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National Cancer Institute®
Ultima Vez Modificado: 1 de junio del 2002
UI - 11441560
AU - Caterino M; Giunta S; Finocchi V; Giglio L; Mainiero G; Carpanese L;
TI - Crecco M Primary cancer of the urinary bladder: CT evaluation of the T parameter with different techniques.
SO - Abdom Imaging 2001 Jul-Aug;26(4):433-8
AD - Department of Radiology, Cancer Institute, Regina Elena, Rome, Italy.
The evaluation of mural invasion (T) in primary urinary bladder carcinoma is important in the planning of an appropriate surgical or radiochemotherapeutic strategy. Previous investigators using computed tomography (CT) have evaluated the bladder filled with urine, urine opacified with iodinated contrast material, or air insufflation. The purpose of this trial was to establish which of these three techniques was the most accurate by comparing data obtained in postoperative staging (pT). Sixty-five patients with primary bladder cancer were enrolled, all of whom were studied by spiral CT with these three techniques. Patients were assigned to four stage groups: Ta-T1, T2-T3a, T3b, and T4. The results demonstrated total accuracies of 95% for the air-insufflated bladder, 90.5% for opacified urine, and 87% for noncontrast studies. In conclusion, the air-insufflated bladder is the more accurate technique in the evaluation of the T parameter in primary bladder cancer, especially in the first and third stage groups.
UI - 11777271
AU - Skacel M; Pettay JD; Tsiftsakis EK; Procop GW; Biscotti CV; Tubbs RR
TI - Validation of a multicolor interphase fluorescence in situ hybridization assay for detection of transitional cell carcinoma on fresh and archival thin-layer, liquid-based cytology slides.
SO - Anal Quant Cytol Histol 2001 Dec;23(6):381-7
AD - Department of Anatomic Pathology, Cleveland Clinic Foundation, Ohio 44195, USA. email@example.com
OBJECTIVE: To evaluate the feasibility of performing multicolor interphase fluorescence in situ hybridization (FISH) on ThinPrep slides of transitional cell carcinoma (TCC). STUDY DESIGN: Slides from 20 voided urine specimens were prepared by the ThinPrep technique (Cytyc, Boxborough, Massachusetts, U.S.A.), pretreated using a pretreatment kit and subjected to hybridization with the multicolor FISH probe UroVysion (Vysis, Downers Grove, Illinois, U.S.A.). Archival slides were placed in xylene, destained in alcohol and washed prior to pretreatment. Urines from patients with cytology-positive, biopsy-proven grade 1 (n = 5), 2 (n = 7) and 3 (n = 5) TCC and negative cytology and biopsy (n = 3) were selected. Freshly prepared (n = 10) and archival (n = 10) slides were used. RESULTS: All carcinoma cases were FISH positive (> 5 cells with complex abnormalities of > or = 2 studied chromosomes per slide). None of the normal samples were aneusomic. Gain of chromosomes 3, 7 and 17 constituted the majority of positive cases. Proper destaining and slight decrease in stringency wash conditions enabled reliable detection of signals in archival cases. CONCLUSION: Routine ThinPrep slides can be used for multicolor interphase FISH analysis of urine cytology specimens. Archival slides provide the opportunity to analyze by FISH the nature of atypical cells identified by cytology. This revised method allows FISH technology more accessibility for routine use in cytology laboratories.
UI - 11815300
AU - Sharp JD; Hausladen DA; Maher MG; Wheeler MA; Altieri DC; Weiss RM
TI - Bladder cancer detection with urinary survivin, an inhibitor of apoptosis.
SO - Front Biosci 2002 Feb 1;7():e36-41
AD - Department of Surgery (Section of Urology), Yale University School of Medicine, New Haven, Connecticut 06520, USA.
