Positive Urinary Cytology Following a Complete Response to Intravesical Bacillus Calmette-Guerin Therapy: Pattern of Recurrence

Schwalb, Murray David; Herr, Harry W.; Sogani, Pramod C.; Russo, Paul; Sheinfeld, Joel; Fair, William R.

doi:10.1016/s0022-5347(17)32744-1

Cited by 28 publications

(9 citation statements)

References 5 publications

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“…In general, patients with superficial bladder cancer need to be periodically followed up by cytology and cystoscopic examinations after TUR [22]. Cytological findings after surgical treatment and intravesical instillation therapy play an important role in the management of those patients.…”

Section: Discussionmentioning

confidence: 99%

Cytological Changes Induced by Intravesical Bacillus Calmette-Guérin Therapy for Superficial Bladder Cancer

Takashi

Schenck²,

Koshikawa³

et al. 2000

Urol Int

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To evaluate cytological changes of urothelial cells with intravesical instillation therapy of the bacillus Calmette-Guérin (BCG), cytological specimens of voided urine from patients with superficial bladder cancer (pTa and pT1) treated with intravesical BCG therapy were examined. The following three groups of patients who had no evidence of recurrence more than 2 years after the treatment were studied: groups 1 and 2, patients who were treated with BCG (n = 22) and epirubicin, a derivative of doxorubicin (n = 22), respectively, for prophylaxis of intravesical recurrence after transurethral resection (TUR); and group 3, patients receiving no intravesical therapy after TUR (n = 12). Sixteen cytological characteristics were studied before and after the treatment in each group. In group 1 patients translucent nuclei and prominent nucleoli, vacuolization of cytoplasm, and eosinophilic cytoplasmic inclusions were frequently observed in urothelial cells as well as an increase in granulocytes, especially within 3 months after BCG instillation therapy. In group 2 patients an increased nuclear/cytoplasmic ratio, hyperchromatic nuclei and prominent nucleoli of urothelial cells were transiently found within 1–2 months after intravesical epirubicin therapy. In group 3, translucent nuclei and prominent nucleoli of urothelial cells were found within 1–2 months after TUR. In conclusion, cytological changes induced by BCG therapy are nonspecific and reactive in nature, different from those due to chemotherapeutic agents and distinguishable from malignant changes of urothelial cells.

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Section: Discussionmentioning

confidence: 99%

Cytological Changes Induced by Intravesical Bacillus Calmette-Guérin Therapy for Superficial Bladder Cancer

Takashi

Schenck²,

Koshikawa³

et al. 2000

Urol Int

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“…This clinical quandary may present following a complete response to intravesical BCG. Schwalb et al (40) reported their experience with 75 patients after an interval of at least 12 months and found that, although the bladder was the single most common site of recurrence, upper urinary tract disease developed in 11 patients (18%) while 7 (11%) had a prostatic recurrence at a median of 5 months.…”

Section: Methods Of Diagnosismentioning

confidence: 99%

“…Schwalb et al (40) found positive urinary cytology following a complete response to BCG (cystoscopically, histologically and cytologically for at least 12 months) in 75 patients. Although the bladder was the single most common site for further tumor, 7 patients (11%) had prostatic tumors at a median of 5 months (range 2-40 months).…”

Section: Urethral Tumors Identification Of Suspected Urothelial Carcmentioning

confidence: 99%

Prevention and Treatment of Urothelial Premalignant and Malignant Lesions

Wijkström

Cohen

Gardiner

et al. 2000

Scandinavian Journal of Urology and Nephrology

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Bladder cancer is believed to develop through reversible premalignant stages followed by irreversible steps, and ending in invasive cancer giving rise to distant metastases. Because of the variation in the clinical course it has also been suggested that different forms of cancer develop along different molecular pathways leading to tumor presentations of various malignant potential. Today we treat and prognosticate bladder cancer on the basis of clinical and histologic findings that are insufficient to assess all the biologic potential of these tumors. Understanding the pathogenesis of bladder cancer might lead to a more precise identification of particular tumors with regard to clinical aggressiveness, resulting in individualized strategies for treatment and prophylaxis.Bladder cancer is seldom diagnosed in its preclinical stage, it is instead detected at cystoscopy and virtually never recognized as an incidental finding on autopsy. Therefore its "natural history" largely reflects that of "treated" disease. The true incidence of premalignant and malignant epithelial changes is not known. Incidences of hyperplasia and dysplasia of %10% and %5%, respectively and only occasional findings of cancer itself were reported in two autopsy series. Urothelial dysplasia is generally believed to be premalignant and a putative precursor of invasive cancer but unfortunately there has been a lack of standardization in terms of terminology and diagnosis. There is also a need for an agreed definition of the boundary between premalignancy, i.e. urothelial changes that have some but not all the features of carcinoma in situ, and malignancy, especially when considering potentially harmful treatments to prevent this transition. Most new diagnostic tools available and being tested today compare new detection techniques with traditional methods such as cytology or conventional histology of malignant rather than premalignant changes. There is probably also a short preclinical latency, as implied by the incidental findings of bladder cancer at autopsy, which makes it necessary to define how and when to promote early detection and treatment.Future studies therefore have to concentrate on methods for early detection of disease as well as characterization of host susceptibility, evaluation of exposure to carcinogens and potential effects of preventive measures. It is also likely that the improved tools of molecular prognostication will allow us to design trials more precisely in order to tailor therapeutic strategies.

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“…If negative, ureteral washings and radiological upper tract assessment with biopsy of the prostatic urethra should all be performed, as 20% of previously aggressive bladder cancer relapses outside the bladder. 55 …”

Section: Follow-upmentioning

confidence: 99%

Update on the management of non-muscle invasive bladder cancer

Aldousari

Kassouf

2013

CUAJ

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Non-muscle invasive bladder cancer (NMIBC) is a heterogeneous population of tumours accounting for 80% of bladder cancers. Over the years, the management of this disease has been changing with improvements in results and outcomes. In this review, we focus on the latest updates on the management of NMIBC.Can Urol Assoc J 2010;4(1):56-64 RésuméLe cancer de la vessie sans envahissement musculaire est un groupe hétérogène de tumeurs représentant 80 % des cancers de la vessie. Au fil des années, la prise en charge de cette maladie a évolué, et les résultats et issues thérapeutiques se sont améliorés. Dans l'article qui suit, nous présentons les plus récents développe-ments dans la prise en charge de ce type de cancer.

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Positive Urinary Cytology Following a Complete Response to Intravesical Bacillus Calmette-Guerin Therapy: Pattern of Recurrence

Cited by 28 publications

References 5 publications

Cytological Changes Induced by Intravesical Bacillus Calmette-Guérin Therapy for Superficial Bladder Cancer

Cytological Changes Induced by Intravesical Bacillus Calmette-Guérin Therapy for Superficial Bladder Cancer

Prevention and Treatment of Urothelial Premalignant and Malignant Lesions

Update on the management of non-muscle invasive bladder cancer

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