Bladder cancer: state-of-the-art care

Droller, Michael J.

doi:10.3322/canjclin.48.5.269

Cited by 106 publications

(68 citation statements)

References 60 publications

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“…Bladder cancer is the second most common tumour of the urogenital tract; urothelial bladder carcinoma (UBC) comprises about 90% of all primary bladder malignancies [1,2]. The debate about the best treatment approach for T1G3 and advanced urothelial carcinoma continually challenges all urologic surgeons and oncologists [3,4].…”

Section: Introductionmentioning

confidence: 99%

CD147 overexpression allows an accurate discrimination of bladder cancer patients’ prognosis

Afonso

Longatto‐Filho

Baltazar

et al. 2011

European Journal of Surgical Oncology (EJSO)

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Background Urothelial bladder carcinoma (UBC) is a chemo-sensitive tumour, but the response to treatment is heterogeneous. CD147 has been associated with chemotherapy resistance. We aimed to define tumours with an aggressive phenotype by the combined analysis of clinicopathological and biological parameters.Methods 77 patients with T1G3 or muscle-invasive UBC treated by radical cystectomy were studied. Immunohistochemistry was performed to detect CD147, heparanase, CD31 (blood vessels identification) and D2-40 (lymphatic vessels identification) expressions. The immunohistochemical reactions were correlated with the clinicopathological and the outcome parameters. 5-year disease free survival (DFS) and overall survival (OS) rates were estimated using the Kaplan-Meier method. Multivariate analysis was performed by Cox proportional hazards analysis. ResultsThe 5-year DFS and OS rates were significantly influenced by the classical clinicopathological parameters, and by the occurrence of lymphovascular invasion.CD147 and heparanase immunoexpression did not affect patients' outcome. However, patients with pT3/pT4 tumours had a median OS time of 14.7 months (95% CI 7.1-22.3, p=0.003), which was reduced to 9.2 months (95% CI 1.5-17.0, p=0.008) if the tumours were CD147 positive. We developed a model of tumour aggressiveness using parameters as stage, grade, lymphovascular invasion and CD147 immunoexpression, which separated a low aggressiveness from a high aggressiveness group, remaining as an independent prognostic factor of DFS (HR 3.746; p=0.019) and OS (HR 3.247; 95% CI 1.015-10.388, p=0.047).Conclusion CD147 overexpression, included in a model of UBC aggressiveness, may help surgeons to identify patients who could benefit from a personalized therapeutic regimen. Additional validation is needed.

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Section: Introductionmentioning

confidence: 99%

CD147 overexpression allows an accurate discrimination of bladder cancer patients’ prognosis

Afonso

Longatto‐Filho

Baltazar

et al. 2011

European Journal of Surgical Oncology (EJSO)

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“…1 Pathological stage is the most important determinant of prognosis and treatment for bladder cancer. [2][3][4][5][6] An ideal staging system should accurately reflect the natural history of cancer at this site, describe the total cancer burden, assess the extent of spread at the time of diagnosis, and stratify patients into prognostic groups for treatment planning. Adoption of a uniform staging system permits comparison of therapeutic interventions among different institutions.…”

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confidence: 99%

Staging and reporting of urothelial carcinoma of the urinary bladder

et al. 2009

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“…Approximately 93% of these tumors are derived from the epithelial lining and are termed urothelial or transitional cell carcinomas. 1 Similar to other epithelial malignancies, patients with carcinoma of the bladder have a high rate of survival (Ͼ 90%) if the disease is diagnosed at an early stage. However, the presence of even superficial invasion into the muscularis propria results in a dramatic fall in the 5-year survival rate to Ͻ 50%.…”

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Does HER2/neu expression provide prognostic information in patients with advanced urothelial carcinoma?

Gandour‐Edwards

Lara

Folkins

et al. 2002

Cancer

118

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BACKGROUNDMuscle‐invasive urothelial carcinoma of the bladder is a highly lethal malignancy, particularly in the setting of locally advanced or metastatic disease. Prior reports of HER2/neu (c‐erbB‐2 or HER2) expression in bladder carcinoma have been mixed; therefore, its value in predicting metastasis or response to therapy has not been established in this tumor type. Thus, the authors evaluated a possible correlation between HER2 expression in patients with high‐grade, muscle‐invasive urothelial carcinoma of the bladder and outcome in patients who received paclitaxel‐based chemotherapy.METHODSArchival tumor tissues from patients with advanced urothelial carcinoma who were enrolled on two clinical trials of paclitaxel‐based chemotherapy regimens were analyzed for HER2/neu expression by immunohistochemistry (IHC). The authors correlated HER2 expression by IHC with clinical outcomes, such as response rate, progression free survival, and overall survival, using univariate analysis.RESULTSThirty‐nine tumor specimens were assessed for HER2 expression, most of which (70%) were collected from patients with metastatic disease. All were high‐grade urothelial carcinomas (transitional cell carcinomas, Grade 3). Strong HER2 expression (2+/3+) was seen in 28 patients (71%). Patients with responding disease had an HER2 expression rate of 78%, similar to the rate seen in patients with stable disease (75%). In contrast, patients with progressive disease had an HER2 expression rate of 50%, although this difference did not reach statistical significance. However, univariate analysis showed that increased HER2 expression predicted an improvement in progression free and overall survival. When HER2 status was used as a dichotomous variable, tumors with positive HER2 expression did not have any association with response or with progression free survival; however, positive HER2 status was associated significantly with a decreased risk of death (P = 0.03).CONCLUSIONSThis study of HER2 expression in bladder carcinoma focused on patients who were treated prospectively in a standardized fashion, unlike prior studies that have evaluated banked, archival specimens. The authors confirmed the findings of others that high‐grade, muscle‐invasive urothelial carcinoma of the bladder has a significant rate of HER2 expression (71%). However, contrary to other reports, the current study found that HER2 expression in the context of paclitaxel‐based chemotherapy decreased the risk of death significantly. Further research is warranted on the possible association of HER2 expression with chemosensitivitiy in urothelial carcinoma as well as the efficacy of HER2‐targeted therapies (such as trastuzumab) for patients with high‐grade, muscle‐invasive urothelial carcinoma of the bladder. Cancer 2002;95:1009–15. © 2002 American Cancer Society.DOI 10.1002/cncr.10808

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Bladder cancer: state-of-the-art care

Cited by 106 publications

References 60 publications

CD147 overexpression allows an accurate discrimination of bladder cancer patients’ prognosis

CD147 overexpression allows an accurate discrimination of bladder cancer patients’ prognosis

Staging and reporting of urothelial carcinoma of the urinary bladder

Does HER2/neu expression provide prognostic information in patients with advanced urothelial carcinoma?

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