The current "gold standard" for the diagnosis of bladder cancer is cystoscopy and urine cytology. Cystoscopy, a naked eye assessment of the bladder, is invasive, uncomfortable and costly while cytology has high specificity but low sensitivity (40-60%) particularly for low-grade lesions. Therefore, there is a need for a molecular tumor marker assay that is simple to perform and sensitive, particularly for low-grade lesions. By looking to the pathophysiology of bladder cancer, we identified survivin, an inhibitor of apoptosis that is not generally expressed in fully differentiated adult tissue and is highly expressed in bladder cancer. Survivin is detected in whole urine of patients with TCC using a simple antibody based test. The sensitivity of survivin testing for new or recurrent bladder cancer is 100% while the specificity for other neoplastic and non-neoplastic genitourinary disease is 95%. The high sensitivity of this simple, noninvasive test is well suited to bladder cancer, a disease with high rates of recurrence.
UI - 11857492
AU - Davies BR; O'Donnell M; Durkan GC; Rudland PS; Barraclough R; Neal DE;
TI - Mellon JK Expression of S100A4 protein is associated with metastasis and reduced survival in human bladder cancer.
SO - J Pathol 2002 Mar;196(3):292-9
AD - Department of Surgery, The Medical School, University of Newcastle, Newcastle-Upon-Tyne NE2 4HH, UK. B.R.Davies@ncl.ac.uk
The calcium-binding protein S100A4 induces the metastatic phenotype in rodent models of breast cancer and its expression correlates strongly with reduced survival in human breast cancer. The expression of S100A4 in normal bladders and 101 bladder tumours has been studied using immunocytochemistry. Moderate or strong expression of S100A4 was found in 28% of the tumours, whilst the remaining tumours and normal urothelium either failed to stain or showed weak staining. S100A4 staining was more frequently observed in invasive bladder tumours than in non-invasive tumours (p<0.05). In invasive tumours, S100A4 staining was usually strongest in invasive regions and single infiltrating cells. Statistically significant associations were found between S100A4 expression and metastasis (p=0.0003) and reduced survival (p<0.0001). It is concluded that S100A4 expression may play an important role in bladder cancer and may identify a subgroup of patients at increased risk of metastasis who should be considered for adjuvant systemic therapy. Copyright 2002 John Wiley & Sons, Ltd.
UI - 11888672
AU - Soulitzis N; Sourvinos G; Dokianakis DN; Spandidos DA
TI - p53 codon 72 polymorphism and its association with bladder cancer.
SO - Cancer Lett 2002 May 28;179(2):175-83
AD - Laboratory of Virology, Medical School, University of Crete, P.O. Box 1393, Heraklion, Crete, Greece.
p53 codon 72 Arg homozygosity has been associated with increased risk of developing cervical cancer. This association has been tested in various human cancers with controversial results. In the present study we investigated the impact of this polymorphism in a population-based case-control study of bladder cancer. Using allele-specific polymerase chain reaction to detect the p53 codon 72 polymorphism, we tested peripheral blood samples from 50 patients with bladder cancer and 99 healthy individuals of similar age and from the same geographical region. Tumor specimens from all bladder cancer patients were examined for the presence of human papilloma virus (HPV). The distribution of p53 alleles in bladder cancer patients and in controls was statistically significant (P<0.002; odds ratio, 2.67; 95% confidence interval, 1.38-5.20), and homozygosity for arginine at residue 72 was associated with an increased risk for bladder cancer (P<0.00002; odds ratio, 4.69; 95% confidence interval, 2.13-10.41). The presence of HPV was found in six of the 50 patients (12%). This is the first study correlating p53 codon 72 polymorphism with bladder cancer. Our results provide evidence that this p53 polymorphism is implicated in bladder carcinogenesis and that individuals harboring the Arg/Arg genotype have an increased risk of developing bladder cancer.
UI - 11953681
AU - Tiguert R; Fradet Y
TI - New diagnostic and prognostic tools in bladder cancer.
SO - Curr Opin Urol 2002 May;12(3):239-43
AD - Laval University Cancer Research Center, CHUQ l'Hotel-Dieu de Quebec, Quebec, Canada.
