Información sobre riesgo, prevención, detección, síntomas, diagnosis, tratamiento y apoyo para el cáncer.
Información sobre el tratamiento del cáncer incluyendo quirúrgica, quimioterapia, radioterapia, estudios clínicos, terapia con protón, medicina complementaria avanzadas.
OncoLink se complace en ofrecer una amplia lista de lista completa de los agentes quimioterapéuticos más comúnmente usados??. Esta guía de referencia incluye información sobre la forma en que cada fármaco se administra, cómo funcionan, y los pacientes los efectos secundarios comunes pueden experimentar.
Maneras que los pacientes de cáncer y las personas que le cuidan puedan enfrentar el cáncer, los efectos secundarios, nutrición, cuestiones en general sobre el apoyo para el cáncer, duelo/decisiones sobre el termino de vida, y experiencias compartidas por sobrevivientes.
National Cancer Institute®
Ultima Vez Modificado: 1 de enero del 2002
UI - 11414630
AU - Siddiqui FA; Amirkhosravi A; Amaya M; Meyer T; Biggerstaff J; Desai H;
TI - Francis JL Hemoglobin enhances tissue factor expression on human malignant cells.
SO - Blood Coagul Fibrinolysis 2001 Apr;12(3):171-7
AD - Clinical and Research Laboratories, Walt Disney Memorial Cancer Institute, Florida Hospital, Orlando 32804, USA. Farooq_Siddiqui_Ph.D.@mail.fhmis.net
Tissue Factor (TF) is a transmembrane glycoprotein that complexes with factor VII/activated factor VII to initiate blood coagulation. TF may be expressed on the surface of various cells including monocytes and endothelial cells. Over-expression of TF in human tumor cell lines promotes metastasis. We recently showed that hemoglobin (Hb) forms a specific complex with TF purified from human malignant melanoma cells and enhances its procoagulant activity (PCA). To further study this interaction, we examined the effect of Hb on the expression of TF on human malignant (TF+) cells and KG1 myeloid leukemia (TF-) cells. Human melanoma A375 and J82 bladder carcinoma cells, which express TF at moderate and relatively high levels, respectively, were incubated with varying concentrations (0-1.5 mg/ml) of Hb. After washing, cells were analyzed for Hb binding and TF expression using flow cytometry and confocal microscopy. Hb bound to the cells in a concentration-dependent manner, and increased both TF expression and PCA. The human A375 malignant melanoma cells incubated with Hb (1 mg/ml) expressed up to six times more TF antigen than cells without Hb. This increase in TF expression and PCA of intact cells incubated with Hb was significantly inhibited by cycloheximide at a concentration of 10 microg/ml (P < 0.01). An increase in total cellular TF antigen content was demonstrated by specific immunoassay. In contrast, Hb (5 mg/ml) did not induce TF expression and PCA on KG1 cells as determined by flow cytometry and TF (FXAA) activity. We conclude that Hb specifically binds to TF-bearing malignant cells and increases their PCA. This effect seems to be at least partly due to de novo synthesis of TF and increased surface expression. However, the exact mechanism by which Hb binds and upregulates TF expression remains to be determined.
UI - 11414591
AU - Albert PS; McShane LM; Shih JH; The U.S. National Cancer Institute
TI - Bladder Tumor Marker Network Latent class modeling approaches for assessing diagnostic error without a gold standard: with applications to p53 immunohistochemical assays in bladder tumors.
SO - Biometrics 2001 Jun;57(2):610-9
AD - Biometric Research Branch, National Cancer Institute, Bethesda, Maryland 20892-7434, USA. firstname.lastname@example.org
Improved characterization of tumors for purposes of guiding treatment decisions for cancer patients will require that accurate and reproducible assays be developed for a variety of tumor markers. No gold standards exist for most tumor marker assays. Therefore, estimates of assay sensitivity and specificity cannot be obtained unless a latent class model-based approach is used. Our goal in this article is to estimate sensitivity and specificity for p53 immunohistochemical assays of bladder tumors using data from a reproducibility study conducted by the National Cancer Institute Bladder Tumor Marker Network. We review latent class modeling approaches proposed by previous authors, and we find that many of these approaches impose assumptions about specimen heterogeneity that are not consistent with the biology of bladder tumors. We present flexible mixture model alternatives that are biologically plausible for our example, and we use them to estimate sensitivity and specificity for our p53 assay example. These mixture models are shown to offer an improvement over other methods in a variety of settings, but we caution that, in general, care must be taken in applying latent class models.
UI - 11432035
AU - Pieras Ayala E; Palou J; Rodriguez-Villamil L; Millan Rodriguez F;
TI - Salvador Bayarri J; Vicente Rodriguez J [Cytoscopic follow-up of initial G3T1 bladder tumors treated with BCG]
SO - Arch Esp Urol 2001 Apr;54(3):211-7
AD - Servicio de Urologia, Fundacion Puigvert, Barcelona, Espana.
