from a large homogeneous collective of patients with primary advanced-stage ovarian carcinoma.
  • METHODS: H and E-stained sections from a total of 302 cases from a prospective randomized, multi-center, phase III study of patients with ovarian cancer, FIGO-stages IIB-IV, comparing cisplatin plus paclitaxel (PT) with paclitaxel plus carboplatin (TC) were available for histological retyping of ovarian carcinomas applying current WHO criteria.
  • 5-year survival of patients with TCC was 57% as compared to 31% for patients with ovarian carcinomas of other types (P = 0.03).
  • In the current series, TCCs had a significantly better prognosis as compared to all other types of ovarian carcinomas after standardized chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Transitional Cell / drug therapy. Ovarian Neoplasms / drug therapy

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  • (PMID = 15790458.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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13. García González J, Pérez Fentes D, Aliste Santos C, Suárez Peñaranda JM, León Mateos L, López López R: [Use of M-VAC in the adjuvant treatment of sarcomatoid carcinoma of the bladder]. Actas Urol Esp; 2009 Apr;33(4):447-9
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  • [Title] [Use of M-VAC in the adjuvant treatment of sarcomatoid carcinoma of the bladder].
  • [Transliterated title] Empleo de M-VAC en el tratamiento adyuvante del carcinoma sarcomatoide de vejiga.
  • Sarcomatoid bladder carcinoma is a high-grade neoplasm and accounts for approximately 0,3% of all bladder malignancies.
  • Sarcomatoid carcinoma originates from transitional cells of the bladder.
  • Sarcomatoid carcinoma is charactericed by a epithelial component and a sarcomatoid component, consisting of spindle cells, that is only epithelial marker-positive.
  • We report a 26-year-old woman diagnosed of stage III sarcomatoid bladder carcinoma (T3aN0M0) treated with partial cistectomy followed by 4 cycles of adjuvant chemotherapy with methotrexate, vinblastine, doxorubicin and cisplatin.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Transitional Cell / drug therapy. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Cisplatin / therapeutic use. Doxorubicin / therapeutic use. Female. Humans. Methotrexate / therapeutic use. Vinblastine / therapeutic use

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  • (PMID = 19579900.001).
  • [ISSN] 0210-4806
  • [Journal-full-title] Actas urologicas espanolas
  • [ISO-abbreviation] Actas Urol Esp
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Spain
  • [Chemical-registry-number] 5V9KLZ54CY / Vinblastine; 80168379AG / Doxorubicin; Q20Q21Q62J / Cisplatin; YL5FZ2Y5U1 / Methotrexate; M-VAC protocol
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14. Duque JL, Loughlin KR: An overview of the treatment of superficial bladder cancer. Intravesical chemotherapy. Urol Clin North Am; 2000 Feb;27(1):125-35, x
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  • [Title] An overview of the treatment of superficial bladder cancer. Intravesical chemotherapy.
  • Superficial bladder cancer accounts for approximately 70% to 80% of all newly diagnosed bladder cancers.
  • The vast majority of these cancers are transitional bladder tumors of various histologic grades (I to III).
  • Superficial tumors include carcinoma in situ (CIS), tumors confined to the epithelium (Ta), and superficial tumors that invade the lamina propria (T1) but do not involve superficial muscle layers.
  • The primary treatment for eradication of stage Ta and T1 bladder cancers is transurethral resection of the tumor.
  • Many patients with superficial bladder tumors treated with endoscopic surgery alone have recurrence or tumor progression at some point in their follow-up, and, in these patients, the need for adjuvant treatment becomes a major concern.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Administration, Intravesical. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma in Situ / drug therapy. Clinical Trials as Topic. Combined Modality Therapy. Doxorubicin / therapeutic use. Epirubicin / therapeutic use. Ethoglucid / therapeutic use. Humans. Immunotherapy. Mitomycin / therapeutic use. Thiotepa / therapeutic use

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  • (PMID = 10696251.001).
  • [ISSN] 0094-0143
  • [Journal-full-title] The Urologic clinics of North America
  • [ISO-abbreviation] Urol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 3Z8479ZZ5X / Epirubicin; 4F9KUA0T4D / Ethoglucid; 50SG953SK6 / Mitomycin; 80168379AG / Doxorubicin; 905Z5W3GKH / Thiotepa
  • [Number-of-references] 72
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15. Khaled HM, Hamza MR, Mansour O, Gaafar R, Zaghloul MS: A phase II study of gemcitabine plus cisplatin chemotherapy in advanced bilharzial bladder carcinoma. Eur J Cancer; 2000 Jul;36 Suppl 2:34-7
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  • [Title] A phase II study of gemcitabine plus cisplatin chemotherapy in advanced bilharzial bladder carcinoma.
  • Bilharzial bladder cancer represents a distinct clinicopathological entity.
  • To investigate whether gemcitabine-cisplatin is also active against bladder cancer of bilharzial origin, we performed a phase II study of previously untreated patients with stage III/IV disease.
  • Thus, these data suggest that gemcitabine plus cisplatin induces high response rates in patients with bilharzial bladder cancer with a moderate toxicity profile.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Transitional Cell / drug therapy. Schistosomiasis / drug therapy. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cisplatin / administration & dosage. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Female. Humans. Male. Middle Aged. Treatment Outcome

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  • (PMID = 10908847.001).
  • [ISSN] 0959-8049
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine; Q20Q21Q62J / Cisplatin
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16. Yamamoto G, Shimada T, Nishida T, Ishida Y, Iba T, Nakata T, Ohtsuki T, Takigami K, Yamaguchi Y, Yoshitake K, Tanaka A, Tsuda Y: [Evaluation of a combination chemotherapy with nedaplatin and 5-FU for oral cancers]. Gan To Kagaku Ryoho; 2001 Aug;28(8):1111-5
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  • [Title] [Evaluation of a combination chemotherapy with nedaplatin and 5-FU for oral cancers].
  • Nedaplatin (cis-diammine-glycolato platinum: CDGP) is a platinum compound with a molecular weight of 303.18 that was recently developed in Japan.
  • There have been reports of the antineoplastic effects of Nedaplatin on cancers in the cranio-cervical region, lung, esophagus, urinary bladder, testis, ovary, and uterus.
  • In this study, we performed combined therapy of CDGP and fluorouracil (5-FU) for 8 patients with oral cancers, and evaluated the results to elucidate the clinical effect and adverse side effects.
  • The subjects were 8 patients with squamous cell carcinoma (5 males and 3 females aged 33-65 years).
  • The primary carcinoma regions were the tongue in 5 patients, oral floor in 2 patients, and mandibular gingiva in 1 patient.
  • The T-classification was T2 in 6 patients and T4 in 2 patients, and the clinical staging was Stage II in 5 patients, Stage III in 1 patient and Stage IV in 2 patients.
  • One patient was Grade IIA, 5 patients Grade IIB, and 2 patients Grade III.
  • Although the oral cancers in this study were extroverted superficial ulcerative cancers, and the number of patients was low at 8, this combined therapy is considered useful and worth evaluating in further accumulated cases.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Mouth Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Organoplatinum Compounds / administration & dosage. Remission Induction

