An Interval Longer than 12 Weeks Between the Diagnosis of Muscle Invasion and Cystectomy is Associated with Worse Outcome in Bladder Carcinoma

S??NCHEZ-ORTIZ, RICARDO F.; Huang, William C.; Arsdalen, Keith N. Van; Wein, Alan J.; Malkowicz, S. Bruce

doi:10.1097/00005392-200301000-00027

Cited by 52 publications

(77 citation statements)

References 12 publications

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“…Concurrent CRT using cisplatin or other agents is an alternative therapy that preserves bladder function (4-6, 17, 29-34). Because the CR rate of CRT for MIBC is 60% to 70%, a simple procedure is needed to select patients with MIBC who are expected to have a good response to CRT so that they will not miss the chance to be cured by immediate cystectomy (8). Although the sample size of our study was small, lack of ERCC1 expression may predict the efficacy of CRT for MIBC, as was shown in our in vitro data.…”

Section: Dercc1mentioning

confidence: 83%

“…However, in various studies, the complete response (CR) rate of chemoradiation therapy (CRT) for MIBC is 60% to 70%. Some patients who fail CRT may miss the chance to be cured by cystectomy (8). Therefore, it is important to select patients with MIBC who are expected to have a good response to CRT by using a simple procedure, such as immunohistochemistry of transurethral resection (TUR) specimens.…”

Section: Introductionmentioning

confidence: 99%

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Excision Repair Cross-Complementing Group 1 May Predict the Efficacy of Chemoradiation Therapy for Muscle-Invasive Bladder Cancer

Kawashima

Nakayama

Kakuta

et al. 2011

Clinical Cancer Research

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Purpose: Chemoradiation therapy (CRT) is now widely recognized as bladder-preserving therapy for muscle-invasive bladder cancer (MIBC). However, some patients who fail CRT may miss the chance to be cured by cystectomy. Therefore, it is important to select patients with MIBC who are expected to have a good response to CRT. Several reports indicate that the excision repair cross-complementing group 1 (ERCC1) gene is associated with resistance to cisplatin and radiation therapy. In this study, we examined the correlation between ERCC1 and CRT in vitro and in vivo in bladder cancer.Experimental Design: Bladder cancer cell lines T24, 5637, Cl8-2 (multidrug-resistant subline of T24), and CDDP10-3 (cisplatin-resistant subline of T24) were used for in vitro assays to measure ERCC1 expression level and growth inhibition with cisplatin or ionizing radiation (IR). We then examined by immunohistochemistry that whether ERCC1 nuclear staining correlates with the efficacy of CRT using cisplatin in 22 patients with MIBC.Results: Cl8-2 cells expressed ERCC1 mRNA 5.96-fold higher than did T24. Cl8-2 and CDDP10-3 were more resistant to cisplatin or IR than was T24. Resistance to IR, but not to cisplatin, was removed by suppressing ERCC1 using siRNA in both Cl8-2 and CDDP10-3 cells. In immunohistochemistry with ERCC1, 6 of 8 positive cases did not have complete response to CRT, whereas 12 of 14 negative cases had complete response. Sensitivity and specificity were 75% and 85.7%, respectively (P ¼ 0.008).Conclusion: Although further study is needed, ERCC1 expression level may predict the efficacy of CRT for MIBC.

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Section: Dercc1mentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Excision Repair Cross-Complementing Group 1 May Predict the Efficacy of Chemoradiation Therapy for Muscle-Invasive Bladder Cancer

Kawashima

Nakayama

Kakuta

et al. 2011

Clinical Cancer Research

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“…Time from establishing indications for RC to surgery correlates with the chance of diagnosis of an organ confined disease and affects recurrence-free, as well as overall survival [8][9][10][11][12][13]. Many studies addressed this issue in the past, as presented in table 4.…”

Section: Discussionmentioning

confidence: 99%

“…From literature review the most common were patient-related, including the search for second medical opinion and the preference of surgery date. They covered 50-84% of cases [9,10,12]. Others included comorbidities and temporary medical contraindications, need for a transfer to the reference center, fear of surgery and related morbidity, as well as unsuccessful attempts of bladder-sparing treatment.…”

Section: Discussionmentioning

confidence: 99%

“…The time from undertaking the decision about RC to surgery is one of the most prominent. While the general rule is "the shorter the time, the better the results", it is proven that exceeding the 12-week or 3-month time period is associated with more advanced cancer stages and reduced survival [8][9][10][11][12][13]. Until now the data on the timing of RC has been limited, while in Central Europe only Polish data has been recently published [14].…”

