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1. Tamas EF, Nielsen ME, Schoenberg MP, Epstein JI: Lymphoepithelioma-like carcinoma of the urinary tract: a clinicopathological study of 30 pure and mixed cases. Mod Pathol; 2007 Aug;20(8):828-34
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  • [Title] Lymphoepithelioma-like carcinoma of the urinary tract: a clinicopathological study of 30 pure and mixed cases.
  • We studied 28 cases of lymphoepithelioma-like carcinoma of the bladder, one case in the renal pelvis, and one in the urethra.
  • Seventeen cases (56.7%) were pure with the remaining mixed with other patterns of carcinoma, including invasive urothelial carcinoma (n=10), invasive adenocarcinoma (n=3), and squamous cell carcinoma (n=2).
  • The surface demonstrated carcinoma in situ (CIS) in six cases, noninvasive high-grade papillary urothelial carcinoma in three cases, and in situ adenocarcinoma in one case.
  • Treatment consisted of radical cystectomy in 13/30 cases (43%); partial cystectomy in 4/30 cases (13%); nephrectomy in one case (3%), and transurethral resection often followed by radiation or chemotherapy in 12/30 (40%) cases.
  • Lymphoepithelioma-like carcinoma, whether in pure or mixed form, has a similar prognosis to ordinary urothelial carcinoma when treated by cystectomy.
  • Of the three pure cases treated by chemotherapy, two were free of disease at 4 and 65 months and the third had recurrent disease at 17 months.
  • Given the association of lymphoepithelioma-like carcinoma with urothelial carcinoma in 47% of our cases and its propensity for multifocality, partial cystectomy would typically be ill advised for lymphoepithelioma-like carcinoma.
  • [MeSH-major] Carcinoma / pathology. Urologic Neoplasms / pathology
  • [MeSH-minor] Adenocarcinoma / pathology. Aged. Aged, 80 and over. Carcinoma in Situ / pathology. Carcinoma, Squamous Cell / pathology. Cell Differentiation. Disease-Free Survival. Epithelial Cells / pathology. Female. Follow-Up Studies. Humans. Lymphocytes / pathology. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Time Factors. Treatment Outcome

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  • (PMID = 17541442.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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2. Hussain M, Vaishampayan U, Du W, Redman B, Smith DC: Combination paclitaxel, carboplatin, and gemcitabine is an active treatment for advanced urothelial cancer. J Clin Oncol; 2001 May 01;19(9):2527-33
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  • [Title] Combination paclitaxel, carboplatin, and gemcitabine is an active treatment for advanced urothelial cancer.
  • PURPOSE: To determine the efficacy and toxicity of the drug combination of carboplatin, paclitaxel, and gemcitabine in patients with advanced urothelial carcinoma.
  • PATIENTS AND METHODS: Patients eligible included those with advanced urothelial malignancy of any histology, no previous chemotherapy for metastatic disease, Southwest Oncology Group performance status of 2 or less, serum creatinine levels of 2 mg/dL or less, and adequate bone marrow and hepatic function.
  • Treatment consisted of paclitaxel 200 mg/m2, carboplatin (target area under the curve = 5) on day 1, and gemcitabine 800 mg/m2 on days 1 and 8, repeated every 21 days.
  • Forty-three patients had transitional cell carcinoma, and six had squamous cell carcinoma or mixed histology.
  • Ten patients had metastases to lymph nodes only, six had locally advanced disease, four had locally recurrent disease, 24 patients had visceral metastases, and five had soft tissue metastases.
  • The incidence of febrile neutropenia was 1.4%; no patients died of drug toxicity.
  • CONCLUSION: Combination paclitaxel, carboplatin, and gemcitabine is active; an encouraging number of patients with advanced urothelial carcinoma treated with this regimen experienced complete remission.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Urinary Bladder Neoplasms / drug therapy

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  • (PMID = 11331332.001).
  • [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
  • [Grant] United States / NCI NIH HHS / CA / 5-P30-CA46592-06; United States / NCI NIH HHS / CA / P30-CA22453-20
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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3. Kim KH, Do IG, Kim HS, Chang MH, Kim HS, Jun HJ, Uhm J, Yi SY, Lim DH, Ji SH, Park MJ, Lee J, Park SH, Kwon GY, Lim HY: Excision repair cross-complementation group 1 (ERCC1) expression in advanced urothelial carcinoma patients receiving cisplatin-based chemotherapy. APMIS; 2010 Dec;118(12):941-8
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  • [Title] Excision repair cross-complementation group 1 (ERCC1) expression in advanced urothelial carcinoma patients receiving cisplatin-based chemotherapy.
  • Cisplatin has been the cornerstone of the chemotherapy regimen for urothelial carcinoma.
  • Recent reports have suggested that ERCC1 is a predictive and prognostic marker in solid cancers treated with platinum-based chemotherapy.
  • We performed this study to determine whether or not immunohistochemical expression of ERCC1 can predict objective tumor response and cancer-specific survival in patients with advanced urothelial carcinoma treated with cisplatin-based chemotherapy.
  • We performed a retrospective analysis of 89 patients with advanced or recurrent urothelial cancer, who had undergone treatment at Samsung Medical Center between May 2001 and August 2007.
  • The overall response rate after chemotherapy was 68.5% (95% CI 54.8-74.8%).
  • These results suggest a negative contribution by ERCC1expression to PFS in metastatic urothelial carcinoma patients treated with cisplatin-based chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. DNA-Binding Proteins / biosynthesis. Endonucleases / biosynthesis. Urologic Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cisplatin / administration & dosage. Female. Humans. Immunohistochemistry. Kaplan-Meier Estimate. Kidney Neoplasms / drug therapy. Kidney Neoplasms / genetics. Kidney Neoplasms / metabolism. Kidney Neoplasms / pathology. Male. Middle Aged. Retrospective Studies. Ureteral Neoplasms / drug therapy. Ureteral Neoplasms / genetics. Ureteral Neoplasms / metabolism. Ureteral Neoplasms / pathology. Urinary Bladder Neoplasms / drug therapy. Urinary Bladder Neoplasms / genetics. Urinary Bladder Neoplasms / metabolism. Urinary Bladder Neoplasms / pathology

