A SINGLE IMMEDIATE POSTOPERATIVE INSTILLATION OF CHEMOTHERAPY DECREASES THE RISK OF RECURRENCE IN PATIENTS WITH STAGE Ta T1 BLADDER CANCER: A META-ANALYSIS OF PUBLISHED RESULTS OF RANDOMIZED CLINICAL TRIALS

Sylvester, Richard; Oosterlinck, Willem; Meijden, A.P.M. van der

doi:10.1097/01.ju.0000125486.92260.b2

Cited by 646 publications

(392 citation statements)

References 20 publications

Supporting

Mentioning

359

Contrasting

Unclassified

Order By: Relevance

“…One immediate instillation reduces the recurrence rate, not only in good-risk patients with single tumors but also in patients with multiple tumors for whom one instillation is an incomplete treatment [3]. Beyond this, the results of this systematic review are disappointing and only limited conclusions can be drawn concerning the value of further treatment.…”

Section: Discussionmentioning

confidence: 90%

See 1 more Smart Citation

The Schedule and Duration of Intravesical Chemotherapy in Patients with Non–Muscle-Invasive Bladder Cancer: A Systematic Review of the Published Results of Randomized Clinical Trials

2008

Self Cite

View full text Add to dashboard Cite

Objectives-Intravesical chemotherapy has been studied in randomized clinical trials for >30 yr; however, the optimal schedule and duration of treatment are unknown. The objective is to determine the effect of schedule and duration of intravesical chemotherapy on recurrence in patients with stage Ta T1 bladder cancer.Methods-A systematic review was conducted of the published results of randomized clinical trials that compared intravesical instillations with respect to their number, frequency, timing, duration, dose, or dose intensity.

show abstract

Section: Discussionmentioning

confidence: 90%

“…One immediate instillation by itself has been shown to be insufficient treatment after TUR in patients with multiple tumors [3]; however, there is no consensus whether further intravesical chemotherapy or intra-vesical BCG should be given in these patients.…”

Section: Introductionmentioning

confidence: 99%

The Schedule and Duration of Intravesical Chemotherapy in Patients with Non–Muscle-Invasive Bladder Cancer: A Systematic Review of the Published Results of Randomized Clinical Trials

2008

Self Cite

View full text Add to dashboard Cite

show abstract

“…A quimioterapia intravesical, nesses casos, com exceção da thiotepa, em dose única, pode ser empregada imediatamente após a ressecção transuretral 15 …”

Section: (C)unclassified

Câncer de bexiga: estadiamento e tratamento I

2008

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

Descrição do método de coleta de evidência: Revisão da literatura. Graus de recomendação e força de evidência: A: Estudos experimentais ou observacionais de melhor consistência. B: Estudos experimentais ou observacionais de menor consistência. C: Relatos de casos (estudos não controlados). D: Opinião desprovida de avaliação crítica, baseada em consensos, estudos fisiológicos ou modelos animais. Objetivo:Oferecer um guia prático, adequado à realidade brasileira, destacando as melhores evidências disponíveis relacionadas ao diagnóstico e ao tratamento do câncer de bexiga. Estadiamento do câncer de bexigaO objetivo do estadiamento é determinar se a doença é superficial ou invasiva (comprometimento da camada muscular), sua extensão locoregional ou metastática. Exames clínicosA ultra-sonografia de abdome total não detecta tumores vesicais menores que 0,5cm 1 (C), assim como a extensão tumoral na parede vesical ou adenomegalias, não devendo, por estas razões, ser utilizada de rotina para o estadiamento.A tomografia computadorizada abdominal e pélvica ou a ressonância magnética são utilizadas rotineiramente nos tumores invasivos para avaliar a extensão local do tumor e na pesquisa de metástases intra-abdominais. Entretanto, a acurácia no estadiamento do tumor vesical da tomografia computadorizada é de cerca de 55% 2 (C), e a ressonância magnética falha em detectar metástases linfonodais em 15% dos pacientes 3 (D).A tomografia por emissão de pósitrons (PET scan) parece ser promissora, com uma possível melhor acurácia do que a tomografia computadorizada e a ressonância magnética, no estadiamento do tumor de bexiga 4 (D), porém as informações ainda são inconsistentes. A radiografia de tórax deve ser realizada rotineiramente na pesquisa de metástases pulmonares, podendo ser, eventualmente, complementada com tomografia computadorizada. A probabilidade de se encontrar lesões ósseas em pacientes com câncer de bexiga invasivo está ao redor de 5% 5 (C), portanto, a cintilografia óssea não é empregada de rotina no estadiamento, sendo reservada a pacientes com sintomas sugestivos de comprometimento ósseo ou fosfatase alcallina elevada 6 (C). EstadiamentoO sistema TNM, da União Internacional Contra o Câncer 2002 (Tabela 1) deve ser empregado, já que é aceito universalmente 7 (D). Com finalidade prática na elaboração da estratégia terapêutica, dividem-se os tumores localizados em: superficiais e invasivos (Figura 1). Os tumores superficiais incluem o Tis, Ta e T1. A penetração da camada muscular identifica os tumores invasivos da bexiga. Graduação histológicaA classificação mais utilizada ainda tem sido a da Organização Mundial da Saúde (OMS) 8 (D) (Figura 2). Em 1998, o consenso OMS/ISUP (International Society of Urological Pathology) propôs nova classificação de grau histológico que tem melhor correlação clínico-histológica 9 (D). Tabela 1 -Classificação TNM da UICC, 2002Bexiga TX -O tumor primário não pode ser avaliado T0 -Não há evidência de tumor primário Ta -Carcinoma papilífero não-invasivo Tis -Carcinoma in situ: "tumor pla...