Many efforts have been made to increase the detection rates and to predict the outcome of bladder cancer. Although to date cystoscopy remains the gold standard method for the detection of new or recurrent bladder cancer, its limitations were emphasized by the results of studies using fluorescence endoscopy that showed an increased detection rate and decreased recurrence after tumor resection. Urine cytology has high specificity and is used routinely as an adjunct to cystoscopy to detect invisible tumors. However, to improve on the low sensitivity of urine cytology, a number of marker tests have been developed. Optimal diagnostic accuracy appears to result from the synergistic combination of cytological markers with urine cytology. The evaluation of new and previously reported markers remains a very active field, but is still limited to inconclusive studies. Tissue and DNA microarrays represent a technological step forward for the analysis of a large number of markers and cohorts of patients that will be required definitively to establish the clinical utility of prognostic tests.
UI - 11992046
AU - Maruniak NA; Takezawa K; Murphy WM
TI - Accurate pathological staging of urothelial neoplasms requires better cystoscopic sampling.
SO - J Urol 2002 Jun;167(6):2404-7
AD - Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, Florida, USA.
PURPOSE: The frequency with which muscularis propria was sampled by urologists and the sources of interpretive discrepancies among pathologists were studied in a community practice setting. MATERIALS AND METHODS: A total of 217 consecutive cases of urothelial neoplasm were independently reviewed by 3 pathologists. The presence or absence of muscularis propria as well as interpretive discrepancies were recorded. RESULTS: Despite clinical emphasis on accurate pathological staging portions of muscularis propria were absent from samples of histologically documented urothelial neoplasms in up to 51% of cases. Failure to obtain muscularis propria varied widely among urologists but was most often associated with cases of low grade papillary neoplasms, in which invasion is less likely. Muscularis propria was usually present in cases of noninvasive carcinoma in situ but this may have represented inadvertent sampling of structures in close proximity. The incidence of interpretive discrepancies among pathologists who are required to assess the status of muscularis propria was significant (24%). Almost all problems were related to artifacts and most may have been avoided if careful attention had been given to specimen sampling and processing. CONCLUSIONS: The well documented tendency toward cystoscopic under staging has not necessarily resulted in a high incidence of muscularis propria in bladder cases of urothelial neoplasms. Even when muscle may have been sampled, artifacts that were often due to thermocoagulation hampered accurate pathological staging.
UI - 11992049
AU - Mahmoud-Ahmed AS; Suh JH; Kupelian PA; Klein EA; Peereboom DM; Dreicer
TI - R; Barnett GH Brain metastases from bladder carcinoma: presentation, treatment and survival.
SO - J Urol 2002 Jun;167(6):2419-22
AD - Department of Radiation Oncology, Brain Tumor Institute, Taussig Cancer Center, 9500 Euclid Avenue, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
PURPOSE: We report the presentation of brain metastases from bladder carcinoma. We investigated the role of whole brain radiation therapy for were treated at our institution. We reviewed patient and tumor characteristics at the time of the primary diagnosis and the brain metastasis diagnosis. We analyzed treatment results in regard to survival and local metastasis control. RESULTS: Brain metastases from bladder carcinoma were commonly accompanied by uncontrolled systemic metastases. Multiple brain lesions developed in 14 of the 16 patients. Of the 16 patients 14 received radiation therapy with or without surgery, 1 was treated surgically and 1 did not receive any treatment. The 11 patients treated with whole brain radiation therapy had a median survival of only 2 months (range 0.5 to 11). A patient who received stereotactic radiosurgery survived 12 months after the brain metastasis diagnosis and 2 treated with radiation therapy after surgery survived 12.75 and 2.75 months, respectively (median 7.75). The patient treated with surgery alone survived 1.25 months after the brain metastasis diagnosis and 1 who received no treatment survived 1.75 months. Patients with multiple brain metastases had shorter survival than those with a single metastasis. CONCLUSIONS: Overall survival after brain metastasis development in patients with bladder carcinoma was poor. Although the number of patients in this study was small, results indicate that radiation therapy alone is inadequate treatment. Therefore, when possible, we advocate more effective treatment by combining radiation therapy with other treatment modalities, as recommended in ongoing clinical trials.