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  • [Copyright] © 2010 The Authors. Journal Compilation © 2010 APMIS.
  • (PMID = 21091775.001).
  • [ISSN] 1600-0463
  • [Journal-full-title] APMIS : acta pathologica, microbiologica, et immunologica Scandinavica
  • [ISO-abbreviation] APMIS
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / DNA-Binding Proteins; EC 3.1.- / ERCC1 protein, human; EC 3.1.- / Endonucleases; Q20Q21Q62J / Cisplatin
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4. Bajorin DF, Halabi S, Small E: Arsenic trioxide in recurrent urothelial cancer: a cancer and leukemia group B phase II trial (CALGB 99903). Clin Genitourin Cancer; 2009 Oct;7(3):E66-70
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  • [Title] Arsenic trioxide in recurrent urothelial cancer: a cancer and leukemia group B phase II trial (CALGB 99903).
  • There are also preclinical data to suggest that this drug might be active in nonhematopoietic malignancies, and transitional cell carcinoma cell lines are particularly sensitive to this agent.
  • PATIENTS AND METHODS: Twelve evaluable patients with metastatic urothelial cancer were treated with arsenic trioxide in a phase II trial conducted by the Cancer and Leukemia Group B.
  • Eligible patients were required to have measurable urothelial cancer and a maximum of 1 previous chemotherapy regimen.
  • CONCLUSION: Arsenic trioxide at this dose and schedule does not have significant activity in previously treated urothelial cancer and has substantial toxicity in this patient population.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Arsenicals / therapeutic use. Oxides / therapeutic use. Urinary Bladder Neoplasms / drug therapy. Urologic Neoplasms / drug therapy. Urothelium
  • [MeSH-minor] Aged. Aged, 80 and over. Female. Humans. Leukemia, Promyelocytic, Acute / drug therapy. Male. Middle Aged. Recurrence. Survival Analysis. Treatment Outcome

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  • (PMID = 19815484.001).
  • [ISSN] 1938-0682
  • [Journal-full-title] Clinical genitourinary cancer
  • [ISO-abbreviation] Clin Genitourin Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Arsenicals; 0 / Oxides; S7V92P67HO / arsenic trioxide
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5. Isbarn H, Budäus L, Pichlmeier U, Conrad S, Huland H, Friedrich MG: [Comparison of the effectiveness between long-term instillation of mitomycin C and short-term prophylaxis with MMC or bacille Calmette-Guérin. Study of patients with non-muscle-invasive urothelial cancer of the urinary bladder]. Urologe A; 2008 May;47(5):608-15
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  • [Title] [Comparison of the effectiveness between long-term instillation of mitomycin C and short-term prophylaxis with MMC or bacille Calmette-Guérin. Study of patients with non-muscle-invasive urothelial cancer of the urinary bladder].
  • [Transliterated title] Vergleich der Effektivität der Langzeitinstillation mit Mitomycin C gegen Kurzzeitprophylaxen mit MMC oder Bacillus Calmette-Guerin. Untersuchung bei Patienten mit nicht muskelinvasivem Urothelkarzinom der Harnblase.
  • BACKGROUND: Adjuvant instillation therapy with chemo- or immunotherapeutic agents is an integral component in the treatment of non-muscle-invasive bladder cancer.
  • There is, however, no general consensus on the choice of medication and the optimal duration of therapy.
  • This multicenter trial compared a long-term treatment regimen with mitomycin C (MMC) with two short-term treatment approaches with MMC or bacille Calmette-Guérin (BCG) for intermediate-/high-risk bladder tumor after transurethral resection.
  • In patients with low-risk bladder tumors, the effectiveness of six weekly MMC instillations was determined and compared with the results of patients not receiving adjuvant treatment.
  • MATERIAL AND METHODS: A total of 495 patients with intermediate-/high-risk bladder tumor (recurrent and/or multifocal pTaG1, pTaG2-3, or pT1G1-3) were randomly administered either BCG-RIVM 2x108 CFU in six weekly instillations, MMC 20 mg in six weekly instillations, or MMC 20 mg in six weekly instillations with subsequent monthly instillations for 3 years.
  • A total of 132 low-risk patients (first diagnosis of a unifocal pTaG1 bladder tumor) were randomly allocated to two treatment arms.
  • In the first arm, 20 mg MMC were instilled weekly six times.
  • In the control arm, the patients received no adjuvant therapy.
  • In the low-risk group, the 3-year recurrence-free rate after adjuvant therapy was 74% (95% CI: 60.0-83.8%) and in the patients receiving no adjuvant treatment 63% (95% CI: 46.6-75.5%, corresponding to a hazard ratio of 0.58 (95% CI: 0.28-1.18%).
  • The difference between the treatment arms was not significant.
  • CONCLUSION: Long-term prophylaxis with MMC results in a significantly reduced recurrence rate in intermediate-/high-risk bladder cancer with a comparable toxicity profile in comparison to short-term MMC or short-term BCG.
  • This treatment approach thus does not represent an alternative to early instillation.
  • [MeSH-major] Antibiotics, Antineoplastic / administration & dosage. BCG Vaccine / administration & dosage. Carcinoma, Transitional Cell / drug therapy. Mitomycin / administration & dosage. Neoplasm Recurrence, Local / drug therapy. Neoplasms, Multiple Primary / drug therapy. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Administration, Intravesical. Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Combined Modality Therapy. Cystoscopy. Disease-Free Survival. Drug Administration Schedule. Female. Follow-Up Studies. Humans. Long-Term Care. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Treatment Outcome

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  • (PMID = 18317718.001).
  • [ISSN] 0340-2592
  • [Journal-full-title] Der Urologe. Ausg. A
  • [ISO-abbreviation] Urologe A
  • [Language] ger
  • [Publication-type] Comparative Study; English Abstract; Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / BCG Vaccine; 50SG953SK6 / Mitomycin
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6. Pruthi RS, Wallen EM: Is robotic radical cystectomy an appropriate treatment for bladder cancer? Short-term oncologic and clinical follow-up in 50 consecutive patients. Urology; 2008 Sep;72(3):617-20; discussion 620-2
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Is robotic radical cystectomy an appropriate treatment for bladder cancer? Short-term oncologic and clinical follow-up in 50 consecutive patients.
  • METHODS: A total of 50 patients underwent robotic-assisted laparoscopic radical cystectomy and extracorporeal urinary diversion for bladder cancer.
  • The outcome measures included the pathologic outcomes, complication rate, timing of adjuvant chemotherapy, disease recurrence, and overall and disease-specific survival.
  • Seven patients had evidence of recurrent disease.
  • Three patients died of advanced urothelial carcinoma, and two died of other causes.
  • Eleven patients underwent adjuvant chemotherapy for Stage pT3 disease and N+ disease at a mean of 7.2 weeks postoperatively.
  • As our follow-up increases, we should expect to continue to truly define the long-term clinical appropriateness and oncologic success of this procedure.
  • [MeSH-major] Cystectomy / methods. Medical Oncology / methods. Robotics / methods. Urinary Bladder Neoplasms / surgery
  • [MeSH-minor] Aged. Cohort Studies. Female. Follow-Up Studies. Humans. Lymph Nodes / pathology. Lymphatic Metastasis. Male. Middle Aged. Treatment Outcome. Urinary Bladder / surgery

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  • (PMID = 18586308.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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7. Siomos VJ, La Rosa FG, Flaig TW, Kondo KL, Mitchell JD, Wilson S, Barqawi AB: Recurrent urothelial carcinoma with pulmonary metastasis. Oncology (Williston Park); 2009 Dec;23(14):1301-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Recurrent urothelial carcinoma with pulmonary metastasis.
  • [MeSH-major] Carcinoma, Papillary / secondary. Kidney Neoplasms / pathology. Lung Neoplasms / secondary. Urinary Bladder Neoplasms / secondary
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Cisplatin / therapeutic use. Female. Humans. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Positron-Emission Tomography. Tomography, X-Ray Computed