OBJECTIVE: To evaluate the cystoscopic findings during initial follow-up, the anatomopathological correlation of tumor endoscopic features and the results of standard control multiple biopsy performed 6 months after TUR in patients with G3T1 transitional carcinoma treated with BCG. METHODS: 114 patients with G3T1 bladder tumor (52% associated with Cis) were treated with 81 mg Connaught BCG intravesical instillations weekly for 6 consecutive weeks. Follow-up was performed with cystoscopy and cytology at 3 months, and cystoscopy and standard multiple biopsy at 6 months. The endoscopic findings were described as normal bladder, macroscopically tumorous lesion or erythematous lesion. RESULTS: During the first 6 months of follow-up superficial recurrence was found in 16% and 5% showed progression to muscle invasion. Tumor recurrence or progression was found in 61% and 39% at 3 and 6 months, respectively. Most of the macroscopically tumorous lesions resulted in a tumor at 3 and 6 months in 56% and 64%, respectively, and the remaining lesions were mainly inflammatory granulomas produced by BCG therapy. Twenty biopsies of erythematous areas detected only one case of Cis (5%) and 98 standard multiple biopsies of endoscopically normal mucosa detected 10 cases of Cis (overall, 3 at 3 months and 7 at 6 months); all cases were preceded by initial Cis except in one case. CONCLUSIONS: Cystoscopy performed at 3 months is very useful since it detected 61% of the superficial recurrences and 66% of the cases with progression to muscle invasion during the first 6 months. Routine biopsy of erythematous areas detected during cystoscopy is of little value since a large number of these biopsies are unnecessary in view of its diagnostic yield (5%). Since 90% of the Cis detected during the first 6 months of follow-up were patients with Cis in the initial tumor, it would be appropriate to perform standard multiple biopsy for control only in this subgroup of patients if the sensitivity of cytology is low in high grade tumors or Cis.
UI - 11450846
AU - Fujiwara H; Emi M; Nagai H; Ohgaki K; Imoto I; Akimoto M; Ogawa O;
TI - Habuchi T Definition of a 1-Mb homozygous deletion at 9q32-q33 in a human bladder-cancer cell line.
SO - J Hum Genet 2001;46(7):372-7
AD - Department of Molecular Biology, Institute of Gerontology, Nippon Medical School, Kawasaki, Japan.
We performed detailed molecular analyses of a suspected homozygous deletion on chromosome 9q32-q33 in a bladder-cancer cell line (KYBTDS) derived from a superficial papillary transitional cell carcinoma (TCC). We examined 13 sequence-tagged site (STS) markers mapped along 9q32-q33 by polymerase chain reaction (PCR), and used 13 bacterial artificial chromosome (BAC)/bacteriophage P1-derived artificial chromosome (PAC) genomic clone probes representing these STS markers as probes for dual-color fluorescence in situ hybridization (FISH) analyses to define the deleted region cytogenetically and at the molecular level. Southern blotting confirmed the findings. This combination of techniques revealed that the homozygous deletion in the KYBTDS cell line involved less than 1 megabase of DNA, flanked by markers A003P42 and SGC33380. This interval overlaps part of a common region of deletion observed in a number of primary bladder cancers; moreover, the DNA sequence within the 1-Mb segment corresponds to part of a YAC genomic clone that encompasses a putative tumor suppressor gene, DBCCR1.
UI - 11455029
AU - Planz B; Synek C; Deix T; Bocking A; Marberger M
TI - Diagnosis of bladder cancer with urinary cytology, immunocytology and DNA-image-cytometry.
SO - Anal Cell Pathol 2001;22(3):103-9
AD - Department of Urology, University of Vienna, Vienna, Austria.
DNA-image-cytometry and antibodies directed against the Lewis X- and the 486p 3/12 antigen were applied to improve diagnostic accuracy of urinary cytology for the detection of bladder cancer. Cytology, immunocytology and DNA-image-cytometry were performed in spontaneously voided urine samples and barbotage bladder washings from 71 patients. The DNA content was determined using the CM-1 Cytometer according to the recommendation of the ESCAP Consensus Report on Standardization of DNA-image-cytometry (1995). For immunocytological examination we used the monoclonal anti Lewis X antibody P-12 and antibody 486p 3/12. All patients underwent subsequent cystoscopy and for any suspicious lesion biopsy or transurethral resection was done. Histological findings revealed 31 patients with transitional cell carcinomas of different stages and grades of malignancy. 40 patients had various benign diseases of the urinary bladder. Cytology yielded a sensitivity of 68% and a specificity of 100%. DNA aneuploidy was detected in 81% of cancer patients with a specificity of 100%. By combination of these two methods the overall sensitivity increased to 87%. Immunocytology with Lewis X and 486p 3/12 antibodies showed reactivity in 84% and 87% in combination with a specificity of 80% and 70%, respectively. By combining urinary cytology, immunocytology and/or DNA-image-cytometry the overall sensitivity increased to 94% with no change in specificity. DNA-image-cytometry should be used to evaluate particularly urothelial cells suspicious for malignancy in urinary specimens. Because of low specificity the monoclonal antibodies against Lewis X- and 486p 3/12 antigens are not helpful in screening for bladder cancer. Nevertheless, their high sensitivity may justify their use in case DNA image cytometry is not available and in the follow up of patients with transitional cell carcinoma.