Section: Introductionmentioning

confidence: 99%

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Timing of radical cystectomy in Central Europe – multicenter study on factors influencing the time from diagnosis to radical treatment of bladder cancer patients

Poletajew¹,

Braticevici²,

Brisuda³

et al. 2014

CEJU

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Citation: Poletajew S, Braticevici B, Brisuda A, Cauni V, Grygorenko V, Lesnyak M-Z, et al. Timing of radical cystectomy in Central Europe -multicenter study on factors influencing the time from diagnosis to radical treatment of bladder cancer patients. Cent European J Urol. 2015; 68: 9-14. Introduction Time that passes between an unfavourable diagnosis to a radical cystectomy (RC) affects oncological outcomes in patients with bladder cancer. Unsatisfactory survival of patients after RC in Central Europe can potentially result from this factor. Material and methods The aim of this study was to assess the time interval between transurethral resection of the bladder tumor (TURBT) and RC in Central Europe and to identify clinical factors of possible delays. 941 consecutive patients who underwent RC in nine Central European urological centers were enrolled into the study. After the TURBT-RC time was calculated, selected clinical and pathological parameters were tested as potential factors influencing the timing of RC. Results On average, RCs were performed 73.8 days after TURBTs (median -53, range 0-1587). In 238 patients (25.3%) the time exceeded 12 weeks. Patients with muscle-invasive cancer were operated earlier on than patients with nonmuscle-invasive cancer (67.6 vs.105.2 days, RR = 1.41, p = 0.00). In high volume centers (>30 RC per year) longer TURBT-RC intervals were observed (97.6 vs. 66.3 days, RR = 2.49, p = 0.00). Simultaneously, factors such as female sex (RR = 1.21), more advanced age of patient (>65 years, RR = 1.23), presence of concomitant CIS (RR = 2.43), grade of cancer cells (RR = 1.67) and final post-RC stage (RR = 1.51) had no statistically significant effect on the results (p >0.05). Conclusions The mean time interval between the diagnosis and radical treatment of patients with bladder cancer in Central Europe is adequate. However, there are still a relatively high number of patients waiting for radical cystectomy longer than 8 weeks. A lower stage of disease as well as a higher case load within of a hospital may delay the surgery. Article history

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Variations in reconstruction after radical cystectomy

Gore

Saigal

Hanley

et al. 2006

Cancer

127

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Background-Most urologists specializing in the management of patients with bladder cancer consider continent urinary diversion the reconstructive technique that affords the best quality of life after radical cystectomy. We sought to evaluate factors that predict reconstructive technique following radical cystectomy. Methods-Using linked data from Medicare and the National Cancer Institute (NCI)'s Surveillance, Epidemiology, and End Results (SEER)-program, we identified 3,980 subjects who underwent radical cystectomy for bladder cancer diagnosed between 1991 and 2000, of whom 776 (19.5%) underwent continent and 3,204 (80.5%) underwent incontinent urinary diversion. We used multivariate logistic regression modeling to identify factors independently associated with utilization of continent reconstruction following radical cystectomy, incorporating patient and provider variables. Results-In multivariate analysis, the likelihood of continent diversion was inversely associated with African American race (OR 0.54, p=0.03) and higher Charlson comorbidity score (OR 0.66, p=0.01), and directly associated with older age (OR 0.92, p<0.001) and education level (OR 1.01, p=0.01). Treatment at academic (OR 1.48, p=0.002) and NCI-designated cancer centers (OR 4.01, p<0.001) and by high volume providers (OR 1.56, p<0.001) was independently associated with continent reconstruction. Conclusions-Disparities in the utilization of continent urinary diversion following radical cystectomy suggest that demographic, socioeconomic, provider-based, and clinical variables predict the likelihood that those undergoing radical cystectomy will receive continent reconstruction. Regionalization of bladder cancer care may ameliorate many of the disparities noted but must be balanced against the risk imposed by a delay in care.

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An Interval Longer than 12 Weeks Between the Diagnosis of Muscle Invasion and Cystectomy is Associated with Worse Outcome in Bladder Carcinoma

Cited by 52 publications

References 12 publications

Excision Repair Cross-Complementing Group 1 May Predict the Efficacy of Chemoradiation Therapy for Muscle-Invasive Bladder Cancer

Excision Repair Cross-Complementing Group 1 May Predict the Efficacy of Chemoradiation Therapy for Muscle-Invasive Bladder Cancer

Timing of radical cystectomy in Central Europe – multicenter study on factors influencing the time from diagnosis to radical treatment of bladder cancer patients

Variations in reconstruction after radical cystectomy

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