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  • (PMID = 20120845.001).
  • [ISSN] 0890-9091
  • [Journal-full-title] Oncology (Williston Park, N.Y.)
  • [ISO-abbreviation] Oncology (Williston Park, N.Y.)
  • [Language] eng
  • [Publication-type] Case Reports; Clinical Conference; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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8. Nativ O, Witjes JA, Hendricksen K, Cohen M, Kedar D, Sidi A, Colombo R, Leibovitch I: Combined thermo-chemotherapy for recurrent bladder cancer after bacillus Calmette-Guerin. J Urol; 2009 Oct;182(4):1313-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Combined thermo-chemotherapy for recurrent bladder cancer after bacillus Calmette-Guerin.
  • PURPOSE: Despite an initial adequate response many patients with nonmuscle invasive urothelial cell carcinoma of the bladder eventually have recurrence after intravesical bacillus Calmette-Guerin treatments.
  • We evaluated the efficacy of combined bladder wall hyperthermia and intravesical mitomycin C instillation (thermo-chemotherapy) in cases of recurrence after bacillus Calmette-Guerin.
  • MATERIALS AND METHODS: A total of 111 patients with recurrent papillary nonmuscle invasive urothelial cell carcinoma of the bladder after previous bacillus Calmette-Guerin treatment underwent complete bladder tumor resection and were referred for prophylactic adjuvant treatment with thermo-chemotherapy.
  • Treatment was received on an outpatient basis weekly for 6 weeks, followed by 6 maintenance sessions at 4 to 6-week intervals.
  • Each treatment included 2, 30-minute cycles of 20 mg mitomycin C and bladder wall hyperthermia to 42C +/- 2C.
  • Cystoscopy and urine cytology were performed after the completion of induction treatment and every 3 months thereafter.
  • No maintenance treatment was associated with decreased efficacy, that is the recurrence rate was 61% at 2 years vs 39% in those with maintenance treatments (p = 0.01).
  • CONCLUSIONS: Thermo-chemotherapy may be effective for papillary nonmuscle invasive urothelial cell carcinoma of the bladder that recurs after BCG treatment without increasing the risk of tumor progression.
  • Maintenance therapy is important and improves the outcome.
  • [MeSH-major] Antibiotics, Antineoplastic / administration & dosage. Hyperthermia, Induced. Mitomycin / administration & dosage. Neoplasm Recurrence, Local / therapy. Urinary Bladder Neoplasms / therapy
  • [MeSH-minor] Adjuvants, Immunologic / therapeutic use. Administration, Intravesical. Adult. Aged. Aged, 80 and over. BCG Vaccine / therapeutic use. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Retrospective Studies

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  • [CommentIn] J Urol. 2009 Oct;182(4):1317; discussion 1317 [19683279.001]
  • (PMID = 19683278.001).
  • [ISSN] 1527-3792
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / Antibiotics, Antineoplastic; 0 / BCG Vaccine; 50SG953SK6 / Mitomycin
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9. Ignatoff JM, Chen YH, Greenberg RE, Pow-Sang JM, Messing EM, Wilding G: Phase II study of intravesical therapy with AD32 in patients with papillary urothelial carcinoma or carcinoma in situ (CIS) refractory to prior therapy with bacillus Calmette-Guerin (E3897): a trial of the Eastern Cooperative Oncology Group. Urol Oncol; 2009 Sep-Oct;27(5):496-501
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  • [Title] Phase II study of intravesical therapy with AD32 in patients with papillary urothelial carcinoma or carcinoma in situ (CIS) refractory to prior therapy with bacillus Calmette-Guerin (E3897): a trial of the Eastern Cooperative Oncology Group.
  • OBJECTIVE: To assess the safety and effectiveness of AD32, a doxorubicin analogue with little systemic exposure when administered intravesically, in patients with recurrent or refractory superficial urothelial carcinoma (formerly called transitional cell carcinoma [TCC]), or carcinoma in situ (CIS), who have failed prior BCG-based immunotherapy.
  • Treatment-related and GU-specific toxicities were also examined.
  • RESULTS: The study was halted due to unavailability of study drug after accrual of 48 of a planned 64 patients; 42 were included in the analysis.
  • Of 21 TCC patients, 18 (85.7%) experienced disease recurrence (median time to recurrence, 5.3 months).
  • Of the 5 CIS patients with complete response (CR), 3 (60%) experienced disease recurrence; (median time to recurrence, 37.3 months).
  • Infection was the most common treatment-related toxicity; no grade 4 or higher toxicity was observed.
  • CONCLUSIONS: AD32 is safe and active for treatment of recurrent or refractory superficial bladder carcinoma.
  • The agent awaits more complete characterization when drug production problems can be solved.

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  • [Cites] Int Urol Nephrol. 2000;32(1):53-8 [11057773.001]
  • (PMID = 18639470.001).
  • [ISSN] 1873-2496
  • [Journal-full-title] Urologic oncology
  • [ISO-abbreviation] Urol. Oncol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA21076; United States / NCI NIH HHS / CA / U10 CA027525; United States / NCI NIH HHS / CA / U10 CA066636-15; United States / NCI NIH HHS / CA / U10 CA011083-33; United States / NCI NIH HHS / CA / CA66636; United States / NCI NIH HHS / CA / U10 CA021115; United States / NCI NIH HHS / CA / CA27525; United States / NCI NIH HHS / CA / U10 CA021076-32; United States / NCI NIH HHS / CA / U10 CA017145; United States / NCI NIH HHS / CA / U10 CA027525-30; United States / NCI NIH HHS / CA / U10 CA021076; United States / NCI NIH HHS / CA / CA11083; United States / NCI NIH HHS / CA / CA011083-33; United States / NCI NIH HHS / CA / U10 CA066636; None / None / / U10 CA027525-30; None / None / / U10 CA023318-32; United States / NCI NIH HHS / CA / U10 CA017145-33; United States / NCI NIH HHS / CA / CA17145; United States / NCI NIH HHS / CA / U10 CA021115-34; None / None / / U10 CA021115-34; United States / NCI NIH HHS / CA / U10 CA023318-32; None / None / / U10 CA017145-33; United States / NCI NIH HHS / CA / U10 CA023318; United States / NCI NIH HHS / CA / U10 CA011083; United States / NCI NIH HHS / CA / CA21115; United States / NCI NIH HHS / CA / CA23318; United States / NCI NIH HHS / CA / CA021076-32; None / None / / U10 CA066636-15
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / BCG Vaccine; 80168379AG / Doxorubicin
  • [Other-IDs] NLM/ NIHMS104680; NLM/ PMC2743955
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10. Schöder H, Larson SM: Positron emission tomography for prostate, bladder, and renal cancer. Semin Nucl Med; 2004 Oct;34(4):274-92
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  • [Title] Positron emission tomography for prostate, bladder, and renal cancer.
  • Prostate cancer, renal cancer, bladder, and other urothelial malignancies make up the common tumors of the male genitourinary tract.
  • 3) prostate-specific antigen (PSA) recurrence after apparently successful primary therapy;.
  • The role of positron emission tomography (PET) is still evolving but is likely to be most important in determining early spread of disease in patients with aggressive tumors and for monitoring response to therapy in more advanced patients.
  • Proper staging of prostate cancer is particularly important in high-risk primary disease before embarking on radical prostatectomy or radiation therapy.
  • PSA relapse frequently is the first sign of recurrent or metastatic disease after radical prostatectomy or radiation therapy.
  • However, essentially all studies have shown that the sensitivity for recurrent disease detection is higher with either acetate or choline as compared with FDG.
  • Accordingly, FDG can be used to monitor the response to chemotherapy and hormonal therapy.
  • Androgen receptor imaging agents like fluorodihydrotestosterone are being explored to predict the biology of treatment response for progressive tumor in late stage disease in castrated patients.
  • The assessment of renal masses and primary staging of renal cell carcinoma are the domain of helical CT.
  • The value of other PET tracers in renal cell carcinoma is under investigation.
  • Few studies have addressed the role of PET in bladder cancer.
  • Because of its renal excretion, FDG is not a useful tracer for the detection of primary bladder tumors.
  • The few studies that investigated its role in the detection of lymph node metastases at the time of primary staging were largely disappointing.
  • Bladder cancer imaging with 11C choline, 11C methionine, or 11C- acetate deserves further study.
  • [MeSH-major] Carcinoma, Renal Cell / radionuclide imaging. Fluorodeoxyglucose F18. Kidney Neoplasms / radionuclide imaging. Positron-Emission Tomography / methods. Prostatic Neoplasms / radionuclide imaging. Radioisotopes. Urinary Bladder Neoplasms / radionuclide imaging
  • [MeSH-minor] Clinical Trials as Topic. Female. Humans. Lymphatic Metastasis. Male. Neoplasm Recurrence, Local / radionuclide imaging. Neoplasm Recurrence, Local / therapy. Neoplasm Staging / methods. Practice Guidelines as Topic. Practice Patterns, Physicians'. Prognosis. Radiopharmaceuticals. Treatment Outcome