UI - 11471896
AU - Mady EA
TI - Cytokeratins as serum markers in egyptian bladder cancer. A comparison of CYFRA 21-1, TPA and TPS.
SO - Int J Biol Markers 2001 Apr-Jun;16(2):130-5
AD - Department of Biochemistry, Faculty of Science, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Cytokeratins (CKs) have been shown to be overexpressed in bladder cancer and to be valuable as tumor markers. The present study was designed to evaluate the single and combined use of three cytokeratin fragments, CYFRA 21-1, TPA, and TPS, in serum of Egyptian bladder cancer patients. The study subjects comprised 40 healthy controls, 30 patients with benign bladder diseases, and 60 patients with histologically confirmed primary bladder cancer. The cutoff was set at 95% specificity versus benign bladder diseases, resulting in cutoff values of 2.93 ng/mL for CYFRA 21-1, 158 U/L for TPA and 143.7 ng/mL for TPS. With 41% true positive results CYFRA 21-1 had a higher sensitivity than TPA (32%) and TPS (27%). Evaluation by histological findings revealed a highest sensitivity of CYFRA 21-1 (46%) in transitional cell carcinoma (TCC) followed by TPA (27%) and TPS (21%). Also in adenocarcinoma CYFRA 21-1 showed the highest sensitivity (38%) followed by TPA (32%) and TPS (28%). A high percentage (41.6%) of Egyptian bladder cancers is represented by squamous cell carcinoma (SCC). In this population TPS showed the highest sensitivity (69%), followed by CYFRA 21-1 (54%) and TPA (41 %). The sensitivity of each of the three markers increased with advancing tumor stage and increasing tumor grade. Combined use of two of the three markers did not raise the sensitivities obtained by single determination of CYFRA 21-1. The present study suggests that serum CYFRA 21-1 could be a marker of choice in bladder cancer.
UI - 11547058
AU - Shigyo M; Sugano K; Tobisu K; Tsukamoto T; Sekiya T; Kakizoe T
TI - Molecular followup of newly diagnosed bladder cancer using urine samples.
SO - J Urol 2001 Oct;166(4):1280-5
AD - Division of Clinical Laboratory, Department of Urology, National Cancer Center Hospital, Tokyo, Japan.
PURPOSE: Patients with superficial bladder cancer can be treated with transurethral resection. However, 50% to 70% of them have intravesical recurrence after transurethral resection and muscle invasive disease develops in 10% to 20%, which is eventually indicated for radical cystectomy. Therefore, reliable predictors of intravesical recurrence are required for management of superficial bladder cancer. We investigated whether detection of the loss of heterozygosity in urine samples would be available as a sensitive diagnostic modality for recurrence of bladder cancer. MATERIALS AND METHODS: Urine samples, cancer tissue and peripheral blood lymphocytes were obtained from 37 patients with newly diagnosed bladder cancer, and analyzed for the loss of heterozygosity on chromosomes 9 and 17p by single strand DNA conformation polymorphism analysis. RESULTS: Chromosomal loss was detected on 24 (65%) cancer tissues and 26 (70%) urine samples. The loss of heterozygosity on chromosome 17p was detected in 19 (51%) urine samples, mostly in cancers with higher grades and/or stages. During postoperative followup of 24 patients with superficial bladder cancer who had undergone transurethral resection, intravesical recurrence did not develop in 9 of 10 without chromosomal aberrations in urine samples. In contrast, intravesical recurrence developed in 11 of 14 patients who had a loss of heterozygosity in urine samples. This loss showed a significant correlation with the intravesical disease-free period (p = 0.004). Multivariate analysis revealed that the loss of heterozygosity in urine samples was a significant predictor of intravesical recurrence. CONCLUSIONS: Detection of the loss of heterozygosity in urine samples is available as a sensitive marker for predicting intravesical recurrence of superficial bladder cancer.
UI - 11547059
AU - Gohji K; Okamoto M; Kitazawa S; Toyoshima M; Dong J; Katsuoka Y;
TI - Nakajima M Heparanase protein and gene expression in bladder cancer.
SO - J Urol 2001 Oct;166(4):1286-90
AD - Department of Urology, Osaka Medical College, Takatsuki, Japan.