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  • (PMID = 11525027.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Clinical Trial; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 8UQ3W6JXAN / nedaplatin; U3P01618RT / Fluorouracil
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17. Khaled H, Emara ME, Gaafar RM, Mansour O, Abdel Warith A, Zaghloul MS, El Malt O: Primary chemotherapy with low-dose prolonged infusion gemcitabine and cisplatin in patients with bladder cancer: a Phase II trial. Urol Oncol; 2008 Mar-Apr;26(2):133-6
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  • [Title] Primary chemotherapy with low-dose prolonged infusion gemcitabine and cisplatin in patients with bladder cancer: a Phase II trial.
  • BACKGROUND: Gemcitabine is an active agent in the treatment of bladder cancer.
  • After an infusion during 30 minutes, this enzyme will be saturated, therefore, accumulation of higher intracellular concentrations of the active gemcitabine triphosphate could be achieved by prolonging the infusion time of gemcitabine.
  • PATIENTS AND METHODS: Based on previously published Phase I trials, the efficacy and safety of a combination of cisplatin and gemcitabine given as prolonged infusion were tried in a Phase II study of 57 untreated patients with stage III/IV bladder cancer, which is the most common malignant tumor among Egyptian males.
  • A total of 37 patients had transitional cell, 15 had squamous cell, 2 had adenocarcinoma, and 3 had undifferentiated cell carcinoma.
  • CONCLUSIONS: Prolonged infusion of gemcitabine and cisplatin is an effective treatment for advanced bilharzial-related bladder cancer.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Cisplatin / administration & dosage. Deoxycytidine / analogs & derivatives. Urinary Bladder Neoplasms / drug therapy

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  • (PMID = 18312930.001).
  • [ISSN] 1078-1439
  • [Journal-full-title] Urologic oncology
  • [ISO-abbreviation] Urol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine; Q20Q21Q62J / Cisplatin
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18. Mangar SA, Logue JP, Shanks JH, Cooper RA, Cowan RA, Wylie JP: Small-cell carcinoma of the urinary bladder: 10-year experience. Clin Oncol (R Coll Radiol); 2004 Dec;16(8):523-7
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  • [Title] Small-cell carcinoma of the urinary bladder: 10-year experience.
  • AIMS: Small-cell carcinoma of the urinary bladder is rarely encountered in clinical practice.
  • MATERIALS AND METHODS: We retrospectively analysed 14 pathologically confirmed cases, specifically looking at stage, presenting features, treatment and overall survival.
  • RESULTS: Ten patients presented with stage III disease, and four patients with stage IV disease (1 = nodal, 3 = distant metastases).
  • Four patients were treated with radical radiotherapy (one patient receiving neoadjuvant chemotherapy) and two underwent a radical cystoprostatectomy.
  • Five patients received palliative bladder radiotherapy and three were too frail for treatment at presentation.
  • Patients receiving radical treatment had a median overall survival of 21 months, with only one long-term survivor.
  • Many are unfit for radical treatment.
  • In patients with disease confined to the pelvis who are able to tolerate radical intervention, the results of local therapy alone are poor.
  • Initial chemotherapy analogous to small-cell lung cancer may offer a durable response with a better chance for long-term survival.
  • [MeSH-major] Carcinoma, Small Cell / surgery. Cystectomy. Neoplasm Staging. Urinary Bladder Neoplasms / surgery
  • [MeSH-minor] Aged. Aged, 80 and over. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoadjuvant Therapy. Prognosis. Retrospective Studies. Survival Analysis

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  • (PMID = 15630844.001).
  • [ISSN] 0936-6555
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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19. Marín AP, Arranz EE, Sánchez AR, Auñón PZ, Barón MG: Role of anti-Her-2 therapy in bladder carcinoma. J Cancer Res Clin Oncol; 2010 Dec;136(12):1915-20
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  • [Title] Role of anti-Her-2 therapy in bladder carcinoma.
  • Bladder cancer, in its advanced stage, has very few therapeutic strategies with proven efficacy.
  • Platinum-combination chemotherapy can be considered a standard for first-line therapy, but after progression there is no standard therapy, and the prognosis is very poor.
  • The development of targeted therapies in the last few years has significantly changed the prognosis of a wide variety of tumors.
  • In bladder cancer, there is no targeted therapy currently approved for its use in advanced disease.
  • There is evidence that Her-2 amplification and/or overexpression is seen in bladder cancer, and may influence prognosis.
  • Anti-Her-2 drugs, such as trastuzumab or lapatinib, are under investigation in urothelial neoplasms, but there is no phase III trial that has evaluated their use in bladder cancer.
  • We review the published evidence about Her-2 determination, its influence on bladder carcinoma prognosis, the clinical development of anti-Her-2-targeted therapies, and the possible future research directions involving this pathway in bladder cancer.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Quinazolines / therapeutic use. Receptor, ErbB-2 / antagonists & inhibitors. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Antibodies, Monoclonal, Humanized. Antineoplastic Agents / therapeutic use. Gene Expression Regulation, Neoplastic. Humans. Models, Biological. Prognosis. Signal Transduction / drug effects. Trastuzumab

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  • (PMID = 20213094.001).
  • [ISSN] 1432-1335
  • [Journal-full-title] Journal of cancer research and clinical oncology
  • [ISO-abbreviation] J. Cancer Res. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Antineoplastic Agents; 0 / Quinazolines; 0VUA21238F / lapatinib; EC 2.7.10.1 / Receptor, ErbB-2; P188ANX8CK / Trastuzumab
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20. Lertsanguansinchai P, Lertbutsayanukul C, Shotelersuk K, Khorprasert C, Rojpornpradit P, Chottetanaprasith T, Srisuthep A, Suriyapee S, Jumpangern C, Tresukosol D, Charoonsantikul C: Phase III randomized trial comparing LDR and HDR brachytherapy in treatment of cervical carcinoma. Int J Radiat Oncol Biol Phys; 2004 Aug 1;59(5):1424-31
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  • [Title] Phase III randomized trial comparing LDR and HDR brachytherapy in treatment of cervical carcinoma.
  • PURPOSE: Intracavitary brachytherapy plays an important role in the treatment of cervical carcinoma.
  • We performed a prospective randomized clinical trial to compare the clinical outcomes between low-dose-rate (LDR) and high-dose-rate (HDR) intracavitary brachytherapy for treatment of invasive uterine cervical carcinoma.
  • METHODS AND MATERIALS: A total of 237 patients with previously untreated invasive carcinoma of the uterine cervix treated at King Chulalongkorn Memorial Hospital were randomized between June 1995 and December 2001.
  • Excluding ineligible, incomplete treatment, and incomplete data patients, 109 and 112 patients were in the LDR and HDR groups, respectively.
  • All patients were treated with external beam radiotherapy and LDR or HDR intracavitary brachytherapy using the Chulalongkorn treatment schedule.
  • The 3-year overall survival rate in the LDR and HDR groups was 70.9% and 68.4% (p = 0.75) and the 3-year pelvic control rate was 89.1% and 86.4% (p = 0.51), respectively.
  • The 3-year relapse-free survival rate in both groups was 69.9% (p = 0.35).
  • Most recurrences were distant metastases, especially in Stage IIB and IIIB patients.
  • The high number of distant failure suggests that other modalities such as systemic concurrent or adjuvant chemotherapy might lower this high recurrence, especially in Stage IIB and IIIB.
  • [MeSH-minor] Adult. Aged. Cesium Radioisotopes / therapeutic use. Female. Humans. Intestine, Small / radiation effects. Iridium Radioisotopes / therapeutic use. Middle Aged. Prospective Studies. Radiation Injuries / etiology. Radiotherapy Dosage. Rectum / radiation effects. Survival Rate. Treatment Failure. Urinary Bladder / radiation effects