11. Chen AA, Grasso M: Is there a role for FISH in the management and surveillance of patients with upper tract transitional-cell carcinoma? J Endourol; 2008 Jun;22(6):1371-4
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  • [Title] Is there a role for FISH in the management and surveillance of patients with upper tract transitional-cell carcinoma?
  • Food and Drug Administration for the detection of recurrent transitional-cell carcinoma (TCC) of the bladder and in the initial workup of hematuria.
  • Of 94 specimens sent for FISH analysis, 25 voided specimens collected at an outpatient encounter and 40 specimens taken as a bladder wash or selective upper-tract washing under anesthesia were followed by upper-tract endoscopy.
  • The sensitivity and specificity of the FISH assay for detecting urothelial lesions in this population were calculated and compared with cytology specimens from the same sources.
  • RESULTS: Overall sensitivity of FISH in the detection of TCC in this population was 52%, compared with 26% for urinary cytology.
  • Selective upper-tract washings were more sensitive and specific for upper-tract TCC than bladder washings or voided specimens.
  • CONCLUSIONS: While the sensitivity of FISH for upper-tract TCC parallels its performance in bladder cancer, the preponderance of low-grade, recurrent disease in the population undergoing surveillance and minimally invasive therapy for upper-tract TCC may limit its usefulness in this setting.
  • Until a high-sensitivity marker for low-grade urothelial lesions is developed, the surveillance of upper-tract TCC will continue to require vigilant direct visual inspection.

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  • (PMID = 18578665.001).
  • [ISSN] 1557-900X
  • [Journal-full-title] Journal of endourology
  • [ISO-abbreviation] J. Endourol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] United States
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12. Cordon-Cardo C, Cote RJ, Sauter G: Genetic and molecular markers of urothelial premalignancy and malignancy. Scand J Urol Nephrol Suppl; 2000;(205):82-93
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  • [Title] Genetic and molecular markers of urothelial premalignancy and malignancy.
  • The molecular genetic changes reported in bladder tumors can be classified as primary and secondary aberrations.
  • There are characteristic primary abnormalities involved in th production of low-grade/well-differentiated neoplasms, which destabilize cellular proliferation but have little effect on cellula "social" interactions or differentiation, as well as the rate of cell death or apoptosis.
  • A primary target leading to low-grade papillary superficial bladder tumors resides on chromosome 9, while p53 gene alterations are commonly seen in flat carcinoma in situ.
  • Novel approaches utilizing tissue microdissection techniques an molecular genetic assays are needed to shed further light on this subject.
  • Multiple molecular abnormalities are identified in most human cancers studied, including bladder neoplasms.
  • These particular molecular aberrations may be especially important to evaluate for their use in the management of bladder cancer because of their commonality in progressive forms of the disease.
  • Thus, clinical trials are underway to explore their use in specific situations, particularly in the surgical management of locally advanced disease, and to determine whether adjuvant chemotherapy in such patients may be of benefit.
  • The use of molecular alterations in the management of non-invasive bladder neoplasms remains to be firmly established.
  • Our knowledge of molecular alterations important in bladder cancer progression is far from complete, and further study is necessary to further elucidate cruci pathways involved in progression and therapeutic response.
  • Nevertheless, molecular alterations involving chromosome 9q and the INK4A locus in papillary superficial tumors vs changes in chromosomes 14q and 8q, p53 and RB in flat carcinoma in situ lesions may indicate a molecular basis for early events that lead to varying pathways in urothelial tumorigenesis.
  • Clinical advances in bladder cancer will be facilitated by novel animal models paralleling the human disease.
  • Molecular diagnostics, particularly specific antigen expression, fluorescence in situ hybridization and microsatellite analyses, have show great promise as screening and follow-up methodologies, and may supplement urine cytology in the diagnosis and characterization of new and recurrent disease.
  • In addition, the use of high-throughput genomic/proteomic assays, linked to comprehensive databases, and coupled with robust bioinformatics will be key elements in elucidating the components of regulatory and signaling pathways involved in bladder tumorigenesis and cancer progression.
  • [MeSH-major] Carcinoma in Situ / genetics. Carcinoma, Transitional Cell / genetics. Genetic Markers / genetics. Precancerous Conditions / genetics. Urinary Bladder Neoplasms / genetics
  • [MeSH-minor] Cell Transformation, Neoplastic / genetics. Cell Transformation, Neoplastic / pathology. Disease Progression. Humans. Urinary Bladder / pathology