PURPOSE: We determined the association of heparanase protein and messenger (m)RNA expression with bladder cancer invasion and metastasis. MATERIALS AND METHODS: The expression of heparanase protein and mRNA was assessed by immunohistochemical staining and in situ hybridization, respectively, in 67 bladder cancer specimens resected at various stages of disease. To our knowledge this is the first systematic study of heparanase protein and mRNA expression in human bladder cancer. RESULTS: The expression of heparanase protein in muscular invasive bladder cancer was significantly higher than in superficial cancer (68% versus 19%, p = 0.0001). It was higher in the primary tumor of patients with lymph node metastatic cancer than those with nonmetastatic cancer (80% versus 37%, p = 0.0006). In high grade disease it was significantly higher than in low grade disease (79% versus 29%, p = 0.0001). The expression of heparanase mRNA was also significantly higher in stage pT3 or greater than in stage pT2 or less bladder cancer (96% versus 33%, p = 0.0003). In metastatic N+ cases it was significantly higher than in nonmetastatic bladder cancer (93% versus 46%, p = 0.0037). The heparanase gene and protein showed similar patterns of expression in bladder cancer. CONCLUSIONS: Our study implies that the expression of heparanase protein and mRNA is associated with bladder cancer invasion and metastasis, and heparanase may have a role in disease progression.
UI - 11547061
AU - Herr HW; Sogani PC
TI - Does early cystectomy improve the survival of patients with high risk superficial bladder tumors?
SO - J Urol 2001 Oct;166(4):1296-9
AD - Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
PURPOSE: We compared survival after early versus delayed cystectomy in patients with high risk superficial bladder tumors. MATERIALS AND METHODS: Of 307 patients with high risk superficial bladder tumors who were treated initially with transurethral resection and bacillus Calmette-Guerin (BCG) therapy 90 (29%) underwent cystectomy for recurrent tumor during a followup of 15 to 20 years. Disease specific survival distribution of these 90 patients was determined relative to the indications for and time of cystectomy. RESULTS: Of the 90 patients who underwent cystectomy 44 (49%) survived a median of 96 months. Of 35 patients with recurrent superficial bladder tumors 92% and 56% survived who underwent cystectomy less than 2 years after initial BCG therapy and after 2 years of followup, respectively. Of 55 patients with recurrent muscle invasive bladder disease 41% and 18% survived when cystectomy was performed within and after 2 years, respectively. Multivariate analysis showed that survival was improved in patients who underwent earlier rather than delayed cystectomy for nonmuscle invasive tumor relapse. CONCLUSIONS: Earlier cystectomy improves the long-term survival of patients with high risk superficial bladder tumors in whom BCG therapy fails.
UI - 11549483
AU - Frimberger D; Zaak D; Stepp H; Knuchel R; Baumgartner R; Schneede P;
TI - Schmeller N; Hofstetter A Autofluorescence imaging to optimize 5-ALA-induced fluorescence endoscopy of bladder carcinoma.
SO - Urology 2001 Sep;58(3):372-5
AD - Department of Urology, Universitaetskrankenhaus Grosshadern der Ludwig-Maximilians Universitaet, Munich, Germany.
OBJECTIVES: To design an optical system for detecting autofluorescence (AF) of bladder tumors and to determine the success of reducing the false-positive rate of 5-aminolevulinic acid-induced fluorescence endoscopy (AFE). AFE provides significantly higher sensitivity in detecting and localizing bladder carcinoma compared with white light endoscopy. The specificity of AFE is equivalent to white light endoscopy, mostly because of the false-positive fluorescence of chronic cystitis lesions. Laser-induced spectral autofluorescence detection is also an efficient method in the diagnosis of bladder carcinoma. METHODS: Bladder tissue was excited to AF using the D-Light (375 to 440 nm) after regular AFE with detection of fluorescence-positive areas. The optical image was produced using a special RGB camera. Biopsies were taken from AFE-positive areas, the peritumoral edges, and normal bladder mucosa. The AF images of the suspicious areas were compared with the AFE images and the histologic results. RESULTS: A total of 43 biopsies were histologically examined (24 benign and 19 neoplastic). AF imaging showed contrast differences between papillary tumors, flat lesions, and normal mucosa. The combination of AFE with AF raised the specificity of AFE alone from 67% to 88%. CONCLUSIONS: AF imaging is possible. The value of the method in reducing the false-positive rate of the highly sensitive AFE needs to be validated with higher numbers. The combination of AF with AFE had a 20% higher specificity than AFE alone in our study.
UI - 11562747
AU - Satoh M; Ito A; Nojiri H; Handa K; Numahata K; Ohyama C; Saito S; Hoshi
TI - S; Hakomori SI Enhanced GM3 expression, associated with decreased invasiveness, is induced by brefeldin A in bladder cancer cells.