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  • (PMID = 15275728.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Cesium Radioisotopes; 0 / Iridium Radioisotopes
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21. Heudel P, El Karak F, Ismaili N, Droz JP, Flechon A: Micropapillary bladder cancer: a review of Léon Bérard Cancer Center experience. BMC Urol; 2009;9:5
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  • [Title] Micropapillary bladder cancer: a review of Léon Bérard Cancer Center experience.
  • BACKGROUND: Micropapillary bladder cancer is a rare and aggressive variant of urothelial carcinoma.
  • A retrospective review of our experience in management of patients with muscle-invasive or metastatic micropapillary bladder cancer was performed to better define the behavior of this disease.
  • METHODS: We reviewed the records of the 11 patients with micropapillary bladder cancer who were evaluated and treated at Léon Bérard Cancer Center between 1994 and 2007, accounting for 1,2% of all urothelial tumors treated in this institution.
  • Two patients presented with stage II, one with stage III and eight with stage IV disease All 5 patients who had node positive metastases and treated with radical surgery and adjuvant chemotherapy relapsed and had a disease free survival of 9.6 months.
  • CONCLUSION: Micropapillary bladder cancer is probably an underreported variant of urothelial carcinoma associated with poor prognosis.
  • Adjuvant chemotherapy might have a questionable efficacy and the optimal treatment strategy is yet to be defined.
  • [MeSH-major] Carcinoma, Papillary / mortality. Carcinoma, Papillary / therapy. Urinary Bladder Neoplasms / mortality. Urinary Bladder Neoplasms / therapy
  • [MeSH-minor] Aged. Cancer Care Facilities. Female. France / epidemiology. Humans. Male. Middle Aged. Prevalence. Retrospective Studies. Survival Analysis. Survival Rate. Treatment Outcome

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  • [Cites] Am J Surg Pathol. 2002 Mar;26(3):358-64 [11859208.001]
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  • (PMID = 19534791.001).
  • [ISSN] 1471-2490
  • [Journal-full-title] BMC urology
  • [ISO-abbreviation] BMC Urol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2713271
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22. Hayashi N, Asano K, Furuta A, Ikemoto I, Kishimoto K, Yamazaki H, Onishi T, Takahashi H, Oishi Y: [Invasive squamous cell carcinoma of the bladder: report of 18 cases and review of literature]. Nihon Hinyokika Gakkai Zasshi; 2004 Jul;95(5):711-7
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  • [Title] [Invasive squamous cell carcinoma of the bladder: report of 18 cases and review of literature].
  • PURPOSE: This study was undertaken to determine the most effective treatment for improvement of the prognosis of patients with squamous cell carcinoma of the bladder (SCC).
  • While clarifying the clinical patterns of these cases, the association between stage, therapy, and prognosis was studied.
  • Of the cases of invasive SCC reported in Japan in the recent 20 years, 54 cases in which the stage, therapy, and prognosis were documented were selected, and the association between the therapy and outcome in each stage was studied.
  • RESULTS: In our series, 11 cases are alive without cancer for over 2 years.
  • Cancer death was experienced in 7 patients.
  • Of these patients, 3 underwent cystectomy, and 6 were classified as stage III or higher.
  • As far as our study of the cases reported in Japan is concerned, the prognosis of the cases having undergone TUR or partial resection of the bladder alone was poor.
  • But, even if patients underwent cystectomy, most of the patients was cancer death in the cases whose cancer was stage III or higher.
  • In the patients receiving some supportive therapy, 4 patients receiving radiation plus cisplatin-based chemotherapy were all alive without for over 2 years.
  • CONCLUSIONS: Total cystectomy is most appropriate as the type of operation for the cases of invasive SCC.
  • But, the cases whose cancer was stage III or higher have high recurrence rate, and must be accompanied with some supportive therapy.
  • We concluded that radiation plus cisplatin-based chemotherapy is a candidate of most effective supportive therapy to improve the prognosis of those patients in the supportive therapy.
  • [MeSH-major] Carcinoma, Squamous Cell / pathology. Urinary Bladder Neoplasms / pathology
  • [MeSH-minor] Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Combined Modality Therapy. Cystectomy. Female. Humans. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Prognosis

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  • (PMID = 15354717.001).
  • [ISSN] 0021-5287
  • [Journal-full-title] Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology
  • [ISO-abbreviation] Nippon Hinyokika Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
  • [Number-of-references] 21
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23. Startsev VY: The role of combined method in organ-sparing treatment of muscle-invasive bladder cancer recurrences. Arch Ital Urol Androl; 2002 Jun;74(2):54-6
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  • [Title] The role of combined method in organ-sparing treatment of muscle-invasive bladder cancer recurrences.
  • OBJECTIVE: To determine the local control and survival of patients with bladder cancer recurrences (BCR) treated by operative methods, external beam radiotherapy (EBRT) and adjuvant chemotherapy (ACT).
  • All patients received different operations (transurethral resection and partial cystectomies) and definitive EBRT (total dose varied from 50 to 64 Gy with a mean of 60.5 Gy, 5 days a week).
  • In a second group of patients we performed 3 courses of 4-drug regimen ACT administered with EBRT.
  • ACT consisting of cisplatin and adriamycin i.a. and methotrexate and vinblastin i.v. (M-VAC) was administered on the fourth week after radiation therapy.
  • The complete response rates in patients with clinical stage T2 and T3a disease was 64.4 and 44.4%, respectively and it was slightly higher in patients with a non-papillary cancer than in those with a papillary one.
  • The acute toxicity was mild: no hematological and renal toxicity over grade II, 14 (7.8%) cases of bowel or rectal reversible grade II toxicity and 12 (6.7%) cases of reversible grade III cystitis.
  • CONCLUSIONS: Four-drug ACT is feasible without major toxicity and offers a potentially curative and conservative treatment for patients with localized muscle-invasive BC (bladder cancer) recurrences.
  • Bladder conservation therapy may be offered to selected patients with BC recurrences as an alternative option to radical cystectomy, and its use should be limited to teams of uro-oncologists, experienced in multi-modalty treatment.

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  • (PMID = 12161935.001).
  • [ISSN] 1124-3562
  • [Journal-full-title] Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica
  • [ISO-abbreviation] Arch Ital Urol Androl
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / BCG Vaccine; 5V9KLZ54CY / Vinblastine; 80168379AG / Doxorubicin; Q20Q21Q62J / Cisplatin; YL5FZ2Y5U1 / Methotrexate
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24. Weiss C, Sauer R, Rödel C: [Radiochemotherapeutic options for bladder cancer]. Aktuelle Urol; 2008 Mar;39(2):123-9
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  • [Title] [Radiochemotherapeutic options for bladder cancer].
  • Radical cystectomy remains the standard of care for muscle-invasive bladder cancer, while for high-risk superficial carcinoma an organ-preserving approach, including transurethral resection (TUR) and intravesical therapy, is recommended.
  • This review summarizes the radiochemotherpeutic options for high risk T1 or muscle-invasive bladder cancer - as an alternative for/or neoadjuvant therapy before radical surgery.
  • Multimodality therapy, including TUR, radiation, and chemotherapy, is associated with recurrence and progression rates of 30 % and 15 %, respectively, in high-risk T1 bladder cancer.
  • Approximately 80 % of the surviving patients maintained their own, well functioning bladder.
  • Ideal candidates for the organ-preserving approach are those with early-stage unifocal tumours (T1/T2).
  • Preoperative radiochemotherapy is likely to improve the results of cystectomy alone in patients with locally advanced bladder cancer (T3b, T4).
  • [MeSH-major] Chemotherapy, Adjuvant. Cystectomy / methods. Radiotherapy, Adjuvant. Urinary Bladder Neoplasms / therapy
  • [MeSH-minor] Antimetabolites, Antineoplastic / therapeutic use. Antineoplastic Agents / therapeutic use. Bridged Compounds / therapeutic use. Cisplatin / therapeutic use. Clinical Trials, Phase III as Topic. Combined Modality Therapy. Deoxycytidine / analogs & derivatives. Deoxycytidine / therapeutic use. Fluorouracil / therapeutic use. Follow-Up Studies. Humans. Multicenter Studies as Topic. Neoadjuvant Therapy. Neoplasm Staging. Preoperative Care. Radiotherapy Dosage. Randomized Controlled Trials as Topic. Risk Factors. Salvage Therapy. Taxoids / therapeutic use. Time Factors. Urinary Bladder / pathology

