Diagnostic delay and prognosis in invasive bladder cancer

Anderson, Harald; Månsson, Alf; Månsson, Wiking

doi:10.1080/00365590310006246

Cited by 26 publications

(14 citation statements)

References 23 publications

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“…This finding is supported by several oncology studies in other cancer models [4,6,10,11,13,16,[18][19][20][21]26] and three sarcoma studies [23,24,27]. In 2007, we published our findings of bone and soft tissue sarcoma [24].…”

Section: Discussionsupporting

confidence: 86%

“…Screening programs for other cancer types have gained popularity in recent decades and have instilled a wave of public awareness to identify all cancers at the first possible sign. The widely believed assumption is earlier diagnosis of any cancer is associated with increased survival [7,8,12,15,16,18,21,22]. However compelling this argument may be, there is no research to support this assumption.…”

Section: Introductionmentioning

confidence: 80%

See 1 more Smart Citation

Length of Symptoms Before Referral: Prognostic Variable for High-grade Soft Tissue Sarcoma?

Rougraff¹,

Lawrence²,

Davis³

2012

Clinical Orthopaedics &Amp; Related Research

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 80%

Length of Symptoms Before Referral: Prognostic Variable for High-grade Soft Tissue Sarcoma?

Rougraff¹,

Lawrence²,

Davis³

2012

Clinical Orthopaedics &Amp; Related Research

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“…There is some evidence to suggest that better survival is seen in those with shorter times to diagnosis. 4,5 This may be particularly relevant to the UK and other countries with a gatekeeper system, where access to specialist care requires referral from primary care clinicians. These countries have worse cancer outcomes.…”

Section: Introductionmentioning

confidence: 99%

Clinical features of bladder cancer in primary care

Shephard

Stapley²,

Neal³

et al. 2012

Br J Gen Pract

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“…The ability to predict disease severity at the time of an initial urine screening test may enable the prioritization of patients for urgent cystoscopy. Treatment delays are often lengthy for bladder cancer, with median delays of 15 to 20 weeks from onset of symptoms to treatment not uncommon in many centers (30,31). Delays of even 12 weeks can result in muscle invasion of T1 tumors and an increased risk of nodal involvement with more advanced tumors (32,33), resulting in major reductions in patient survival.…”

Section: Discussionmentioning

confidence: 99%

Development of a Multiplex RNA Urine Test for the Detection and Stratification of Transitional Cell Carcinoma of the Bladder

Holyoake

O’Sullivan

Pollock

et al. 2008

Clinical Cancer Research

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Purpose: New markers that enable the percentage of transitional cell carcinomas (TCC) of the bladder that are diagnosed before invasion of the bladder muscle layers to be increased would reduce the morbidity and mortality associated with this disease. The purpose of this study was to develop a simple, accurate urine test based on mRNA markers and simple gene signatures that (a) could detect TCC before muscle invasion while maintaining high specificity in patients with hematuria or urinary tract infections and (b) identify patients most likely to have grade 3 or stage zT1disease. Experimental Design: RNA markers with high overexpression in stage Ta tumors and/or T1 to T4 tumors but low expression in blood or inflammatory cells were characterized by quantitative reverse transcription-PCR using 2 mL of voided urine from 75 TCC patients and 77 control patients with other urological diseases. Results: A combination of the RNAs CDC2, MDK, IGFBP5, and HOXA13 detected 48%, 90%, and 100% of stage Ta, T1, and >T1 TCCs, respectively, at a specificity of 85%. Detection of Ta tumors increased to 60% for primary (non-recurrent) Ta tumors and 76% forTa tumors z1cm in diameter. Test specificity was 80% for the 20 control patients with urinary tract infections. The combination of CDC2 and HOXA13 distinguished between grade 1 to 2 TCCs and grade 3 or stage zT1TCCs with f80% specificity and sensitivity. Conclusions: Simple gene expression signatures can be used as urine markers for the accurate detection and characterization of bladder cancer.There are f360,000 new cases of bladder cancer worldwide annually and f145,000 deaths from the disease (1). About 30% of tumors have invaded into or beyond the muscularis propria at the time of diagnosis. Patients with these muscleinvasive tumors (stages T2-T4) have 10-year recurrence-free survival rates ranging from >80% for organ-confined tumors to f30% for tumors with regional lymph node metastases (2). Muscle-invasive tumors are generally treated by radical cystectomy with bilateral pelvic lymph node dissection followed by urinary diversion. In contrast, tumors that have not invaded the muscularis propria (stage Ta, T1, and in situ carcinomas) are usually resected by organ-preserving transurethral resection and present 10-year survival rates of 70% to 85% (2). Screening high-risk groups, such as the elderly, cigarette smokers, and certain occupational groups including truck drivers, painters, and workers in the textile dye and rubber tire industries (3, 4), would be predicted to lead to a higher proportion of tumors being identified at the pre -muscle-invasive stage and an overall decrease in the bladder cancer burden.Recent studies using high-throughput microarray analysis have shown that mRNA expression profiles are a powerful method for discriminating between bladder tumors and normal urothelium and defining subgroups of bladder tumors (5-8). The informativeness of these expression profiles and the high frequency of tumor cell exfoliation into urine have raised the prospect of...

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Diagnostic delay and prognosis in invasive bladder cancer

Cited by 26 publications

References 23 publications

Length of Symptoms Before Referral: Prognostic Variable for High-grade Soft Tissue Sarcoma?

Length of Symptoms Before Referral: Prognostic Variable for High-grade Soft Tissue Sarcoma?

Clinical features of bladder cancer in primary care

Development of a Multiplex RNA Urine Test for the Detection and Stratification of Transitional Cell Carcinoma of the Bladder

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