show abstract

“…5 The non-invasive papillary tumors and non-invasive in situ UCs are typically treated with the installation of intraluminal (intravesical) chemotherapy and immunotherapy. [6][7][8][9] Although this approach controls the disease in most patients for long periods of time, many patients ultimately experience disease progression heralded by both transformation of the tumor from low grade to high grade and the development of muscle-invasive disease. 6 Both patients who experience disease progression and the patients who initially present with muscle-invasive UC are most often treated surgically by either partial or total cystectomies.…”

mentioning

confidence: 99%

Advanced urothelial carcinoma: next-generation sequencing reveals diverse genomic alterations and targets of therapy

Wang²,

et al. 2014

View full text Add to dashboard Cite

Although urothelial carcinoma (UC) of the urinary bladder generally portends a favorable prognosis, metastatic tumors often follow an aggressive clinical course. DNA was extracted from 40 lm of formalin-fixed, paraffinembedded (FFPE) sections from 35 stage IV UCs that had relapsed and progressed after primary surgery and conventional chemotherapy. Next-generation sequencing (NGS) was performed on hybridization-captured, adaptor ligation-based libraries for 3320 exons of 182 cancer-related genes plus 37 introns from 14 genes frequently rearranged in cancer to at an average sequencing depth of 1164 Â and evaluated for all classes of genomic alterations (GAs). Actionable GAs were defined as those impacting the selection of targeted anticancer therapies on the market or in registered clinical trials. A total of 139 GAs were identified, with an average of 4.0 GAs per tumor (range 0-10), of which 78 (56%) were considered actionable, with an average of 2.2 per tumor (range 0-7). Twenty-nine (83%) cases harbored at least one actionable GA including: PIK3CA (9 cases; 26%); CDKN2A/B (8 cases; 23%); CCND1 (5 cases; 14%); FGFR1 (5 cases; 14%); CCND3 (4 cases; 11%); FGFR3 (4 cases; 11%); MCL1 (4 cases; 11%); MDM2 (4 cases; 11%); EGFR (2 cases, 6%); ERBB2 (HER2/neu) (2 cases, 6%); NF1 (2 cases, 6%) and TSC1 (2 cases, 6%). Notable additional alterations included TP53 (19 cases, 54%) and RB1 (6 cases; 17%). Genes involved in chromatin modification were altered by nonsense mutation, splice site mutation or frameshift indel in a mutually exclusive manner in nearly half of all cases including KDM6A (10 cases; 29%) and ARID1A (7 cases; 20%). Comprehensive NGS of 35 UCs of the bladder revealed a diverse spectrum of actionable GAs in 83% of cases, which has the potential to inform treatment decisions for patients with relapsed and metastatic disease.

show abstract

A SINGLE IMMEDIATE POSTOPERATIVE INSTILLATION OF CHEMOTHERAPY DECREASES THE RISK OF RECURRENCE IN PATIENTS WITH STAGE Ta T1 BLADDER CANCER: A META-ANALYSIS OF PUBLISHED RESULTS OF RANDOMIZED CLINICAL TRIALS

Cited by 646 publications

References 20 publications

The Schedule and Duration of Intravesical Chemotherapy in Patients with Non–Muscle-Invasive Bladder Cancer: A Systematic Review of the Published Results of Randomized Clinical Trials

The Schedule and Duration of Intravesical Chemotherapy in Patients with Non–Muscle-Invasive Bladder Cancer: A Systematic Review of the Published Results of Randomized Clinical Trials

Câncer de bexiga: estadiamento e tratamento I

Advanced urothelial carcinoma: next-generation sequencing reveals diverse genomic alterations and targets of therapy

Contact Info

Product

Resources

About