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  • (PMID = 18379965.001).
  • [ISSN] 0001-7868
  • [Journal-full-title] Aktuelle Urologie
  • [ISO-abbreviation] Aktuelle Urol
  • [Language] ger
  • [Publication-type] Comparative Study; English Abstract; Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 0 / Bridged Compounds; 0 / Taxoids; 0W860991D6 / Deoxycytidine; 1605-68-1 / taxane; B76N6SBZ8R / gemcitabine; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Number-of-references] 45
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25. Castagneto B, Zai S, Marenco D, Bertetto O, Repetto L, Scaltriti L, Mencoboni M, Ferraris V, Botta M: Single-agent gemcitabine in previously untreated elderly patients with advanced bladder carcinoma: response to treatment and correlation with the comprehensive geriatric assessment. Oncology; 2004;67(1):27-32
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  • [Title] Single-agent gemcitabine in previously untreated elderly patients with advanced bladder carcinoma: response to treatment and correlation with the comprehensive geriatric assessment.
  • OBJECTIVE: The study aimed at evaluating the activity and toxicity of gemcitabine monochemotherapy in a unselected series of elderly patients with advanced bladder cancer.
  • The secondary objectives were to establish whether there is a correlation between treatment and Comprehensive Geriatric Assessment (CGA) and, in addition, to determine overall patient survival.
  • METHODS: Treatment consisted of six courses of chemotherapy with gemcitabine at a dosage of 1,200 mg/m2 on days 1 and 8, every 21 days.
  • CGA, as described by Gruppo Italiano di Oncologia Geriatrica, was assessed for evaluating the functional status of patients before, during, and after treatment.
  • Characteristics of patients: median age 76 years (range 71-87); ECOG performance status (PS) 1 in 12 patients and 2 in 13 patients; clinical stage III in 6 patients and IV in 19 patients.
  • At the end of the therapy the parameters of CGA improved in 4 cases (17%), remained unchanged in 17 cases (74%) and worsened only in 2 cases (9%).
  • Median overall survival was 8 months and median time to progression was 5 months.
  • Treatment was generally well tolerated, with 1 patient having grade 3 gastrointestinal toxicity and 3 having grade 4 neutropenia.
  • CONCLUSIONS: We conclude that gemcitabine can be safely administered in monochemotherapy, is effective and does not worsen the functional status of elderly patients with advanced bladder cancer.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Carcinoma / drug therapy. Deoxycytidine / analogs & derivatives. Deoxycytidine / therapeutic use. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Aged. Aged, 80 and over. Disease-Free Survival. Drug Administration Schedule. Female. Geriatric Assessment. Humans. Male. Survival Analysis. Treatment Outcome

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  • [Copyright] Copyright 2004 S. Karger AG, Basel
  • (PMID = 15459492.001).
  • [ISSN] 0030-2414
  • [Journal-full-title] Oncology
  • [ISO-abbreviation] Oncology
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine
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26. Lebret T, Bohin D, Kassardjian Z, Herve JM, Molinie V, Barre P, Lugagne PM, Botto H: Recurrence, progression and success in stage Ta grade 3 bladder tumors treated with low dose bacillus Calmette-Guerin instillations. J Urol; 2000 Jan;163(1):63-7
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  • [Title] Recurrence, progression and success in stage Ta grade 3 bladder tumors treated with low dose bacillus Calmette-Guerin instillations.
  • PURPOSE: Bacillus Calmette-Guerin (BCG) therapy is considered to be an effective prophylactic and therapeutic agent for high risk superficial transitional cell carcinoma of the bladder.
  • Nevertheless, in a select uncommon population of stage Ta grade 3 superficial lamina-free tumors the results of this treatment have not yet been well established.
  • We evaluated recurrence and progression rates, and the success of BCG therapy in a population with stage Ta grade 3 transitional cell carcinoma of the bladder.
  • MATERIALS AND METHODS: Of the 605 patients treated at our institution from 1982 to 1996 for the histopathological diagnosis of primary bladder cancer 32 (5.3%) with stage Ta grade 3 noninvasive primary bladder tumor were treated with intravesical instillations of 75 mg.
  • At a followup of 2 to 13 years (mean 58.4 months) patients were evaluated with urinary cytology, cystoscopy, transurethral resection and random mucosal biopsies.
  • Recurrence, grade and stage progression, death and causality were analyzed.
  • RESULTS: Of the 32 patients 9 (28%) responded positively to BCG without recurrence, while disease recurred as stage Ta in 8 (25%) and T1 in 7 (22%), and progressed to muscle layer infiltration in 8 (25%).
  • Four patients (12%) died of bladder cancer.
  • The number of tumors at primary resection, gross examination, the mitotic index or an association with carcinoma in situ did not appear to be predictive factors of progression to muscle invasion.
  • Urine cytology (I to II versus III to IV) appeared to correlate highly with progression and BCG response (p<0.001) with excellent sensitivity (1) but low specificity (0.67).
  • CONCLUSIONS: Our study demonstrates the high progression potential of stage Ta grade 3 tumors, since nearly 50% recurred and 25% progressed to invasive disease.
  • These results may be closely compared with the results of previous trials of stage T1 grade 3 disease.
  • We suggest that recurrence should be detected at an early stage using long-term followup with strict observance of the surveillance protocols during a minimum 5-year tumor-free period.
  • [MeSH-major] Adjuvants, Immunologic / administration & dosage. BCG Vaccine / administration & dosage. Carcinoma, Transitional Cell / drug therapy. Carcinoma, Transitional Cell / pathology. Neoplasm Recurrence, Local / epidemiology. Urinary Bladder Neoplasms / drug therapy. Urinary Bladder Neoplasms / pathology

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  • [CommentIn] J Urol. 2000 Jan;163(1):79-80 [10604318.001]
  • (PMID = 10604315.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / BCG Vaccine
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27. Addeo R, Caraglia M, Bellini S, Abbruzzese A, Vincenzi B, Montella L, Miragliuolo A, Guarrasi R, Lanna M, Cennamo G, Faiola V, Del Prete S: Randomized phase III trial on gemcitabine versus mytomicin in recurrent superficial bladder cancer: evaluation of efficacy and tolerance. J Clin Oncol; 2010 Feb 1;28(4):543-8
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  • [Title] Randomized phase III trial on gemcitabine versus mytomicin in recurrent superficial bladder cancer: evaluation of efficacy and tolerance.
  • PURPOSE: Approximately 30% to 40% patients with a superficial bladder cancer treated with Bacille Calmette-Guerin (BCG) or epirubicin do not respond; of the initial responders, 35% have a relapse within 5 years.
  • We compare the therapeutic efficacy and toxicity of intravescical infusions of gemcitabine (GEM) with mitomycin (MMC) in patients with a recurrent superficial bladder cancer.
  • PATIENTS AND METHODS: Patients with a history of a previously treated, recurrent Ta-T1, G1-G3 bladder transitional cell carcinoma were enrolled in the study.
  • In both arms, for the initial responders who remained free of recurrences, maintenance therapy consisted of 10 monthly treatments during the first year.
  • RESULTS: A total of 120 patients were enrolled and randomly assigned to either the MMC or GEM treatment arm.
  • Among patients with recurrences, 10 in the MMC arm and six in the GEM arm also had a progressive disease by stage.
  • CONCLUSION: This study demonstrates that GEM has better efficacy and lower toxicity than MMC; therefore, GEM appears as a logical candidate for intrabladder therapy in patients with refractory transitional cancer.
  • [MeSH-major] Antibiotics, Antineoplastic / therapeutic use. Antimetabolites, Antineoplastic / therapeutic use. Carcinoma, Transitional Cell / drug therapy. Deoxycytidine / analogs & derivatives. Mitomycin / therapeutic use. Neoplasm Recurrence, Local / drug therapy. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Aged. Female. Humans. Male. Maximum Tolerated Dose. Neoplasm Staging. Prognosis. Survival Rate. Treatment Outcome


