Recommandations en Onco-Urologie 2010 : Tumeurs urothéliales

Pfister, Christian; Rouprêt, Morgan; Wallerand, Hervé; Davin, Jean-Louis; Quintens, H.; Guy, Laurent; Houédé, Nadine; Bernardini, S.; Larré, S.; Mazerolles, Catherine; Roy, Catherine; Amsellem, Delphine; Saint, F.; Irani, Jacques; Soulié, M.

doi:10.1016/s1166-7087(10)70043-9

Cited by 62 publications

(20 citation statements)

References 109 publications

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“…For patients with urothelial bladder cancer that are unfit for surgery, radiotherapy associated with chemotherapy remains a possible alternative (3,6,7).…”

Section: Discussionmentioning

confidence: 99%

The efficacy of hemostatic radiotherapy for bladder cancer-related hematuria in patients unfit for surgery

et al. 2013

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Objective: The aim of our study was to assess short and mid-term clinical efficacy of external beam radiation therapy to achieve hemostasis in patients with bladder-cancer related gross hematuria who were unfit for surgery. We also assessed hypofractionation as a possible alternative option for more severe patients. Patients and Methods: Thirty-two patients were included for hemostatic radiation therapy, with two schedules based on Eastern Cooperative Oncology Group performance status. The standard treatment was 30 Gy in 10 fractions over 2 weeks. More severe patients underwent a hypofractionated regimen, with 20 Gy in 5 fractions over a one week period. Clinical evaluation was performed at 2 weeks and 6 months. Results: At 2 weeks, 69% of patients were hematuria-free. Subgroup analysis showed that 79% of patients undergoing hypofractionated regimen were hematuria-free. A total of 54% were hematuria-free with the standard regimen. Based on tumor stage, hematuria was controlled at 2 weeks for 57% of non-muscle invasive tumors and 72% of muscle--invasive tumors. After 6 months, 69% of patients had relapsed, regardless of tumor stage or therapy schedules. Conclusions: Hemostatic radiotherapy is an effective option for palliative-care hematuria related to bladder cancer in patients unfit for surgery. Although it appears to be rapidly effective, its effect is of limited duration. Hypofractionation also seems to be an effective option; however larger cohorts and prospective trials are needed to evaluate its efficacy compared to standard schedules.

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“…For patients with urothelial bladder cancer that are unfit for surgery, radiotherapy associated with chemotherapy remains a possible alternative (3,6,7).…”

Section: Discussionmentioning

confidence: 99%

The efficacy of hemostatic radiotherapy for bladder cancer-related hematuria in patients unfit for surgery

et al. 2013

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“…The correct diagnosis rate for standard CT is estimated to be less than 65%. 1,19 Other methods of detection of pathological lymph nodes have been investigated, such as preoperative and intraoperative sentinel node detection, as initially described by Sherif et al in bladder cancer, but without convincing results. 20 PET and CT image fusion has improved the diagnostic performances and several meta-analyses have clearly shown that the performance of PET is superior to that of CT alone for many types of cancer.…”

Section: 5%mentioning

confidence: 99%

“…1 Commonly, 18-fluoro-2-deoxyglucose is used with PET, as it accumulates in cancer cells and tissues that show a high level of glycolysis. 18 F-fluorodeoxyglucose positron emission tomography-computed tomography ( 18 F-FDG PET-CT) can detect a wide variety of tumors including lymphoma, melanoma, sarcoma, lung cancer, colon cancer and squamous cell carcinoma.…”

Section: Editorial Commentmentioning

confidence: 99%

“…The 5-year overall survival after radical cystectomy, all pT stages combined, but without lymph node invasion (pN0), ranges between 48% and 68%, and decreases to 25% in the presence of lymph node invasion (pN+). 1,2 In the subgroup of pN+ patients, the prognosis appears to be correlated, in addition to the extent of lymph node dissection, with the number of nodes removed, the number of nodes invaded (<5 or 8), the lymph node density (number of positive lymph nodes/total number of lymph nodes) and the presence of capsular penetration. 3,4 Abdomen and pelvis CT and MRI have a global sensitivity of 36%, and a specificity of 80-97% to detect lymph node metastasis preoperatively.…”

Section: Introductionmentioning

confidence: 99%

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¹⁸F‐fluorodeoxyglucose positron emission tomography–computed tomography for preoperative lymph node staging in patients undergoing radical cystectomy for bladder cancer: A prospective study