SO - Int J Oncol 2001 Oct;19(4):723-31
AD - Department of Urology, Tohoku University School of Medicine, Sendai 980-8574, Japan. email@example.com
We reported previously that non-invasive bladder cancer expresses high level of GM3 ganglioside, whereas invasive tumors have low levels. Since glycosphingolipid synthesis in Golgi is modified greatly by a macrocyclic lactone isolated from fungi, brefeldin A (BFA), we studied effects of BFA on expression of glycosphingolipids and on invasiveness of bladder cancer cell lines. Only GM3 synthesis in invasive tumors was greatly enhanced upon treatment with BFA; synthesis of other glycosphingolipids with lacto-series type 2 or globo-series structure in both invasive and non-invasive tumors was not changed. Invasiveness of bladder cancer cells was greatly decreased in association with the great increase of GM3 synthesis induced by BFA treatment. Level of sialyl-Lex expressed in invasive cell line YTS1, which provides the adhesive property of the cells to E-selectin, was unchanged upon BFA treatment. All the bladder cancer cell lines, regardless of invasiveness, highly express tetraspanin CD9. GM3 has been implicated as a co-factor of CD9 in control of tumor cell motility. Down-regulation of CD9 is associated with metastatic properties of tumor cells and survival of patients with colonic cancer. Therefore, enhanced synthesis of GM3 induced by BFA, causing decrease of invasiveness in bladder cancer, is ascribable to the capability of GM3 to interconnect integrin with CD9, in analogy to colonic cancer and perhaps many other types of cancer.
UI - 11564895
AU - Tomobe M; Shimazui T; Uchida K; Akaza H
TI - AgNOR count in resting cells (resting NOR) is a new prognostic marker in invasive bladder tumor.
SO - Anal Cell Pathol 2001;22(4):193-9
AD - Department of Urology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
PURPOSE: We have previously demonstrated that the AgNOR count in proliferating cells is a predictor of tumor recurrence in superficial bladder tumor (J. Urol. 162 (1999), 63-68). In the present study, we evaluate the type of AgNOR associated with cell cycles as a prognostic factor in invasive bladder tumor using a double staining technique employing both AgNOR and MIB-1 labelling. MATERIALS AND METHODS: Forty-four paraffin sections of invasive bladder tumors were stained simultaneously with AgNOR and MIB-1. The number of AgNORs in proliferating (MIB-1 positive) or resting (MIB-1 negative) cells were counted from a total of 100 nuclei. Correlations between MIB-1 associated AgNOR count and clinicopathological parameters were statistically analyzed. RESULTS: The AgNOR count in proliferating cells (proliferating NOR) was significantly higher than that in resting cells (resting NOR) (p<0.01). The resting NOR in tumors with distant metastases was significantly higher than that in tumors without metastases (p<0.05). Patients with a low resting NOR tumor had a better prognosis than those with a high resting NOR tumor, whereas the proliferating NOR was not associated with survival. Survival analysis revealed that the resting NOR was the most powerful prognostic marker in patients with invasive bladder tumor (p<0.05). CONCLUSIONS: Resting NOR had a predictive value in the prognosis of patients with invasive bladder tumor.
UI - 11577435
AU - Mizuno K; Sasaki T; Saito Y; Itabashi Y; Miura H; Yodono H; Abe Y;
TI - Kawaguchi T [Gadolinium-enhanced MR imaging, T2-weighted MR imaging, and transurethral ultrasonography]
SO - Nippon Igaku Hoshasen Gakkai Zasshi 2001 Aug;61(9):496-501
AD - Department of Radiology, Iwate Prefectural Central Hospital.
PURPOSE: To assess the value and problems of dynamic gadolinium-enhanced MR imaging, T2-weighted MR imaging, and transurethral ultrasonography(TUUS) in staging of urinary bladder cancer. MATERIALS AND METHODS: Dynamic gadolinium-enhanced MR imaging and FSE T2-weighted MR imaging of 64 patients with urinary bladder cancer who subsequently had surgery were retrospectively reviewed and compared with TUUS findings. RESULTS: Specificity for muscular invasion was 90.5% with TUUS, significantly better than with dynamic MR imaging (64.9%) (p < 0.05). The rates of overestimation of superficial cancer(pT1) with dynamic MRI and T2-weighted MR imaging were 35.1%(13/37) and 24.3%(9/37), respectively. The staging accuracy of invasive cancer(pT2 or over) was 85.2% with dynamic MR imaging, which was better than the rate of 75.0% achieved with T2-weighted MR imaging. CONCLUSION: Although TUUS was a better modality for diagnosing superficial cancer(pT1), dynamic MR imaging was found to be better for diagnosing invasive(pT2 or over) cancer.
UI - 11593561
AU - Zhuang L; Zhang Z; Guo Y
TI - Aberrant expression of growth factor Wnt-5A in six urinary malignant cell lines.
SO - Chin Med J (Engl) 1999 Mar;112(3):251-5
AD - Department of Urology, First Hospital, Beijing Medical University, Institute of Urology, Beijing Medical University, Beijing 100034, China.