28. Efstathiou JA, Bae K, Shipley WU, Kaufman DS, Hagan MP, Heney NM, Sandler HM: Late pelvic toxicity after bladder-sparing therapy in patients with invasive bladder cancer: RTOG 89-03, 95-06, 97-06, 99-06. J Clin Oncol; 2009 Sep 1;27(25):4055-61
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  • [Title] Late pelvic toxicity after bladder-sparing therapy in patients with invasive bladder cancer: RTOG 89-03, 95-06, 97-06, 99-06.
  • PURPOSE: In selected patients with muscle-invasive bladder cancer, combined-modality therapy (transurethral resection bladder tumor [TURBT], radiation therapy, chemotherapy) with salvage cystectomy, if necessary, can achieve survival rates similar to radical cystectomy.
  • PATIENTS AND METHODS: Between 1990 and 2002, 285 eligible patients enrolled on four prospective protocols (Radiation Therapy Oncology Group [RTOG] 8903, 9506, 9706, 9906) and 157 underwent combined-modality therapy, surviving >or= 2 years from start of treatment with their bladder intact.
  • Rates of late genitourinary (GU) and GI toxicity were assessed using the RTOG Late Radiation Morbidity Schema, with worst toxicity grade (scale 0 to 5) occurring >or= 180 days after start of consolidation therapy reported for each patient.
  • Logistic and Cox regression analyses were performed to evaluate relationship between clinical characteristics, frequency, and time to late grade 3+ pelvic toxicity.
  • Covariates included age, sex, stage, presence of carcinoma in situ, completeness of TURBT, and protocol.
  • Notably there were no late grade 4 toxicities and no treatment-related deaths.
  • CONCLUSION: Rates of significant late pelvic toxicity for patients completing combined-modality therapy for invasive bladder cancer and retaining their native bladder are low.

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  • (PMID = 19636019.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / U10 CA32115; United States / NCI NIH HHS / CA / U10 CA21661; United States / NCI NIH HHS / CA / U10 CA37422; United States / NCI NIH HHS / CA / U10 CA037422; United States / NCI NIH HHS / CA / U10 CA021661; United States / NCI NIH HHS / CA / U10 CA032115
  • [Publication-type] Clinical Trial, Phase II; Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2734419
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29. Streeper NM, Simons CM, Konety BR, Muirhead DM, Williams RD, O'Donnell MA, Joudi FN: The significance of lymphovascular invasion in transurethral resection of bladder tumour and cystectomy specimens on the survival of patients with urothelial bladder cancer. BJU Int; 2009 Feb;103(4):475-9
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  • [Title] The significance of lymphovascular invasion in transurethral resection of bladder tumour and cystectomy specimens on the survival of patients with urothelial bladder cancer.
  • OBJECTIVE: To test the hypothesis that patients with bladder cancer who had evidence of lymphovascular invasion (LVI) in their transurethral resection of bladder tumour (TURBT) and radical cystectomy (RC) specimens would have a worse prognosis and higher likelihood of clinical understaging, and to assess the effect of LVI discovered at RC on subsequent disease-related mortality, as the prognostic significance of LVI in TURBT or RC specimens of patients treated for urothelial carcinoma of the bladder is not completely established.
  • PATIENTS AND METHODS: We retrospectively reviewed the records of 163 patients with urothelial carcinoma of the bladder seen at our institution, and who had TURBT (69) or RC (94) between 1995 and 2005.
  • LVI at TURBT varied with clinical stage (P = 0.049).
  • Patients with LVI and who were clinical stage I or II had lower survival than those without LVI (P = 0.049; hazard ratio 2.68).
  • LVI did not affect survival among those with clinical stage III or IV (P = 0.29).
  • Patients with LVI detected in their RC specimen were significantly more likely to have cancer recurrence than were those with no evidence of LVI (48% vs 19%, P = 0.006).
  • CONCLUSIONS: Our findings suggest that LVI is a histological feature that might be associated with a poorer prognosis in patients with urothelial carcinoma of the bladder.
  • The presence of LVI in TURBT specimens predicts shorter survival for patients with stage I or II disease.
  • Further studies are needed to determine whether this group of patients would benefit from early RC and/or perioperative chemotherapy to improve clinical outcomes.
  • [MeSH-major] Cystectomy / methods. Urinary Bladder Neoplasms / pathology. Vascular Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Prognosis. Regression Analysis. Retrospective Studies. Risk Factors. Survival Analysis. Treatment Outcome

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  • (PMID = 18990174.001).
  • [ISSN] 1464-410X
  • [Journal-full-title] BJU international
  • [ISO-abbreviation] BJU Int.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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30. Lehmann J, Retz M, Wiemers C, Beck J, Thüroff J, Weining C, Albers P, Frohneberg D, Becker T, Funke PJ, Walz P, Langbein S, Reiher F, Schiller M, Miller K, Roth S, Kälble T, Sternberg D, Wellek S, Stöckle M, AUO-AB 05/95: Adjuvant cisplatin plus methotrexate versus methotrexate, vinblastine, epirubicin, and cisplatin in locally advanced bladder cancer: results of a randomized, multicenter, phase III trial (AUO-AB 05/95). J Clin Oncol; 2005 Aug 1;23(22):4963-74
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  • [Title] Adjuvant cisplatin plus methotrexate versus methotrexate, vinblastine, epirubicin, and cisplatin in locally advanced bladder cancer: results of a randomized, multicenter, phase III trial (AUO-AB 05/95).
  • PURPOSE: Radical cystectomy as standard treatment of muscle-invasive urothelial carcinoma of the urinary bladder cures less than 50% of patients with locally advanced bladder cancer.
  • We compared two adjuvant combination chemotherapies in patients with stage pT3a-4a and/or pathologic node-positive transitional-cell carcinoma of the bladder after radical cystectomy.
  • PATIENTS AND METHODS: A total of 327 patients were randomly assigned to either adjuvant systemic chemotherapy with three cycles of cisplatin 70 mg/qm(2) on day 1 and methotrexate 40 mg/qm(2) on days 8 and 15 of a 21-day cycle (CM) or three cycles of methotrexate 30 mg/qm(2) on days 1, 15, and 22, vinblastine 3 mg/qm(2) on days 2, 15, and 22, epirubicin 45 mg/qm(2) on day 2, and cisplatin 70 mg/qm(2) on day 2 of a 28-day cycle (M-VEC).
  • The 5-year progression-free, tumor-specific, and overall survival rates (point estimates +/- SE) for CM versus M-VEC were 46.3% +/- 4.6% v 48.8% +/- 4.5%, 52.0% +/- 4.6% v 52.3% +/- 4.8%, and 46.1% +/- 4.3% v 45.1% +/- 4.6%, respectively.
  • WHO grade 3 and 4 leukopenia occurred in 7.0% of patients treated with CM and 22.2% of patients treated with M-VEC (P < .0001).
  • CONCLUSION: CM cannot be considered inferior to M-VEC with regard to progression-free survival of patients with locally advanced bladder cancer after radical cystectomy.
  • Moreover, patients receiving adjuvant CM combination therapy experienced significantly less grade 3 and 4 leukopenia than patients treated with M-VEC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Disease Progression. Epirubicin / administration & dosage. Female. Humans. Male. Methotrexate / administration & dosage. Middle Aged. Survival Analysis. Treatment Outcome. Vinblastine / administration & dosage