UI - 12056036
AU - Furuya S; Ogura H; Shimamura S; Itoh N; Tsukamoto T
TI - [The value of using urinary red cell volume distribution curve of patients with positive urinary occult blood detected in a mass examination]
SO - Nippon Hinyokika Gakkai Zasshi 2002 May;93(4):525-31
AD - Department of Urology, Furuya Hospital.
PURPOSE: We investigated the usefulness of the urinary red blood cell volume distribution curve (RVDC) for screening patients who are positive for asymptomatic urinary occult blood on mass examination. SUBJECTS AND METHODS: The subjects were 200 individuals over 40 years old (44 men with a median age of 53.4 years and 156 women with a median age of 57.2 years) who were positive for urinary occult blood on mass examination into three groups based on the pattern of their RVDC. Group NG showed a nonglomerular pattern, group M showed a mixed pattern, and group G showed a glomerular pattern. The urological examinations performed included DIP, ultrasound of the kidney and urinary bladder and urethrocystoscopy. To investigate the prognosis, a questionnaire was the state of their disease during the period since the initial examination. RESULTS: Group G consisted of 192 patients, or almost all of the subjects (96%). There were five patients (2.5%) who had serious urological diseases, including two with bladder cancer, and all were found in Groups NG and M. During the period from initial examination until the prognosis survey (mean of 5.7 year), one patient in group G developed both bladder and ureteral cancer. The CVDC showed a mixed pattern when this patient was discovered. CONCLUSION: RVDC was useful for screening patients who were found to be positive for urinary occult blood on mass examination. When the RVDC shows a non-glomerular or mixed pattern, detailed urological examination including endoscopy is necessary.
UI - 11984131
AU - Woolcott CG; King WD; Marrett LD
TI - Coffee and tea consumption and cancers of the bladder, colon and rectum.
SO - Eur J Cancer Prev 2002 Apr;11(2):137-45
AD - Department of Community Health Sciences, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada.
Coffee has been observed to be associated weakly or not at all with bladder cancer risk, inversely with colon cancer risk, and inconsistently with rectal cancer risk. The association between these cancers and consumption of coffee and tea was examined in a single case-control study conducted in Ontario, Canada from 1992 to 1994. A questionnaire was filled out by 927 bladder cancer cases, 991 colon cancer cases, 875 rectal cancer cases, and 2118 population controls. Although bladder cancer risk was not associated with coffee or tea, risk estimates associated with coffee among subjects who had never smoked were non-significantly increased. Colon cancer risk was inversely associated with coffee. Relative to those drinking less than 1 cup of coffee per day, the odds ratios (OR) for those drinking 1-2 cups was 0.9 (95% CI 0.8-1.1), for those drinking 3-4 cups was 0.8 (95% CI 0.7-1.0), and for those drinking 5 or more cups was 0.7 (95% CI 0.5-0.9); these ORs decreased linearly (P = 0.008). The reduced risk estimates were more pronounced with cancer of the proximal colon than the distal colon. Rectal cancer risk was not associated with either coffee or tea. Coffee consumption was observed to have a different relationship for each of the cancer sites and tea consumption was not related to any cancer site.
UI - 11435814
AU - Mills RD; Turner WH; Fleischmann A; Markwalder R; Thalmann GN; Studer UE
TI - Pelvic lymph node metastases from bladder cancer: outcome in 83 patients after radical cystectomy and pelvic lymphadenectomy.
SO - J Urol 2001 Jul;166(1):19-23
AD - Department of Urology and Institutes of Pathology, University of Berne, Berne, Switzerland.