OBJECTIVE: To investigate the expression of growth factor Wnt-5A in urinary tumor cell lines. METHODS: By semi-quantitative RT-PCR (reverse transcriptase polymerase chain reaction), the expression of Wnt-5A in six urinary malignant cell lines, one primary cultured renal fibroblast and one case of normal human renal tissue was detected using Gel Doc 1000 computer controlled molecular analysis system. RESULTS: The expression of Wnt-5A in-urinary tumor cell lines was much higher than that in primary cultured renal fibroblasts (PRF) and normal human renal tissue (NRT). The levels of Wnt-5A mRNA were different between six malignant cell lines. CONCLUSION: The overexpression of growth factor Wnt-5A has a potential effect on the oncogenesis of urinary malignancies.
UI - 11584321
AU - Troxel DB
TI - Diagnostic errors in surgical pathology uncovered by a review of malpractice claims: part VI--urinary bladder and branchial cleft cyst.
SO - Int J Surg Pathol 2001 Jul;9(3):227-9
AD - Department of Pathology, Mt Diablo Medical Center, Concord, California 94520, USA.
UI - 11598176
AU - Iczkowski KA; Shanks JH; Gadaleanu V; Cheng L; Jones EC; Neumann R;
TI - Nascimento AG; Bostwick DG Inflammatory pseudotumor and sarcoma of urinary bladder: differential diagnosis and outcome in thirty-eight spindle cell neoplasms.
SO - Mod Pathol 2001 Oct;14(10):1043-51
AD - Department of Pathology and Laboratory Medicine, University of Florida and Veterans Administration Medical Center, Gainesville, Florida 32608-1197, USA. firstname.lastname@example.org
We assessed diagnostic criteria among 38 spindle cell tumors of the urinary bladder and obtained follow-up in 36 patients. Patients comprised 28 males and 10 females aged 2.5 months to 87 years. Hematuria was the commonest presenting symptom (27 patients). After review and immunohistochemical workup, 17 patients had inflammatory pseudotumor (myofibroblastic tumor), 4 postoperative spindle cell nodule, 1 leiomyoma, 13 sarcoma (7 low-grade; 6 high-grade), and 3 carcinoma. Mean age was 38 years for pseudotumor (range 15 to 74), 65 for postoperative spindle cell nodule, 51 for sarcoma, and 76 for carcinoma. Size of pseudotumor averaged 4.4 +/- 0.7 cm (range 1.5 to 13.0), similar to sarcoma, 4.0 +/- 0.6 cm (range 0.5 to 7.0). Similar proportions of benign tumors and sarcomas had muscularis propria invasion. The criteria that best differentiated sarcoma from inflammatory pseudotumor were presence of necrosis at the tumor-detrusor muscle interface in muscle-invasive cases, and nuclear atypia. Sarcoma also had less prominent microvasculature, less variable cellularity, consistently > or =1 mitotic figure per 10 high-power fields, and predominant acute inflammation without plasma cells. p53 protein nuclear immunostaining was moderate, unlike the rare to absent staining in pseudotumors. Because all 12 sarcomas were desmin-negative, we did not call them leiomyosarcoma; they overlapped with benign tumor in epithelial, mesenchymal, and actin immunostaining. Among 12 sarcoma patients, 2 died of tumor (at 3 months). Two of four experienced tumor recurrence after partial cystectomy (2 and 26 months). No pseudotumors recurred after transurethral resection or partial cystectomy, although one patient, 5 months after transurethral resection, had histologically identical pseudotumor that the surgeon considered residual. Another patient with pseudotumor, not a candidate for tumor ablation after transurethral resection, had continued tumor growth and he died of urosepsis. In conclusion, inflammatory pseudotumor, although overlapping with sarcoma in presentation, age range, and size, does not metastasize and remains histologically distinct from low-grade sarcoma.
UI - 11597537
AU - Patard J; Moudouni S; Saint F; Rioux-Leclercq N; Manunta A; Guy L;
TI - Ballanger P; Lanson Y; Hajri M; Irani J; Guille F; Beurton D; Lobel B; Bernard Lobel and The members of the Groupe Necker Tumor progression and survival in patients with T1G3 bladder tumors: multicentric retrospective study comparing 94 patients treated during 17 years.
SO - Urology 2001 Oct;58(4):551-6
AD - Department of Urology, Centre Hospitalo-Universitaire Rennes, Rennes, France.