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  • [CommentIn] J Clin Oncol. 2005 Aug 1;23(22):4823-6 [15939919.001]
  • (PMID = 15939920.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; 5V9KLZ54CY / Vinblastine; Q20Q21Q62J / Cisplatin; YL5FZ2Y5U1 / Methotrexate; M-VEC protocol
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31. Ro JY, Shen SS, Lee HI, Hong EK, Lee YH, Cho NH, Jung SJ, Choi YJ, Ayala AG: Plasmacytoid transitional cell carcinoma of urinary bladder: a clinicopathologic study of 9 cases. Am J Surg Pathol; 2008 May;32(5):752-7
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  • [Title] Plasmacytoid transitional cell carcinoma of urinary bladder: a clinicopathologic study of 9 cases.
  • In this report, we summarized the clinicopathologic features of 9 cases of plasmacytoid transitional cell carcinoma (TCC) of the urinary bladder, a rare variant of TCC.
  • One patient had TNM stage I disease, 2 had stage II disease, 3 had stage III disease, and 3 had stage IV disease.
  • Four patients were treated by radical cystectomy with chemotherapy, 2 by radical cystectomy alone, 1 each by chemotherapy or intravesical bacillus Calmette-Guerin infusion alone, and 1 did not receive any further therapy.
  • Eight of 9 cases were associated with high-grade TCC, and transitional cell carcinoma in situ was present in 4 cases.
  • Interestingly, plasmacytoid transitional cell carcinoma in situ was noted in 1 case.
  • The mean follow-up in 8 patients was 24.5 months (range, 5 to 47 mo); the other patient was lost to follow-up.
  • In summary, plasmacytoid TCC tends to present at an advanced stage and to have a poor prognosis.
  • [MeSH-major] Carcinoma, Transitional Cell / pathology. Plasma Cells / pathology. Urinary Bladder Neoplasms / pathology
  • [MeSH-minor] Aged. Aged, 80 and over. Biomarkers, Tumor / analysis. Carcinoma in Situ / pathology. Cell Nucleus / pathology. Combined Modality Therapy. Cystoscopy. Cytoplasm / pathology. Humans. Immunohistochemistry. Male. Middle Aged. Neoplasm Staging. Prognosis. Treatment Outcome

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  • (PMID = 18379419.001).
  • [ISSN] 1532-0979
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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32. von der Maase H, Hansen SW, Roberts JT, Dogliotti L, Oliver T, Moore MJ, Bodrogi I, Albers P, Knuth A, Lippert CM, Kerbrat P, Sanchez Rovira P, Wersall P, Cleall SP, Roychowdhury DF, Tomlin I, Visseren-Grul CM, Conte PF: Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III study. J Clin Oncol; 2000 Sep;18(17):3068-77
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  • [Title] Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III study.
  • PURPOSE: Gemcitabine plus cisplatin (GC) and methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) were compared in patients with locally advanced or metastatic transitional-cell carcinoma (TCC) of the urothelium.
  • PATIENTS AND METHODS: Patients with stage IV TCC and no prior systemic chemotherapy were randomized to GC (gemcitabine 1,000 mg/m2 days 1, 8 and 15; cisplatin 70 mg/m2 day 2) or standard MVAC every 28 days for a maximum of six cycles.
  • Overall survival was similar on both arms (hazards ratio [HR], 1.04; 95% confidence interval [CI], 0.82 to 1.32; P = .75), as were time to progressive disease (HR, 1.05; 95% CI, 0.85 to 1.30), time to treatment failure (HR, 0.89; 95% CI 0.72 to 1.10), and response rate (GC, 49%; MVAC, 46%).
  • More GC patients completed six cycles of therapy, with fewer dose adjustments.
  • Quality of life was maintained during treatment on both arms; however, more patients on GC fared better regarding weight, performance status, and fatigue.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Transitional Cell / drug therapy. Deoxycytidine / analogs & derivatives. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Anti-Infective Agents / therapeutic use. Cisplatin / administration & dosage. Cisplatin / adverse effects. Doxorubicin / administration & dosage. Doxorubicin / adverse effects. Female. Granulocyte Colony-Stimulating Factor / therapeutic use. Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use. Hospitalization. Humans. Male. Methotrexate / administration & dosage. Methotrexate / adverse effects. Middle Aged. Neoplasm Metastasis. Neoplasm Staging. Prognosis. Quality of Life. Survival Analysis. Vinblastine / administration & dosage. Vinblastine / adverse effects

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  • [CommentIn] J Clin Oncol. 2001 Feb 15;19(4):1229-31 [11181690.001]
  • (PMID = 11001674.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anti-Infective Agents; 0W860991D6 / Deoxycytidine; 143011-72-7 / Granulocyte Colony-Stimulating Factor; 5V9KLZ54CY / Vinblastine; 80168379AG / Doxorubicin; 83869-56-1 / Granulocyte-Macrophage Colony-Stimulating Factor; B76N6SBZ8R / gemcitabine; Q20Q21Q62J / Cisplatin; YL5FZ2Y5U1 / Methotrexate; M-VAC protocol
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33. Mack D, Höltl W, Bassi P, Brausi M, Ferrari P, de Balincourt C, Sylvester R, European Organization for Research and Treatment of Cancer Genitourinary Group: The ablative effect of quarter dose bacillus Calmette-Guerin on a papillary marker lesion of the bladder. J Urol; 2001 Feb;165(2):401-3
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  • [Title] The ablative effect of quarter dose bacillus Calmette-Guerin on a papillary marker lesion of the bladder.
  • PURPOSE: Low dose bacillus Calmette-Guerin (BCG) for stage TaT1 transitional cell carcinoma of the bladder has been given in various studies with the aim of decreasing side effects while maintaining the same efficacy as full dose bacillus Calmette-Guerin.
  • We examined the ablative activity and incidence of side effects of intravesical quarter dose BCG given for a papillary marker lesion of the bladder.
  • MATERIALS AND METHODS: Included in our study were 44 patients with primary or recurrent, multiple but no more than 10 lesions of stage pTaT1, grades 1 to 2 transitional cell carcinoma of the bladder.
  • Intravesical treatment begun 14 days after the complete transurethral resection of all visible tumors except 1 marker lesion no larger than 1 cm. consisted of instillations of 30 mg.
  • RESULTS: There was a complete response in 27 of the 44 patients (61%), no response in 12 (27%) and progression to carcinoma in situ in 1 (2%), while the response was not evaluable in 4.
  • CONCLUSIONS: Quarter dose BCG has a clear ablative effect on superficial bladder cancer with a 61% response rate.
  • Phase III trials are now required to compare its efficacy and toxicity to those of full dose BCG.
  • [MeSH-major] Adjuvants, Immunologic / administration & dosage. BCG Vaccine / administration & dosage. Carcinoma, Transitional Cell / drug therapy. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Neoplasm Staging. Postoperative Care

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  • (PMID = 11176382.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / 2U10 CA11488-25; United States / NCI NIH HHS / CA / 2U10 CA11488-28; United States / NCI NIH HHS / CA / 5U10 CA11488-26; United States / NCI NIH HHS / CA / 5U10 CA11488-27
  • [Publication-type] Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / BCG Vaccine
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34. Chen WJ, Kuo JY, Chen KK, Lin AT, Chang YH, Chang LS: Primary urothelial carcinoma of the ureter: 11-year experience in Taipei Veterans General Hospital. J Chin Med Assoc; 2005 Nov;68(11):522-30