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  • (PMID = 11144907.001).
  • [ISSN] 0300-8886
  • [Journal-full-title] Scandinavian journal of urology and nephrology. Supplementum
  • [ISO-abbreviation] Scand J Urol Nephrol Suppl
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Sweden
  • [Chemical-registry-number] 0 / Genetic Markers
  • [Number-of-references] 111
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13. Maeda T, Takahashi A, Hirobe M, Honma I, Masumori N, Itoh N, Tsukamoto T: Adverse events of MVAC chemotherapy in patients with advanced urothelial cancer of the bladder. Hinyokika Kiyo; 2007 Apr;53(4):213-9
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  • [Title] Adverse events of MVAC chemotherapy in patients with advanced urothelial cancer of the bladder.
  • There have only been a few reports about adverse events of methotrexate, vinblastine, adriamycin and cisplatin (MVAC) chemotherapy under supportive care with granulocyte stimulating factor (G-CSF) and 5-hydroxytryptamine 3 receptor (5-HT3R) antagonists.
  • The purpose of this study was to retrospectively review the adverse events of the chemotherapy.
  • We analyzed 59 patients with advanced bladder cancer who received MVAC chemotherapy at Sapporo Medical University hospital from January 1992 to September 2004.
  • Two courses of chemotherapy were most frequently used in the neoadjuvant and adjuvant settings, and treatment of metastatic or recurrent lesions.
  • More than 90% of patients experienced hematological adverse events such as some grade of leukocytopenia and neutropenia in each course of the chemotherapy.
  • Grade 3 or 4 leukopenia and/or neutropenia in the first course of the chemotherapy was associated with patients with impaired renal function (60 mL/min< or = creatinine clearance <80 mL/min).
  • MVAC chemotherapy for advanced bladder cancer was performed with tolerable adverse events.
  • The current results provide relevant information mainly for those who need 2 courses of chemotherapy in the neoadjuvant or adjuvant setting.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Carcinoma, Transitional Cell / drug therapy. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Anemia / chemically induced. Cisplatin / adverse effects. Doxorubicin / adverse effects. Drug Administration Schedule. Female. Granulocyte Colony-Stimulating Factor / administration & dosage. Humans. Leukopenia / chemically induced. Male. Methotrexate / adverse effects. Middle Aged. Neoadjuvant Therapy. Neutropenia / chemically induced. Retrospective Studies. Serotonin Antagonists / administration & dosage. Thrombocytopenia / chemically induced. Vinblastine / adverse effects

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  • (PMID = 17515069.001).
  • [ISSN] 0018-1994
  • [Journal-full-title] Hinyokika kiyo. Acta urologica Japonica
  • [ISO-abbreviation] Hinyokika Kiyo
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Serotonin Antagonists; 143011-72-7 / Granulocyte Colony-Stimulating Factor; 5V9KLZ54CY / Vinblastine; 80168379AG / Doxorubicin; Q20Q21Q62J / Cisplatin; YL5FZ2Y5U1 / Methotrexate; M-VAC protocol
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14. Soga N, Arima K, Sugimura Y: Adjuvant methotrexate, vinblastine, adriamycin, and cisplatin chemotherapy has potential to prevent recurrence of bladder tumors after surgical removal of upper urinary tract transitional cell carcinoma. Int J Urol; 2008 Sep;15(9):800-3
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  • [Title] Adjuvant methotrexate, vinblastine, adriamycin, and cisplatin chemotherapy has potential to prevent recurrence of bladder tumors after surgical removal of upper urinary tract transitional cell carcinoma.
  • OBJECTIVES: To evaluate the efficacy of adjuvant platinum based chemotherapy in upper urinary tract urothelial cancer following surgical resection in terms of survival benefit and inhibition of bladder cancer recurrence.
  • METHODS: Between April 1986 and August 2005, a total of 132 patients with a diagnosis of upper urinary tract urothelial cancer underwent radical nephroureterectomy with cuff of bladder at our department.
  • A total of 46 patients (13 with pT2pN0M0 and 33 with pT3 pN0M0 transitional cell carcinoma without prior bladder cancer) were enrolled.
  • Patients with locally advanced disease were divided into two groups: the adjuvant chemotherapy group (24 patients) who received adjuvant methotrexate, vinblastine, adriamycin, and cisplatin (M-VAC) and the non-adjuvant chemotherapy group who did not receive adjuvant M-VAC (22 patients).
  • The recurrence rate in the non-adjuvant chemotherapy group was significantly higher than in the adjuvant chemotherapy group (log-rank test, P < 0.0001).
  • Only non-adjuvant chemotherapy was a significant and independent risk factor (hazard ratio 6.97) for the development of intravesical recurrence (P < 0.01).
  • CONCLUSION: Adjuvant M-VAC is an important optional adjuvant therapy and can prevent recurrent bladder tumors following surgery for upper urinary tract transitional cell carcinoma.
  • To determine whether adjuvant chemotherapy has further benefit, a randomized study would be needed.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Transitional Cell / prevention & control. Carcinoma, Transitional Cell / surgery. Kidney Neoplasms / surgery. Neoplasm Recurrence, Local / prevention & control. Neoplasms, Second Primary / prevention & control. Ureteral Neoplasms / surgery. Urinary Bladder Neoplasms / prevention & control
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Case-Control Studies. Cisplatin / therapeutic use. Doxorubicin / therapeutic use. Female. Humans. Male. Methotrexate / therapeutic use. Middle Aged. Nephrectomy. Vinblastine / therapeutic use

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  • (PMID = 18651862.001).
  • [ISSN] 1442-2042
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 5V9KLZ54CY / Vinblastine; 80168379AG / Doxorubicin; Q20Q21Q62J / Cisplatin; YL5FZ2Y5U1 / Methotrexate; M-VAC protocol
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15. Higano CS, Tangen CM, Sakr WA, Faulkner J, Rivkin SE, Meyers FJ, Hussain M, Baker LH, Russell KJ, Crawford ED, Southwest Oncology Group Trial 8733: Treatment options for muscle-invasive urothelial cancer for patients who were not eligible for cystectomy or neoadjuvant chemotherapy with methotrexate, vinblastine, doxorubicin, and cisplatin: report of Southwest Oncology Group Trial 8733. Cancer; 2008 May 15;112(10):2181-7
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  • [Title] Treatment options for muscle-invasive urothelial cancer for patients who were not eligible for cystectomy or neoadjuvant chemotherapy with methotrexate, vinblastine, doxorubicin, and cisplatin: report of Southwest Oncology Group Trial 8733.
  • BACKGROUND: Many patients with invasive urothelial cell cancer are poor candidates for cisplatin-based chemotherapy, and many are high risk for cystectomy.
  • Southwest Oncology Group Trial 8733 was designed to address treatment for such patients.
  • METHODS: Eligible patients had primary or recurrent muscle-invasive disease with transitional cell or squamous cell histology, a performance status from 0 to 2, no extrapelvic disease, a life expectancy >3 months, and adequate hematologic function.
  • CONCLUSIONS: In the current study, the combination of 5-FU and radiation was found to be tolerated well by patients with numerous comorbidities who could not tolerate cisplatin-based therapy or cystectomy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cystectomy. Muscle Neoplasms / therapy. Neoadjuvant Therapy. Urinary Bladder Neoplasms / therapy
  • [MeSH-minor] Aged. Aged, 80 and over. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / surgery. Carcinoma, Squamous Cell / therapy. Carcinoma, Transitional Cell / drug therapy. Carcinoma, Transitional Cell / radiotherapy. Carcinoma, Transitional Cell / surgery. Carcinoma, Transitional Cell / therapy. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Combined Modality Therapy. Doxorubicin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Male. Methotrexate / administration & dosage. Middle Aged. Prognosis. Survival Rate. Treatment Outcome. Vinblastine / administration & dosage