Hitier-Berthault¹,

Ansquer

Branchereau³

et al. 2012

Int J of Urology

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Abbreviations & AcronymsObjectives: The objective of our study was to analyze the diagnostic performance of 18 F-fluorodeoxyglucose positron emission tomography-computed tomography for lymph node staging in patients with bladder cancer before radical cystectomy and to compare it with that of computed tomography. Methods: A total of 52 patients operated on between 2005 and 2010 were prospectively included in this prospective, mono-institutional, open, non-randomized pilot study. Patients who had received neoadjuvant chemotherapy or radiotherapy were excluded. 18 F-fluorodeoxyglucose positron emission tomography-computed tomography in addition to computed tomography was carried out for lymph node staging of bladder cancer before radical cystectomy. Lymph node dissection during radical cystectomy was carried out. Findings from 18 F-fluorodeoxyglucose positron emission tomography-computed tomography and computed tomography were compared with the results of definitive histological examination of the lymph node dissection. The diagnostic performance of the two imaging modalities was assessed and compared. Results: The mean number of lymph nodes removed during lymph node dissection was 16.5 Ϯ 10.9. Lymph node metastasis was confirmed on histological examination in 22 cases (42.3%). This had been suspected in five cases (9.6%) on computed tomography and in 12 cases (23.1%) on 18 F-fluorodeoxyglucose positron emission tomographycomputed tomography. Sensitivity, specificity, positive predictive value, negative predictive value, relative risk and accuracy were 9.1%, 90%, 40%, 57.4%, 0.91 and 55.7%, respectively, for computed tomography, and 36.4%, 86.7%, 66.7%, 65%, 2.72, 65.4%, respectively, for 18 F-fluorodeoxyglucose positron emission tomography-computed tomography. Conclusions:18 F-fluorodeoxyglucose positron emission tomography-computed tomography is more reliable than computed tomography for preoperative lymph node staging in patients with invasive bladder carcinoma undergoing radical cystectomy.

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“…In our series, 92.5% of patients were males. Women are generally less likely to develop bladder cancer compared to men, but once they acquire this disease, they have a less favorable prognosis [12]. It has been hypothesized that women have more advanced stages than men due to late diagnosis in women.…”

Section: ) Patients and Tumor Characteristicsmentioning

confidence: 99%

Therapeutic Specificities and Prognosis of Advanced Stage and Metastatic Bladder Cancers in a Tunisian University Hospital

Zaied¹,

Khechine²,

Rim³

et al. 2017

OALib

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In Tunisia, bladder cancer represents the first urological cancer before even prostate cancer. However, its diagnosis is often delayed to the stage of invasive tumor. Systemic chemotherapy represents an option for inoperable and/or metastatic forms. Our study's aims were to report our center's therapeutic results for locally advanced and metastatic forms of bladder cancer and to analyze its prognosis factors. In our 40 patients with bladder cancer advanced stages (locally advanced and metastatic), transitional cell carcinoma was the most common histological type (82.5%); mean age at diagnosis was 63.3 ± 10.5 years with a sex ratio equal to 12.3; radical cystectomy and radiation therapy were performed separately both in 35% of cases and chemotherapy in 60%; cisplatin associated with gemcitabine was the most used regimen and navelbine monotherapy was used as second-line chemotherapy; median overall survival was 14.4 months, and its influencing factors according to our results were: ECOG score, T and M tumor stages, primary tumor surgery and adjuvant chemotherapy.

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Recommandations en Onco-Urologie 2010 : Tumeurs urothéliales

Cited by 62 publications

References 109 publications

The efficacy of hemostatic radiotherapy for bladder cancer-related hematuria in patients unfit for surgery

The efficacy of hemostatic radiotherapy for bladder cancer-related hematuria in patients unfit for surgery

¹⁸F‐fluorodeoxyglucose positron emission tomography–computed tomography for preoperative lymph node staging in patients undergoing radical cystectomy for bladder cancer: A prospective study

Therapeutic Specificities and Prognosis of Advanced Stage and Metastatic Bladder Cancers in a Tunisian University Hospital

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Recommandations en Onco-Urologie 2010 : Tumeurs urothéliales

Cited by 62 publications

References 109 publications

The efficacy of hemostatic radiotherapy for bladder cancer-related hematuria in patients unfit for surgery

The efficacy of hemostatic radiotherapy for bladder cancer-related hematuria in patients unfit for surgery

18F‐fluorodeoxyglucose positron emission tomography–computed tomography for preoperative lymph node staging in patients undergoing radical cystectomy for bladder cancer: A prospective study

Therapeutic Specificities and Prognosis of Advanced Stage and Metastatic Bladder Cancers in a Tunisian University Hospital

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¹⁸F‐fluorodeoxyglucose positron emission tomography–computed tomography for preoperative lymph node staging in patients undergoing radical cystectomy for bladder cancer: A prospective study