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  • [Title] Primary urothelial carcinoma of the ureter: 11-year experience in Taipei Veterans General Hospital.
  • BACKGROUND: Urothelial carcinoma of the upper urinary tract is relatively rare, occurring in 5% of all urothelial tumors.
  • Ureteral urothelial carcinoma is even less common than that of the renal pelvis, accounting for about 25% of all upper urinary tract tumors.
  • The aim of this study was to evaluate the clinical behavior, survival, recurrence and prognostic information of primary ureteral urothelial carcinoma from our 11 years of experience at the Taipei Veterans General Hospital.
  • METHODS: We retrospectively reviewed 111 patients with ureteral urothelial carcinoma who had been treated in our hospital between January 1993 and December 2003.
  • Tumor staging was according to the 2002 AJCC TNM classification and stage groupings.
  • Patients with stage Oa and stage Ois were categorized as stage Oa/is, and patients with pathologic T stage pTa and pTis were categorized as pTa/is for statistical analysis.
  • Of the 111 patients, 5 presented with stage Oa/is, 38 with stage I, 23 with stage II, 21 with stage III, and 24 with stage IV.
  • Nephroureterectomy with bladder cuff excision was performed in 78 patients, 12 patients received segmental resection of the ureter, 4 received ureteroscopic laser coagulation, and 17 underwent chemotherapy or radiotherapy or both.
  • Disease recurrence in the nephroureterectomy group occurred in 36 patients (46.2%), with 17 (21.8%) at the urinary bladder, 2 (2.6%) at the retroperitoneum, 1 (1.3%) at the contralateral ureter, 6 (7.7%) with distant metastases to the lung, bone, distant lymph nodes or liver, and 10 (12.8%) at multiple sites.
  • The 5-year cancer-specific survival rate was 100% for pTa/is, 95.2% for pT1, 69.4% for pT2, and 43.8% for pT3.
  • All 3 pT4 cases died of cancer in a median of 12 months.
  • Significant prognostic factors for cancer-specific survival by univariate analysis were pT (p = 0.00001), stage (p = 0.00001), type of treatment (p = 0.00001) and grade (p = 0.0001).
  • On multivariate analysis, only stage (p = 0.0001) and grade (p = 0.014) were significant for cancer-specific and overall survival.
  • Stage (p = 0.0001), pT (p =0.0001) and grade (p = 0.026) were also significant prognostic factors of recurrence in multivariate analysis.
  • Tumor stage and grade are the only significant prognostic factors for both cancer-specific and overall survival.

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  • (PMID = 16323396.001).
  • [ISSN] 1726-4901
  • [Journal-full-title] Journal of the Chinese Medical Association : JCMA
  • [ISO-abbreviation] J Chin Med Assoc
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China (Republic : 1949- )
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35. Waidelich R, Beyer W, Knüchel R, Stepp H, Baumgartner R, Schröder J, Hofstetter A, Kriegmair M: Whole bladder photodynamic therapy with 5-aminolevulinic acid using a white light source. Urology; 2003 Feb;61(2):332-7
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  • [Title] Whole bladder photodynamic therapy with 5-aminolevulinic acid using a white light source.
  • OBJECTIVES: To determine whether whole bladder photodynamic therapy after intravesical administration of 5-aminolevulinic acid using a white light source would destroy urothelial carcinoma.
  • We sought to define the optimal target group of patients for this therapy.
  • The side effects of treatment were also assessed.
  • METHODS: We performed whole bladder photodynamic therapy with 100 J/cm(2) white light 2 to 4.5 hours after intravesical administration of 17% 5-aminolevulinic acid in 12 patients with recurring, multifocal, Stage pTa, grade I to III, urothelial tumors of the bladder and carcinoma in situ.
  • RESULTS: Immediately after whole bladder irradiation, histologic examination of biopsies taken from flat suspicious lesions showed no viable cells; remnants of malignant cells were found in papillary tumors.
  • At a median follow-up of 18 months (range 3 to 25), 3 of the 7 patients with carcinoma in situ and 2 of the 4 patients with papillary tumors were free of disease.
  • In all patients, urinary frequency and urgency subsided within 3 weeks.
  • No decreased bladder capacity or systemic side effects were observed.
  • CONCLUSIONS: Our preliminary data show that whole bladder photodynamic therapy with intravesically applied 5-aminolevulinic acid using a white light source is effective in destroying flat malignant lesions of the bladder such as carcinoma in situ.
  • The procedure is easy to perform and is not associated with any major side effects.
  • [MeSH-major] Aminolevulinic Acid / therapeutic use. Carcinoma, Transitional Cell / drug therapy. Photochemotherapy / methods. Photosensitizing Agents / therapeutic use. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Administration, Intravesical. Biopsy. Carcinoma in Situ / drug therapy. Carcinoma in Situ / pathology. Follow-Up Studies. Humans. Treatment Outcome

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  • (PMID = 12597941.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Photosensitizing Agents; 88755TAZ87 / Aminolevulinic Acid
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36. Au JL, Badalament RA, Wientjes MG, Young DC, Warner JA, Venema PL, Pollifrone DL, Harbrecht JD, Chin JL, Lerner SP, Miles BJ, International Mitomycin C Consortium: Methods to improve efficacy of intravesical mitomycin C: results of a randomized phase III trial. J Natl Cancer Inst; 2001 Apr 18;93(8):597-604
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  • [Title] Methods to improve efficacy of intravesical mitomycin C: results of a randomized phase III trial.
  • BACKGROUND: Intravesical chemotherapy (i.e., placement of the drug directly in the bladder) with mitomycin C is beneficial for patients with superficial bladder cancer who are at high risk of recurrence, but standard therapy is empirically based and patient response rates have been variable, in part because of inadequate drug delivery.
  • We carried out a prospective, two-arm, randomized, multi-institutional phase III trial to test whether enhancing the drug's concentration in urine would improve its efficacy.
  • METHODS: Patients with histologically proven transitional cell carcinoma and at high risk for recurrence were eligible for the trial.
  • Patients in the optimized-treatment arm (n = 119) received a 40-mg dose of mitomycin C, pharmacokinetic manipulations to increase drug concentration by decreasing urine volume, and urine alkalinization to stabilize the drug.
  • Patients in the standard-treatment arm (n = 111) received a 20-mg dose without pharmacokinetic manipulations or urine alkalinization.
  • Both treatments were given weekly for 6 weeks.
  • Primary endpoints were recurrence and time to recurrence.
  • Treatment outcome was examined by use of Kaplan-Meier analysis with log-rank tests.
  • RESULTS: Patients in the two arms did not differ in demographics or history of intravesical therapy.
  • Dysuria occurred more frequently in the optimized arm but did not lead to more frequent treatment termination.
  • In an intent-to-treat analysis, patients in the optimized arm showed a longer median time to recurrence (29.1 months; 95% confidence interval [CI] = 14.0 to 44.2 months) and a greater recurrence-free fraction (41.0%; 95% CI = 30.9% to 51.1%) at 5 years than patients in the standard arm (11.8 months; 95% CI = 7.2 to 16.4 months) and 24.6% (95% CI = 14.9% to 34.3%) (P =.005, log-rank test for time to recurrence).
  • Improvements were found in all risk groups defined by tumor stage, grade, focality, and recurrence.
  • CONCLUSIONS: This study identified a pharmacologically optimized intravesical mitomycin C treatment with statistically significantly enhanced efficacy.
  • [MeSH-major] Antibiotics, Antineoplastic / administration & dosage. Carcinoma, Transitional Cell / drug therapy. Mitomycin / administration & dosage. Urinary Bladder Neoplasms / drug therapy