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  • [Copyright] (c) 2008 American Cancer Society.
  • (PMID = 18404692.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA04919; United States / NCI NIH HHS / CA / CA12644; United States / NCI NIH HHS / CA / CA14028; United States / NCI NIH HHS / CA / CA16385; United States / NCI NIH HHS / CA / CA20319; United States / NCI NIH HHS / CA / CA22433; United States / NCI NIH HHS / CA / CA27057; United States / NCI NIH HHS / CA / CA32102; United States / NCI NIH HHS / CA / CA35176; United States / NCI NIH HHS / CA / CA35192; United States / NCI NIH HHS / CA / CA38926; United States / NCI NIH HHS / CA / CA46282; United States / NCI NIH HHS / CA / CA46441; United States / NCI NIH HHS / CA / CA58686; United States / NCI NIH HHS / CA / CA58861; United States / NCI NIH HHS / CA / CA76447
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 5V9KLZ54CY / Vinblastine; 80168379AG / Doxorubicin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; YL5FZ2Y5U1 / Methotrexate
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16. Dovedi SJ, Davies BR: Emerging targeted therapies for bladder cancer: a disease waiting for a drug. Cancer Metastasis Rev; 2009 Dec;28(3-4):355-67
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  • [Title] Emerging targeted therapies for bladder cancer: a disease waiting for a drug.
  • Urothelial cell carcinoma is the fifth most common cancer and the costliest to treat.
  • The standard of care, intravesical chemo- and immunotherapy, while effective, is associated with a considerable side-effect profile and approximately 30% of patients either fail to respond to treatment or suffer recurrent disease within 5 years.
  • Muscle-invasive bladder cancer is life threatening, showing modest chemosensitivity, and usually requires radical cystectomy.
  • Although bladder cancer is fairly well-genetically characterized, clinical trials with molecularly targeted agents have, in comparison to other solid tumors such as lung, breast and prostate, been few in number and largely unsuccessful, with no new agents being registered in the last 20 years.
  • Hence, bladder cancer represents a considerable opportunity and challenge for molecularly targeted therapy.
  • [MeSH-major] Antineoplastic Agents / pharmacology. Carcinoma, Transitional Cell / drug therapy. Drug Delivery Systems. Drugs, Investigational / therapeutic use. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Administration, Intravesical. Angiogenesis Inhibitors / therapeutic use. BCG Vaccine / administration & dosage. BCG Vaccine / therapeutic use. Carcinoma in Situ / drug therapy. Carcinoma in Situ / economics. Carcinoma in Situ / epidemiology. Carcinoma in Situ / immunology. Carcinoma in Situ / surgery. Carcinoma, Papillary / drug therapy. Carcinoma, Papillary / economics. Carcinoma, Papillary / epidemiology. Carcinoma, Papillary / immunology. Carcinoma, Papillary / surgery. Cell Cycle / drug effects. Clinical Trials as Topic. Combined Modality Therapy. Cyclooxygenase 2 Inhibitors / therapeutic use. Cystectomy. Disease Management. Genetic Therapy. Humans. Intercellular Signaling Peptides and Proteins. Neoplasm Invasiveness. Neoplasm Proteins / antagonists & inhibitors. Neoplasm Proteins / physiology. Neovascularization, Pathologic / drug therapy. Signal Transduction / drug effects. Tumor Suppressor Protein p53 / antagonists & inhibitors

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  • (PMID = 19997963.001).
  • [ISSN] 1573-7233
  • [Journal-full-title] Cancer metastasis reviews
  • [ISO-abbreviation] Cancer Metastasis Rev.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Antineoplastic Agents; 0 / BCG Vaccine; 0 / Cyclooxygenase 2 Inhibitors; 0 / Drugs, Investigational; 0 / Intercellular Signaling Peptides and Proteins; 0 / Neoplasm Proteins; 0 / Tumor Suppressor Protein p53
  • [Number-of-references] 105
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17. Wasco MJ, Daignault S, Bradley D, Shah RB: Nested variant of urothelial carcinoma: a clinicopathologic and immunohistochemical study of 30 pure and mixed cases. Hum Pathol; 2010 Feb;41(2):163-71
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  • [Title] Nested variant of urothelial carcinoma: a clinicopathologic and immunohistochemical study of 30 pure and mixed cases.
  • Nested urothelial carcinoma (UC) is a rare histologic variant of UC, characterized by deceptively bland histologic features resembling von Brunn's nests but usually with a poor outcome.
  • In addition, its relationship to usual UC and response to traditional bladder cancer management are largely unknown.
  • At resection, all but 1 case demonstrated invasive carcinoma-9% into lamina propria, 4% into muscularis propria, 65% into perivesical fat, and 17% into adjacent organ(s).
  • Follow-up was available on 29 patients (97%) with a median of 12 months (range, 1-31 months) of follow-up; 3 (10%) died of disease, 16 (55%) are alive with persistent or recurrent disease, and 10 (34%) are alive without disease.
  • Response to neoadjuvant chemotherapy was observed in 2 (13%) of 15 patients.
  • [MeSH-major] Carcinoma / pathology. Urinary Bladder Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / metabolism. Combined Modality Therapy. Female. Humans. Immunohistochemistry. Immunophenotyping. Kaplan-Meier Estimate. Male. Middle Aged. Urothelium / metabolism. Urothelium / pathology

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  • [Copyright] Copyright 2010 Elsevier Inc. All rights reserved.
  • (PMID = 19800100.001).
  • [ISSN] 1532-8392
  • [Journal-full-title] Human pathology
  • [ISO-abbreviation] Hum. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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18. Koga H, Naito S: [Recent progress in the treatment for urothelial cancer]. Gan To Kagaku Ryoho; 2006 Feb;33(2):164-70
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  • [Title] [Recent progress in the treatment for urothelial cancer].
  • Recent progress in the treatment for urothelial cancer is reviewed, especially concerning systemic chemotherapy and surgical techniques.
  • A guideline for chemotherapy of urothelial cancer according to clinical stage is shown on the basis of evidence level in Japan.
  • MVAC chemotherapy is regarded as the gold standard for advanced metastatic urothelial cancer.
  • Randomized controlled trial revealed that gemcitabine in combination with cisplatin (GC therapy) has an efficacy similar to MVAC and is less toxic.
  • Thus, GC therapy will become the standard treatment for advanced metastatic urothelial cancer instead of MVAC.
  • Many chemotherapeutic regimens including gemcitabine and taxane have been introduced for patients with MVAC refractory or recurrent urothelial cancer.
  • It was not yet clarified whether neoadjuvant chemotherapy provides survival benefits.
  • Recent metaanalysis, however, revealed that neoadjuvant chemotherapy, especially cisplatin-based chemotherapy, has a survival advantage compared with total cystectomy alone.
  • Intravesical BCG instillation is the standard treatment for carcinoma in situ and prophylaxis of recurrence for high-risk superficial bladder cancer.
  • For higher efficacy and lower adverse effect, maintenance instillation and low-dose therapy are proposed, respectively, but further investigation is needed.
  • Endoscopic treatment for upper tract urothelial cancer using laser can be safe and effective for a properly selected patient with a normal contralateral kidney.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Urinary Bladder Neoplasms / drug therapy. Urologic Neoplasms / drug therapy. Urologic Neoplasms / surgery
  • [MeSH-minor] Administration, Intravesical. BCG Vaccine / therapeutic use. Bridged Compounds / administration & dosage. Cisplatin / administration & dosage. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Doxorubicin / administration & dosage. Endoscopy, Gastrointestinal. Evidence-Based Medicine. Humans. Laparoscopy. Laser Therapy. Methotrexate / administration & dosage. Neoadjuvant Therapy. Taxoids / administration & dosage. Vinblastine / administration & dosage