OBJECTIVES: To compare tumor recurrence, progression, and patient survival in T1G3 bladder tumors treated with transurethral resection (TUR) alone, early cystectomy, or TUR with an adjuvant 6-week course of bacille Calmette-Guerin (BCG) and followed up for a minimum of 5 years. METHODS: Between 1979 and 1996, 94 patients with T1G3 bladder tumors (lamina propria invasion) were treated at nine different centers. The time to tumor recurrence, tumor stage and grade progression, number of delayed cystectomies, and patient survival were analyzed retrospectively in relation to the initial treatment. RESULTS: The mean follow-up was 62 months. Thirty patients were treated by TUR alone (32%), 50 patients by TUR plus BCG (53%), and 14 patients by primary cystectomy (15%). The recurrence, progression, and cystectomy rates were significantly different between patients treated by TUR alone and TUR plus BCG (Fisher's exact test, P = 0.0005, P = 0.02, and P = 0.005, respectively). The disease-free survival was also significantly different when comparing TUR plus BCG with TUR alone or primary cystectomy (Kaplan-Meier analysis, log-rank test, P = 0.02). CONCLUSIONS: Endoscopic resection plus BCG treatment of pT1G3 tumors allows an 80% rate of disease-free 5-year survival with bladder preservation. This conservative option has been widely accepted as first-line treatment, offering good cancer control with excellent quality of life. Very accurate surgical and pathologic evaluations before treatment and lifelong follow-up are obviously required.
UI - 11668518
AU - Seripa D; Parrella P; Gallucci M; Gravina C; Papa S; Fortunato P; Alcini
TI - A; Flammia G; Lazzari M; Fazio VM Sensitive detection of transitional cell carcinoma of the bladder by microsatellite analysis of cells exfoliated in urine.
SO - Int J Cancer 2001 Nov 20;95(6):364-9
AD - Unita Patologia Molecolare e Terapia Genica, IRCCS H. Casa Sollievo Sofferenza, Opera Padre Pio da Pietrelcina, San Giovanni Rotondo, Italy.
Transitional cell carcinoma (TCC) is the most common bladder tumor. Urine cytology can identify most high-grade tumors but sensitivity is lower if one includes lesions of all grades. Microsatellite marker alterations have been found in many tumor types including bladder cancer and have been used to detect cancer cells in body fluids including urine. The aim of our study is to further evaluate feasibility and sensitivity of microsatellite analysis to detect bladder cancer cells in urine. We studied 55 individuals: 21 with symptoms suggestive of bladder cancer, 23 patients with previous history of TCC and 11 healthy subjects. Genomic DNA was extracted from blood lymphocytes, urine sediment, bladder washings and tumor or normal bladder mucosa. Twenty highly informative microsatellite markers were analyzed for loss of heterozigosity (LOH) and microsatellite instability (MIN) by polymerase chain reaction. Microsatellite analysis of urine identified 33 of 34 (97%) patients with either primary or tumor recurrence, whereas urine cytology identified 27 of 34 (79%) patients (p = 0.0001). Detection of microsatellite abnormalities improved the sensitivity of detecting low-grade and/or stage bladder tumor: from 75-95% for grades G1-G2 and from 75-100% for pTis-pTa tumors. Bladder washings from 25 patients were also analyzed, and in all cases results were identical to those obtained from voided urine. None of the 16 patients without evidence of TCC showed LOH and/or MIN in urine samples or bladder washings. Interestingly, in a patient with persistent bladder mucosa abnormalities, microsatellite alterations were demonstrated 8 months before the histopathologic diagnosis of tumor recurrence. These results further indicate that microsatellite marker analysis is more sensitive than conventional urine cytology in detecting bladder cancer cells in urine and represents a potential clinical tool for monitoring patients with low-grade/stage TCC. Copyright 2001 Wiley-Liss, Inc.
UI - 11592769
AU - Zeegers MP; Goldbohm RA; van den Brandt PA
TI - Are retinol, vitamin C, vitamin E, folate and carotenoids intake associated with bladder cancer risk? Results from the Netherlands Cohort Study.
SO - Br J Cancer 2001 Sep 28;85(7):977-83
AD - Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
In the Netherlands Cohort Study among 120 852 subjects aged 55-69 years at baseline (1986), the association between vitamins and carotenoids intake, vitamin supplement use, and bladder cancer incidence was examined. Exposure status was measured with a food-frequency questionnaire. After 6.3 years of follow-up, data from 569 cases and 3123 subcohort members were available for case-cohort analyses. The age-, sex-, and smoking-adjusted relative risks (RRs) for retinol, vitamin E, folate, a-carotene, b-carotene, lutein and zeaxanthin, and lycopene were 1.04, 0.98, 1.03, 0.99, 1.16, 1.11, and 1.08, respectively, comparing highest to lowest quintile of intake. Only vitamin C (RR: 0.81, 95% CI: 0.61-1.07, P-trend = 0.08), and b-cryptoxanthin intake (RR: 0.74, 95% CI: 0.53-1.03, P-trend < 0.01) were inversely associated with bladder cancer risk. The association with vitamin C disappeared after adjustment for b-cryptoxanthin but not vice versa. The RRs for supplemental use of vitamin A, C or E compared to no use were around unity. We conclude that dietary or supplemental intake of vitamin A, vitamin C, vitamin E, and intake of folate, and most carotenoids are not associated with bladder cancer. In this study, only b-cryptoxanthin intake appeared to be inversely associated. Copyright 2001 Cancer Research Campaign
UI - 11678759
AU - Saint F; Patard JJ; Groux Muscatelli B; Lefrere Belda MA; Gil Diez de
TI - Medina S; Abbou CC; Chopin DK Evaluation of cellular tumour rejection mechanisms in the peritumoral bladder wall after bacillus Calmette-Guerin treatment.