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  • [CommentIn] J Natl Cancer Inst. 2001 Apr 18;93(8):572-3 [11309425.001]
  • [CommentIn] J Natl Cancer Inst. 2001 Oct 17;93(20):1574-5 [11604485.001]
  • (PMID = 11309436.001).
  • [ISSN] 0027-8874
  • [Journal-full-title] Journal of the National Cancer Institute
  • [ISO-abbreviation] J. Natl. Cancer Inst.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / R01 CA58983; United States / NCI NIH HHS / CA / R01 CA58988; United States / NCI NIH HHS / CA / R01 CA58989
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 50SG953SK6 / Mitomycin
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37. Hobdy EM, Ciesielski TE, Kummar S: Unusual sites of colorectal cancer metastasis. Clin Colorectal Cancer; 2003 May;3(1):54-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Unusual sites of colorectal cancer metastasis.
  • We present 2 separate cases of adenocarcinoma of the colon with metastasis to the chin and the bladder, both of which are unusual sites of colorectal cancer metastasis.
  • Patient 1 is a 77-year-old man who was diagnosed with adenocarcinoma of the colon, American Joint Committee on Cancer (AJCC) T4 N0 M0 (stage II), and underwent a right hemicolectomy.
  • Fourteen months later he developed a firm 2.5-cm mass involving the chin.
  • Patient 2 is a 75-year-old man who was diagnosed with AJCC T3 N1 M0 (stage III) adenocarcinoma of the colon and underwent sigmoid colectomy.
  • Ten years later, he was found to have transitional cell carcinoma involving retroperitoneal nodes with no identifiable bladder or ureteral primary, for which he received chemotherapy.
  • Eighteen months following this diagnosis, he developed hematuria and was found to have metastatic colon adenocarcinoma involving the bladder.
  • [MeSH-major] Adenocarcinoma / diagnosis. Adenocarcinoma / secondary. Colorectal Neoplasms / diagnosis. Colorectal Neoplasms / pathology. Urinary Bladder Neoplasms / diagnosis. Urinary Bladder Neoplasms / secondary

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  • (PMID = 12777193.001).
  • [ISSN] 1533-0028
  • [Journal-full-title] Clinical colorectal cancer
  • [ISO-abbreviation] Clin Colorectal Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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38. Garlipp B, Ptok H, Schmidt U, Meyer F, Gastinger I, Lippert H: Neoadjuvant chemoradiotherapy for rectal carcinoma: effects on anastomotic leak rate and postoperative bladder dysfunction after non-emergency sphincter-preserving anterior rectal resection. Results of the Quality Assurance in Rectal Cancer Surgery multicenter observational trial. Langenbecks Arch Surg; 2010 Nov;395(8):1031-8
NCI CPTC Antibody Characterization Program. NCI CPTC Antibody Characterization Program .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Neoadjuvant chemoradiotherapy for rectal carcinoma: effects on anastomotic leak rate and postoperative bladder dysfunction after non-emergency sphincter-preserving anterior rectal resection. Results of the Quality Assurance in Rectal Cancer Surgery multicenter observational trial.
  • INTRODUCTION: Randomized trials have demonstrated a reduction in local recurrence rate in rectal cancer patients treated with preoperative chemoradiotherapy and total mesorectal excision (TME) compared to patients undergoing TME alone.
  • Accordingly, preoperative chemoradiotherapy in all UICC stages II and III rectal cancers has been recommended in the German treatment guidelines as of 2004.
  • However, this policy has been questioned in recent years, partly due to concern regarding an increase in postoperative complications through preoperative therapy.
  • It was the aim of our analysis to investigate the influence of preoperative chemoradiotherapy on anastomotic leak rate and postoperative bladder dysfunction in rectal cancer patients using a representative data set from the Quality Assurance in Rectal Cancer Surgery multicenter observational trial.
  • METHOD: This is a retrospective analysis of data from the Quality Assurance in Rectal Cancer Surgery prospective multicenter observational trial.
  • Data of all patients undergoing curatively intended sphincter-preserving resection for UICC stage I through III rectal carcinoma between 01 Jan 2005 and 31 Dec 2007 with or without preoperative chemoradiotherapy (groups A and B, respectively) were included.
  • Multivariate statistical analysis using propensity score analysis was carried out regarding outcome parameters total anastomotic leak rate, rate of anastomotic leaks requiring reoperation, and postoperative bladder dysfunction.
  • Significant differences were present between groups regarding age, sex, distance of the tumor from the anal verge, pT-stage, UICC stage, hepatic risk factors, and use of protective enterostomy by univariate analysis.
  • When outcome parameters were compared between groups A and B after stratification for propensity score, no significant differences regarding postoperative bladder dysfunction (p = 0.12), total anastomotic leak rate (p = 0.56), and anastomotic leaks requiring reoperation (p = 0.56) could be demonstrated.
  • CONCLUSION: Neoadjuvant chemoradiotherapy for rectal carcinoma does not increase the risk for anastomotic leakage or postoperative bladder dysfunction after curatively intended sphincter-preserving rectal resection.
  • [MeSH-major] Anal Canal / surgery. Anastomotic Leak / etiology. Neoadjuvant Therapy. Postoperative Complications / etiology. Quality Assurance, Health Care. Rectal Neoplasms / drug therapy. Rectal Neoplasms / radiotherapy. Rectum / surgery. Urinary Bladder Diseases / etiology
  • [MeSH-minor] Aged. Aged, 80 and over. Chemotherapy, Adjuvant / adverse effects. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Multivariate Analysis. Neoplasm Staging. Prospective Studies. Radiotherapy, Adjuvant / adverse effects. Retrospective Studies. Risk Factors

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  • (PMID = 20711786.001).
  • [ISSN] 1435-2451
  • [Journal-full-title] Langenbeck's archives of surgery
  • [ISO-abbreviation] Langenbecks Arch Surg
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study
  • [Publication-country] Germany
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39. Gontero P, Casetta G, Maso G, Sogni F, Pretti G, Zitella A, Frea B, Tizzani A: Phase II study to investigate the ablative efficacy of intravesical administration of gemcitabine in intermediate-risk superficial bladder cancer (SBC). Eur Urol; 2004 Sep;46(3):339-43
MedlinePlus Health Information. consumer health - Bladder Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase II study to investigate the ablative efficacy of intravesical administration of gemcitabine in intermediate-risk superficial bladder cancer (SBC).
  • New treatment options are needed for intermediate-risk SBC recurring after conventional intravesical treatments.
  • METHODS: The study was designed as a two-stage phase II trial, with a sample size of 39 patients.
  • The efficacy of intravesical Gemcitabine at a concentration of 40 mg/ml (2000 mg in 50 ml saline solution) administered weekly for 6 weeks was assessed on a single marker tumour left in the bladder after a complete TUR of all other lesions.
  • Patients underwent TUR or biopsy at the site of the marker lesion 2 weeks after completion of the treatment.
  • CONCLUSION: The ablative effect of Gemcitabine produced a higher number of responses than the minimum required by the protocol to indicate a significant probability of drug efficacy.
  • It is worth testing the drug in phase III trials to assess for durability of response.
  • [MeSH-major] Antimetabolites, Antineoplastic / administration & dosage. Carcinoma, Transitional Cell / drug therapy. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Administration, Intravesical. Aged. Female. Humans. Male. Middle Aged. Remission Induction. Treatment Outcome

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  • (PMID = 15306105.001).
  • [ISSN] 0302-2838
  • [Journal-full-title] European urology
  • [ISO-abbreviation] Eur. Urol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine
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