PURPOSE: We evaluate the outcome in patients with node positive bladder cancer with particular reference to the effect of individual characteristics of positive nodes on survival after meticulous pelvic lymphadenectomy at cystectomy. MATERIALS AND METHODS: This prospective analysis contains 452 cases of bladder cancer staged preoperatively as N0M0, managed with pelvic lymphadenectomy and cystectomy between 1984 and 1997. A total of 83 (18%) patients with histologically confirmed node positive disease are included in our study. RESULTS: The median overall survival of patients with positive nodes was 20 months. Median 5-year survival was 29%. Patients who survived were found with positive nodes at each site in the pelvis. The median survival of 57 patients with less than 5 positive nodes was 27 months, compared with 15 months for 26 with 5 nodes or more (log-rank test p = 0.0027). Median survival of 26 patients with no lymph node capsule perforation was 93 months, compared with 16 months for 57 with capsule perforation (p = 0.0004). The median survival of 18 patients with a maximum diameter of lymph node metastasis up to 0.5 cm. was 64 months, compared with 16 months for 65 with nodal metastasis greater than 0.5 cm. (p = 0.024). Contralateral positive nodes were found in 16 of 39 (41%) patients with unilateral bladder cancer. CONCLUSIONS: Long-term survival is possible with node positive bladder cancer. Those patients with few as well as smaller and, therefore, unsuspected nodal metastases, and those without lymph node capsule perforation have the best results after removal of pelvic metastatic nodal disease. Because patients who survive may be found regardless of the site of pelvic nodal metastases, meticulous bilateral pelvic lymphadenectomy is warranted in all patients at the time of attempted curative cystectomy for bladder cancer, particularly if there is no clinical evidence of nodal involvement.
UI - 11792943
AU - Neulander EZ
TI - Re: pelvic lymph node metastases from bladder cancer: outcome in 83 patients after radical cystectomy and pelvic lymphadenectomy.
SO - J Urol 2002 Feb;167(2 Pt 1):651
UI - 11966640
AU - Lipinski M; Jeromin L
TI - Comparison of the bladder tumour antigen test with photodynamic diagnosis in patients with pathologically confirmed recurrent superficial urinary bladder tumours.
SO - BJU Int 2002 May;89(7):757-9
AD - Clinic of Urology, Medical University of Lodz, Pabianicka 62, 93-513 Lodz, Poland. firstname.lastname@example.org
OBJECTIVE: To verify the sensitivity of the bladder tumour antigen (BTAstat, Bard Urological, Covington, GA) test against the sensitive procedure of photodynamic diagnosis (PDD), in which 5-aminolaevulinic acid (5-ALA, a precursor of fluorescent porphyrins) is absorbed by the tumour and detected by ultraviolet cystoscopy, in the early diagnosis of urinary bladder tumours. PATIENTS AND METHODS: Forty-three patients (31 men and 12 women, age range 21-87 years) were assessed after transurethral resection of their bladder tumour using the BTAstat test and PDD. Sixty-nine biopsies from suspect areas of bladder mucosa were taken during cystoscopy under ultraviolet light and all suspect lesions electrocoagulated. RESULTS: Thirty-five patients (81%) had a positive BTAstat test; in these patients PDD detected malignant lesions (17 Ta1G1-2, two T1G2, two T1G3 and 14 Tis). In eight patients (19%) the BTAstat was negative but PDD detected three malignant lesions (two Tis and one TaG1). CONCLUSIONS: PDD is valuable for detecting bladder malignancy and can identify small lesions not detected by the BTAstat test.
UI - 11966641
AU - D'Hallewin MA; Kamuhabwa AR; Roskams T; De Witte PA; Baert L
TI - Hypericin-based fluorescence diagnosis of bladder carcinoma.
SO - BJU Int 2002 May;89(7):760-3
AD - Department of Urology, UZ Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. email@example.com
OBJECTIVE: To determine the use of hypericin instillation for the fluorescent detection of papillary bladder cancer and carcinoma in situ. PATIENTS AND METHODS: Eighty-seven patients with papillary bladder cancer and/or carcinoma in situ received instillations with 40 mL of an 8 micromol/L hypericin solution for at least 2 h. Fluorescent excitation with blue light was effective for up to 16 h, and biopsies were examined by fluorescence microscopy. RESULTS: There were no side-effects reported, no photobleaching and all papillary lesions fluoresced red. The sensitivity and specificity for detecting carcinoma in situ was 94% and 95%, respectively. An interval of 4 months is recommended after BCG instillations before using this test. Fluorescence microscopy showed that hypericin was selectively localized in the epithelium. CONCLUSIONS: Hypericin-induced fluorescence has a high sensitivity and specificity for detecting bladder cancer. After 4 months there are few false-positive results in patients treated with BCG.