SO - BJU Int 2001 Oct;88(6):602-10
AD - Department of Urology, Hopital Henri Mondor, Creteil, France.
OBJECTIVE: To compare the immunological status of normal and peritumoral bladder walls, and to characterize immunocompetent cells before and during intravesical instillations of bacillus Calmette-Guerin (BCG). PATIENTS AND METHODS: Twenty-three patients with superficial urothelial bladder carcinoma (stages pTa to pT1, grades 1-3) were treated with six weekly instillations of 150 mg of BCG (Pasteur strain). Biopsies of cystoscopically normal bladder wall were taken before, 3 weeks and 3 months after BCG instillation. The controls comprised bladder biopsy specimens from 13 brain-dead ventilated kidney donors. Local infiltrating cell types, i.e. lymphocyte infiltrates (CD4, CD8, CD20, CD3, interleukin-2-receptor-positive, natural killer, gammadelta), macrophages and dendritic cells, adhesion and costimulatory molecules (ICAM-1 and B7-BB1) and major histocompatibility complex (MHC) class I and class II antigens were assessed using semi-quantitative immunohistochemical analysis. RESULTS: Before BCG the peritumoral bladder wall had fewer macrophages than control bladder wall. BCG treatment restored normal numbers of macrophages and enhanced T helper lymphocytes, B lymphocytes, natural killer cells, activated lymphocytes, dendritic cells, normal MHC class I, adhesion (ICAM-1) and costimulatory (B7-BB1) expression. The enhancement of these immunological variables was transient, with a return to baseline 3 months after BCG instillation. CONCLUSIONS: These results support the concept that there is a host-immune escape associated with bladder cancer. BCG therapy may temporarily restore impaired tumour rejection mechanisms in the peritumoral bladder wall, suggesting a need for maintenance therapy after the first course of BCG.
UI - 11679798
AU - Kaye JA; Myers MW; Jick H
TI - Acetaminophen and the risk of renal and bladder cancer in the general practice research database.
SO - Epidemiology 2001 Nov;12(6):690-4
AD - Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, MA 02421, USA.
We conducted a nested, matched case-control study in the General Practice Research Database (GPRD) to assess whether acetaminophen use is associated with renal or bladder cancer. We matched 109 cases of renal cancer and 189 cases of bladder cancer with up to 4 controls each by age, sex, general practice, duration of drug history in the GPRD, and index date. We found that use of acetaminophen from 1 to 5 years before the index date was associated with an increased risk of renal cancer, with a direct relation between risk and number of prescriptions and an adjusted odds ratio of 2.3 (95% CI 1.0-5.3) for subjects with 20 or more prescriptions. There was no evidence for an increase in risk of bladder cancer with acetaminophen use. We found no association between use of non-steroidal anti-inflammatory drugs and either renal or bladder cancer. These results support previous findings from our group and are consistent with a slight increase in the risk of renal cancer, but not bladder cancer, with heavy acetaminophen use.
UI - 11679802
AU - Michaud DS; Clinton SK; Rimm EB; Willett WC; Giovannucci E
TI - Risk of bladder cancer by geographic region in a U.S. cohort of male health professionals.
SO - Epidemiology 2001 Nov;12(6):719-26
AD - Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
Large regional variations in bladder cancer rates have been observed for numerous decades in the United States and persist to date. We examined the incidence rates of bladder cancer by geographic region among U.S. male health professionals to determine whether diet or other lifestyle factors can account for variations observed. During 12 years of follow-up, 328 cases of bladder cancer were diagnosed in the Health Professionals Follow-up Study cohort. We inquired about diet, lifetime history of smoking, race, marital status, and other nondietary factors using mailed questionnaires. An elevated risk of bladder cancer was observed in the Northeast compared with the West [relative risk (RR) = 1.71, 95% confidence interval (CI) = 1.23-2.39], which was slightly attenuated after controlling for smoking (RR = 1.65, 95% CI = 1.18-2.30). Smoking patterns, diet, and other lifestyle factors could not account for all of the elevated bladder cancer risk in the Northeast. Bladder cancer risk was highest among men who had a long residency in the Northeast compared with a long residency in the West (RR = 1.77, 95% CI = 1.15-2.71, adjusted for smoking). Diet and other known characteristics do not appear to be responsible for the regional variations in bladder cancer rates in the United States.
Endocrine System Cancers
Head and Neck Cancers
Urinary Tract Cancers
Bone Marrow Transplants
General Treatment Concerns
Newly Diagnosed Patients
Causes and Prevention
Legal and Financial Information for Patients
Cancer Resource List
Resources for Young Adults