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  • (PMID = 16484850.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / BCG Vaccine; 0 / Bridged Compounds; 0 / Taxoids; 0W860991D6 / Deoxycytidine; 1605-68-1 / taxane; 5V9KLZ54CY / Vinblastine; 80168379AG / Doxorubicin; B76N6SBZ8R / gemcitabine; Q20Q21Q62J / Cisplatin; YL5FZ2Y5U1 / Methotrexate; M-VAC protocol
  • [Number-of-references] 26
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19. Savic S, Zlobec I, Thalmann GN, Engeler D, Schmauss M, Lehmann K, Mattarelli G, Eichenberger T, Dalquen P, Spieler P, Schoenegg R, Gasser TC, Sulser T, Forster T, Zellweger T, Casella R, Bubendorf L: The prognostic value of cytology and fluorescence in situ hybridization in the follow-up of nonmuscle-invasive bladder cancer after intravesical Bacillus Calmette-Guérin therapy. Int J Cancer; 2009 Jun 15;124(12):2899-904
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The prognostic value of cytology and fluorescence in situ hybridization in the follow-up of nonmuscle-invasive bladder cancer after intravesical Bacillus Calmette-Guérin therapy.
  • Molecular markers reliably predicting failure or success of Bacillus Calmette-Guérin (BCG) in the treatment of nonmuscle-invasive urothelial bladder cancer (NMIBC) are lacking.
  • The aim of our study was to evaluate the value of cytology and chromosomal aberrations detected by fluorescence in situ hybridization (FISH) in predicting failure to BCG therapy.
  • Bladder washings collected before and after BCG instillation were analyzed by conventional cytology and by multitarget FISH assay (UroVysion, Abbott/Vysis, Des Plaines, IL) for aberrations of chromosomes 3, 7, 17 and 9p21.
  • Persistent and recurrent bladder cancers were defined as positive events during follow-up.
  • Cytology and FISH in post-BCG bladder washings are highly interrelated and a positive result predicts failure to BCG therapy in patients with NMIBC equally well.
  • [MeSH-major] Adjuvants, Immunologic / therapeutic use. BCG Vaccine / therapeutic use. Carcinoma, Papillary / diagnosis. In Situ Hybridization, Fluorescence / utilization. Urinary Bladder Neoplasms / diagnosis
  • [MeSH-minor] Administration, Intravesical. Adult. Aged. Aged, 80 and over. Carcinoma in Situ / diagnosis. Carcinoma in Situ / drug therapy. Carcinoma in Situ / genetics. Chromosome Aberrations. Cytodiagnosis. DNA, Neoplasm / analysis. Female. Follow-Up Studies. Humans. Incidence. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Recurrence, Local / diagnosis. Neoplasm Recurrence, Local / genetics. Prognosis. Prospective Studies


20. Giannarini G, Kessler TM, Thoeny HC, Nguyen DP, Meissner C, Studer UE: Do patients benefit from routine follow-up to detect recurrences after radical cystectomy and ileal orthotopic bladder substitution? Eur Urol; 2010 Oct;58(4):486-94
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  • [Title] Do patients benefit from routine follow-up to detect recurrences after radical cystectomy and ileal orthotopic bladder substitution?
  • BACKGROUND: The need for and intensity of follow-up to detect disease recurrence after radical cystectomy (RC) for transitional cell carcinoma (TCC) remains a matter for debate.
  • DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of 479 patients with nonmetastatic bladder TCC receiving no neoadjuvant chemotherapy/radiation therapy and prospectively followed with a standardised protocol for a median 4.3 yr (range: 0.3-20.9) after RC at an academic tertiary referral centre.
  • INTERVENTION: RC and extended pelvic lymph node dissection with ileal orthotopic bladder substitution.
  • MEASUREMENTS: Cancer-specific survival (CSS) and overall survival (OS) probability for asymptomatic and symptomatic recurrent patients were estimated using the Kaplan-Meier method.
  • The effects of age, nerve-sparing surgery, pathologic tumour stage, lymph node status, adjuvant chemotherapy, mode of recurrence diagnosis, and recurrence site on survival were assessed with multivariable Cox regression models.
  • Of 24 patients with urethral recurrences, 13 had carcinoma in situ (CIS).
  • Of these, 12 were successfully managed with urethra-sparing treatment, and 6 are still alive with no evidence of disease.
  • Most other recurrent long-term survivors had lung and extrapelvic lymph node metastases.
  • Patients with recurrences detected by routine follow-up investigations and with secondary urothelial tumours as site of recurrence had a slightly but significantly higher survival probability.
  • Routine follow-up appears particularly effective in early detection of urethral CIS, which can be treated conservatively.
  • [MeSH-major] Carcinoma, Transitional Cell / diagnosis. Carcinoma, Transitional Cell / surgery. Cystectomy. Ileum / transplantation. Neoplasm Recurrence, Local / diagnosis. Urinary Bladder Neoplasms / diagnosis. Urinary Bladder Neoplasms / surgery. Urinary Reservoirs, Continent
  • [MeSH-minor] Aged. Early Detection of Cancer. Female. Follow-Up Studies. Humans. Male. Middle Aged. Retrospective Studies. Time Factors


21. Ramos D, Navarro S, Villamón R, Gil-Salom M, Llombart-Bosch A: Cytokeratin expression patterns in low-grade papillary urothelial neoplasms of the urinary bladder. Cancer; 2003 Apr 15;97(8):1876-83
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  • [Title] Cytokeratin expression patterns in low-grade papillary urothelial neoplasms of the urinary bladder.
  • BACKGROUND: The differential expression patterns of cytokeratin 20 (CK20) and 34betaE12 antigen in low-grade papillary urothelial tumors of the bladder are discussed.
  • METHODS: A retrospective study of 120 patients with low-grade papillary bladder tumors (45 neoplasms of low malignant potential and 75 low-grade WHO G1 carcinomas) was performed.
  • The mean follow-up was 76.6 months (range, 36-168 mos), considering for prognostic purposes the time to first recurrence, or relapse-free interval (RFI), and the total number of recurrent patients.
  • Independent of adjuvant intravesical chemotherapy, these 2 markers showed a strong statistical correlation (p < 0.001) in univariate studies with both the prediction of disease recurrences and RFI.
  • [MeSH-major] Biomarkers, Tumor / metabolism. Carcinoma, Papillary / metabolism. Intermediate Filament Proteins / metabolism. Keratins / metabolism. Urinary Bladder Neoplasms / metabolism