UI - 11455318
AU - Giovagnoli MR; Rocchi M; Grillo L; Vecchione A
TI - [The significance of "atypical metaplasia" in the follow-up of patients operated for bladder cancer]
SO - Minerva Urol Nefrol 2001 Jun;53(2):93-7
AD - II Facolta di Medicina e Chirurgia, Scuola di Specializzazione in Oncologia II, Universita degli Studi La Sapienza, Rome. firstname.lastname@example.org
BACKGROUND: The aim of this study was to evaluate the clinical usefulness of urinary cytology in the follow-up of patients who under-went surgery for bladder cancer. Particularly, the positive predictive value of urinary cytology and time elapsed between a positive test and the diagnosis of a cystoscopically confirmed bladder tumor are analyzed. METHODS: This study was carried out at the Cytological Laboratory Department of Experimental Medicine and Pathology, University La Sapienza, Rome. Among 230 cases studied since 1996, 30 male patients over 50 were examined (25 with a previous bladder cancer and 5 with a previous prostate cancer) with long time follow-up, who underwent more than two cytological examinations on voided urine (2-12) at pre-fixed intervals. RESULTS: Nine (30%) of the patients suffered from recurrent disease. The cytological examinations was positive in 8 out of the 9 positive cases and negative in 17 out of the 21 negative cases. Absence of disease was confirmed in all the latter cases both by cystoscopic examination and clinical follow-up. One negative case showed clearly malignant cells in more than one specimen taken at different time intervals. This patient is actually under strict control. In 5 cases atypical metaplasia was present in the cytological specimen. In two of those cases cystoscopic examination 5 and 8 months later confirmed progressive disease. In the other three cases cystoscopy showed no evidence of disease. Two of the patients are well and alive after 2 and 14 months respectively. One is dead of prostatic cancer. CONCLUSIONS: Considering the cases of atypical metaplasi as positive the cytological examinations showed 100% sensibility, 81% specificity, a predictive negative value of 1 and a predictive positive value of 0.66.
UI - 11692797
AU - Rodriguez-Rubio Cortadellas FI; Garrido Insua S; Rivas Aguayo D; Hens
TI - Perez A; Bachiller Burgos J; Beltran Aguilar V; Varo Solis C; Sanchez Bernal C; Juarez Soto A; Gonzalez Moreno D [Second resection in patients with Ta-T1 bladder tumors]
SO - Actas Urol Esp 2001 Sep;25(8):553-8
AD - Servicio de Urologia, Hospital Universitario de Puerto Real, Cadiz.
OBJECTIVES: To study the incidence of "residual/recurrence" tumor after a second bladder resection (2nd TUR). METHODS: 40 patients with new or recurrent superficial bladder tumor underwent repeat transurethral resection within 3 months after the initial resection. 37 patients were staged as Ta-T1. We study the incidence of tumor after the 2nd TUR both macroscopically detected or included in the bladder scar. We also study the influence of possible factors as the time between both resections, stage, grade, number of tumor size, localization in the bladder, primary or recurrent tumor and tumor pattern. RESULTS: After the 2nd TUR we found tumor in 14 of 37 (37.8%) Ta-T1 bladder tumors. Among the 14 tumors, 10 (71.5%) were macroscopically visible tumors and 4 cases the tumor were found after resection of the bladder scar of the first resection. We did not find relation between the presence of tumor in the 2nd TUR and any of the variables. CONCLUSIONS: After a TUR of superficial bladder tumor the complete removal of tumor is not always achieved. The early 3 months cystoscopy may not find residual tumor. Although we have found tumor in 37.8% in the 2a TUR we can not recommend routine 2nd TUR in superficial bladder cancer.
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