Contemporary Rates of Gynecologic Organ Involvement in Females with Muscle Invasive Bladder Cancer: A Retrospective Review of Women Undergoing Radical Cystectomy following Neoadjuvant Chemotherapy

Bree, Kelly; Hensley, Patrick J.; Westerman, Mary E.; Kokorovic, Andrea; Nogueras‐González, Graciela M.; Dinney, Colin P.N.; Navai, Neema

doi:10.1097/ju.0000000000001784

Cited by 20 publications

(16 citation statements)

References 29 publications

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“…According to a systematic review, up to one-fourth of the women are affected by metastatic recurrence after an organpreserving approach, similar to ORC and LRC (29). On the other hand, a recent retrospective study did not find any differences in survival outcomes for ROPRC compared to non-ROPRC in women with variant histology and it was suggested, also by other studies, that presence of advanced disease does not preclude ROPRC (33,34).…”

Section: Oncological Safety Of Roprcmentioning

confidence: 95%

Radical cystectomy and urinary diversion in women: techniques, outcomes, and challenges—a narrative review

Deimling¹,

Laukhtina²,

Pradère³

et al. 2022

Transl Androl Urol

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Background and Objective: Standard radical cystectomy (RC) in women includes the removal of the bladder, urethra, uterus with the adnexa, and the anterior vaginal wall, thereby severely affecting the urinary, sexual, and reproductive system. To limit these detrimental effects, organ-sparing, including nerve-sparing approaches, have been developed. Health-related quality of life (HRQOL) and functional outcomes are, indeed, becoming increasingly central to the shared decision-making with the patient. The objectives of this narrative review are: (I) to review the current status of RC in women, including the use of different urinary diversions (UDs); (II) to discuss organ-sparing approaches and their impact on oncological and functional outcomes in women; (III) to discuss the impact of RC on HRQOL and sexual function in women.Methods: We performed a non-systematic literature review of the available publications in the PubMed database.

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Section: Oncological Safety Of Roprcmentioning

confidence: 95%

Radical cystectomy and urinary diversion in women: techniques, outcomes, and challenges—a narrative review

Deimling¹,

Laukhtina²,

Pradère³

et al. 2022

Transl Androl Urol

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“…Ovarian cancer is rare among women undergoing RC. In a retrospective study by Bree et al of 149 women undergoing RC in the era of neoadjuvant chemotherapy, no patient had primary ovarian malignancy or urothelial cancer involving the ovary [16 ▪▪ ]. Among women who did not undergo BSO at the time of RC, there were no episodes of urothelial recurrence in the ovaries and/or development of primary ovarian malignancy during a median of 32.1 months of follow-up [16 ▪▪ ].…”

Section: Ovarian Preservation and Sexual Functionmentioning

confidence: 99%

“…In a retrospective study by Bree et al of 149 women undergoing RC in the era of neoadjuvant chemotherapy, no patient had primary ovarian malignancy or urothelial cancer involving the ovary [16 ▪▪ ]. Among women who did not undergo BSO at the time of RC, there were no episodes of urothelial recurrence in the ovaries and/or development of primary ovarian malignancy during a median of 32.1 months of follow-up [16 ▪▪ ]. Similarly, in a SEER analysis, Abboud et al [17] found just two cases of subsequent ovarian cancer among 1851 women who underwent RC for BC between 1998 and 2010.…”

Section: Ovarian Preservation and Sexual Functionmentioning

confidence: 99%

“…Historically, factors such as preoperative SF, performance status, age <55, absence of CIS, absence of tumor involvement at bladder neck or trigone, and stage ≤cT2 have been suggested [25]. However, recent data from Bree et al [16 ▪▪ ] showed that in the era of neoadjuvant chemotherapy, higher risk patients (i.e. cT3, hydronephrosis) who received NAC had similar rates of vaginal involvement as lower risk patients who did not get NAC (7.6% vs. 10.3%), indicating vaginal preservation may be safe in the majority of women.…”

Section: Ovarian Preservation and Sexual Functionmentioning

confidence: 99%

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Radical cystectomy and women's sexual health – can we do better?

Escott

Avulova

Bree

et al. 2022

Current Opinion in Urology

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Purpose of reviewFemale sexual function after radical cystectomy is a crucial, but historically overlooked component of bladder cancer survivorship. This review focuses on recent studies, which have investigated pelvic health and sexual function after radical cystectomy. We discuss modifiable factors, which may contribute to decreased sexual function after radical cystectomy and techniques, which may lead to improved outcomes.Recent findingsSexual function is important to women and there is a significant desire (and unmet need) for more perioperative counseling and discussion regarding sexual function changes and quality of life impacts. Sexual function may be altered due to a combination of hormonal changes from ovarian removal, anatomic changes from vaginal alteration, and sensation changes due to damage to the neurovascular bundle. Techniques to preserve these structures have been developed.SummarySexual function is an important component of survivorship and increasing attention is being focused on this area. Long term studies with objective measures are needed for to compare various techniques and ensure oncologic safety. Ovarian preservation, anterior vaginal wall preservation, and vaginal estrogen replacement should be carefully considered for most patients.

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“…Surgery and traditional chemotherapy are still the current standard treatment for BC patients [ 2 ]. However, the high mortality rate caused by tumor recurrence and metastasis after treatment is a major clinical problem that urgently needs to be resolved [ 3 ]. Therefore, exploring new treatments for BC has been a huge clinic demand.…”

Section: Introductionmentioning

confidence: 99%

Inhibitory role of proguanil on the growth of bladder cancer via enhancing EGFR degradation and inhibiting its downstream signaling pathway to induce autophagy

Xiao

Peng

et al. 2022

Cell Death Dis

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A major reason for the high mortality of patients with bladder cancer (BC) is that chemotherapy and surgery are only effective for very limited patients. Thus, developing novel treatment options becomes an urgent need for improving clinical outcomes and the quality of life for BC patients. Here, we demonstrated that proguanil significantly inhibited the growth of BC in vitro and in vivo. Importantly, our results indicated that the sensitivity of BC cells to proguanil is positively correlated with the expression of epidermal growth factor receptor (EGFR). Mechanistically, proguanil specifically targeted EGFR and promoted EGFR binding to Caveolin-1, enhanced its endocytosis in a Clathrin-independent manner, and then recruited c-Cbl to promote EGFR ubiquitination and degradation through the lysosomal pathway. Further studies suggested that proguanil induced autophagy by destabilizing EGFR and inhibiting its downstream signaling pathway. Thus, this study reveals the novel mechanism of proguanil on anticancer activity and implies the potential benefits of this drug in the treatment of BC.

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Contemporary Rates of Gynecologic Organ Involvement in Females with Muscle Invasive Bladder Cancer: A Retrospective Review of Women Undergoing Radical Cystectomy following Neoadjuvant Chemotherapy

Abstract: Conclusions: Even among high risk patients with MIBC, gynecologic organ involvement of MIBC is rare, and organ preservation, especially of the ovaries, is likely safe.

Cited by 20 publications

References 29 publications

Radical cystectomy and urinary diversion in women: techniques, outcomes, and challenges—a narrative review

Radical cystectomy and urinary diversion in women: techniques, outcomes, and challenges—a narrative review

Radical cystectomy and women's sexual health – can we do better?

Inhibitory role of proguanil on the growth of bladder cancer via enhancing EGFR degradation and inhibiting its downstream signaling pathway to induce autophagy

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