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  • [Copyright] Copyright 2003 American Cancer Society.
  • (PMID = 12673713.001).
  • [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 / Biomarkers, Tumor; 0 / CK-34 beta E12; 0 / Intermediate Filament Proteins; 0 / KRT20 protein, human; 0 / Keratin-20; 68238-35-7 / Keratins
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22. Iori F, Di Seri M, De Nunzio C, Leonardo C, Franco G, Spalletta B, Laurenti C: Long-term maintenance bacille Calmette-Guérin therapy in high-grade superficial bladder cancer. Urology; 2002 Mar;59(3):414-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term maintenance bacille Calmette-Guérin therapy in high-grade superficial bladder cancer.
  • OBJECTIVES: To assess the long-term results of intravesical bacille Calmette-Guérin (BCG) induction plus long-term maintenance treatment for high-grade superficial bladder cancer.
  • METHODS: Between 1994 and 2000, 41 patients who presented to our clinic with superficial urothelial carcinoma of the bladder (T1G3, T1G3 plus carcinoma in situ, or recurrent TaG2-3) were treated by transurethral resection of all visible tumor and an induction cycle of BCG plus a long-term maintenance BCG course consisting of 11 monthly instillations followed by 4 quarterly instillations and then by 6 six-monthly instillations.
  • CONCLUSIONS: Adjuvant immunotherapy with BCG after complete transurethral resection of bladder tumor represents a highly effective primary treatment for high-grade superficial bladder cancer.
  • [MeSH-major] BCG Vaccine / administration & dosage. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Administration, Intravesical. Adult. Aged. Carcinoma in Situ / drug therapy. Chemotherapy, Adjuvant. Disease Progression. Disease-Free Survival. Female. Follow-Up Studies. Humans. Immunotherapy. Male. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / surgery. Neoplasm Staging. Remission Induction

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  • (PMID = 11880083.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / BCG Vaccine
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23. Yang MH, Yen CC, Chen PM, Wang WS, Chang YH, Huang WJ, Fan FS, Chiou TJ, Liu JH, Chen KK: Prognostic-factors-based risk-stratification model for invasive urothelial carcinoma of the urinary bladder in Taiwan. Urology; 2002 Feb;59(2):232-8; discussion 238-9
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  • [Title] Prognostic-factors-based risk-stratification model for invasive urothelial carcinoma of the urinary bladder in Taiwan.
  • Objectives. To develop a prognostic-factors-based predictive model for invasive urothelial carcinoma of the urinary bladder derived from statistical comparison of clinical characteristics.Methods.
  • The medical records for patients with invasive urinary bladder urothelial carcinoma were reviewed.
  • Clinical data for age, sex, serum lactate dehydrogenase, creatinine, albumin, alkaline phosphatase, alanine aminotransferase, total bilirubin and hemoglobin levels, white blood cell and platelet counts, positive urine cytology, Eastern Cooperative Oncology Group performance status score, tumor size, histologic grading, T stage, presence of lymph node metastases, squamous differentiation, hydronephrosis, prostatic involvement, Charlson comorbidity index, surgical procedures, and adjuvant chemotherapy status were recorded.
  • A scoring system was developed on the basis the relative risk associated with the proposed prognostic factors and patients were stratified into three groups according to their scores, with statistically significant prognostic differences revealed for each of the between-group comparisons.
  • Independent factors affecting recurrence-free survival and best predicted disease recurrence were pretreatment serum creatinine, T stage, and surgical procedure.Conclusions.
  • This prognostic-factors-based risk-stratification model for invasive urothelial carcinoma of the urinary bladder may help clinicians predict outcome and select the most appropriate therapeutic modalities.
  • The incidence of recurrent disease is significantly higher for patients with poor renal function before treatment or advanced T stage and those undergoing transurethral tumor resection instead of radical cystectomy.
  • [MeSH-major] Carcinoma, Transitional Cell. Urinary Bladder Neoplasms

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  • (PMID = 11834392.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Neoplasm Proteins
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24. Halling KC, Kipp BR: Bladder cancer detection using FISH (UroVysion assay). Adv Anat Pathol; 2008 Sep;15(5):279-86
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Bladder cancer detection using FISH (UroVysion assay).
  • UroVysion is a fluorescence in situ hybridization assay that was developed for the detection of bladder cancer in urine specimens.
  • The UroVysion assay works by detecting urinary cells that have chromosomal abnormalities consistent with a diagnosis of bladder cancer.
  • Studies have shown that UroVysion is more sensitive than urine cytology for the detection of all stages and grades of bladder cancer.
  • UroVysion is Food and Drug Administration-approved for the detection of recurrent bladder cancer in voided urine specimens from patients with a history of bladder cancer and for the detection of bladder cancer in voided urine specimens from patients with gross or microscopic hematuria, but no previous history of bladder cancer.
  • Recent studies also suggest that UroVysion may be useful for assessing superficial bladder cancer patients' response to bacillus Calmette-Guerin therapy and in detecting upper tract urothelial carcinoma.
  • [MeSH-major] Carcinoma / diagnosis. Carcinoma / urine. In Situ Hybridization, Fluorescence. Urinary Bladder Neoplasms / diagnosis. Urinary Bladder Neoplasms / urine
  • [MeSH-minor] BCG Vaccine / therapeutic use. BK Virus. Chromosome Aberrations. Device Approval. Hematuria / diagnosis. Humans. Polyomavirus Infections / diagnosis. Sensitivity and Specificity. Urine / cytology

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  • (PMID = 18724101.001).
  • [ISSN] 1533-4031
  • [Journal-full-title] Advances in anatomic pathology
  • [ISO-abbreviation] Adv Anat Pathol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / BCG Vaccine
  • [Number-of-references] 48
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25. Siefker-Radtke AO, Walsh GL, Pisters LL, Shen Y, Swanson DA, Logothetis CJ, Millikan RE: Is there a role for surgery in the management of metastatic urothelial cancer? The M. D. Anderson experience. J Urol; 2004 Jan;171(1):145-8
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  • [Title] Is there a role for surgery in the management of metastatic urothelial cancer? The M. D. Anderson experience.
  • PURPOSE: Although rarely curative, chemotherapy remains the mainstay of treatment for metastatic urothelial cancer.
  • The role of surgery for metastatic disease is not well established for urothelial cancer, but is sometimes undertaken in the face of persistent or recurrent disease that can be surgically resected.
  • MATERIALS AND METHODS: We identified 31 patients with metastatic urothelial cancer undergoing metastasectomy with the intent of rendering them free of disease.
  • RESULTS: Median survival from diagnosis of metastases and from time of metastasectomy was 31 and 23 months, respectively.
  • Median time to progression following metastasectomy was 7 months.
  • CONCLUSIONS: The results in this highly selected cohort, with 33% alive at 5 years after metastasectomy, suggest that resection of metastatic disease is feasible and may contribute to long-term disease control especially when integrated with chemotherapy.
  • [MeSH-major] Carcinoma, Squamous Cell / secondary. Carcinoma, Squamous Cell / surgery. Urinary Bladder Neoplasms / pathology

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  • (PMID = 14665863.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P50-CA91846
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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