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Genitourinary cancer
Neoadjuvant Cisplatin-Based Chemotherapy Followed by Selective Bladder Preservation Chemoradiotherapy in Muscle-Invasive Urothelial Carcinoma of the Bladder: Post Hoc Analysis of Two Prospective Studies
Sung Wook Cho, Sung Hee Lim, Ghee Young Kwon, Chan Kyo Kim, Won Park, Hongryull Pyo, Jae Hoon Chung, Wan Song, Hyun Hwan Sung, Byong Chang Jeong, Se Hoon Park
Cancer Res Treat. 2024;56(3):893-897.   Published online February 15, 2024
DOI: https://doi.org/10.4143/crt.2024.015
AbstractAbstract PDFPubReaderePub
Purpose
Bladder preservation chemoradiotherapy (CRT) in patients with a clinical complete response (cCR) following cisplatin-based neoadjuvant chemotherapy (NAC) is a promising treatment strategy for muscle-invasive bladder urothelial carcinoma (MIBC). A combined analysis of raw data from two prospective phase II studies was performed to better evaluate the feasibility of selective bladder preservation CRT.
Materials and Methods
The analysis was based on primary efficacy data from two independent studies, including 76 MIBC patients receiving NAC followed by bladder preservation CRT. The efficacy data included metastasis-free survival (MFS) and disease-free survival (DFS). For the present analysis, starting point of survival was defined as the date of commencing CRT.
Results
Among 76 patients, 66 had a cCR following NAC. Sixty-four patients received gemcitabine and cisplatin (GC) combination chemotherapy in neoadjuvant setting, and 12 received nivolumab plus GC. Bladder preservation CRT following NAC was generally well-tolerated, with low urinary tract symptoms being the most common late complication. With a median follow-up of 64 months, recurrence was recorded in 43 patients (57%): intravesical only (n=20), metastatic only (n=16), and both (n=7). In 27 patients with intravesical recurrence, transurethral resection, and Bacillus Calmette-Guerin treatment was given to 17 patients. Salvage cystectomy was performed in 10 patients. Median DFS was 46.3 (95% confidence interval [CI], 25.1 to 67.5) months, and the median MFS was not reached. Neither DFS nor MFS appeared to be affected by any of the baseline characteristics. However, DFS was significantly longer in patients with a cCR than in those without (hazard ratio, 0.465; 95% CI, 0.222 to 0.976).
Conclusion
The strategy of NAC followed by selective bladder preservation CRT based on the cCR is feasible in the treatment of MIBC. A standardized definition of cCR is needed to better assess disease status post-NAC.

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  • News and prospects on radiotherapy for bladder cancer: Is trimodal therapy becoming the gold standard?
    Olivier Riou, Christophe Hennequin, Jonathan Khalifa, Paul Sargos
    Cancer/Radiothérapie.2024; 28(6-7): 623.     CrossRef
  • 2,868 View
  • 147 Download
  • 1 Web of Science
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Physical Activity and Bladder Cancer Risk: Findings of the Japan Collaborative Cohort Study
Hang An, Keyang Liu, Kokoro Shirai, Ryo Kawasaki, Akiko Tamakoshi, Hiroyasu Iso
Cancer Res Treat. 2024;56(2):616-623.   Published online October 6, 2023
DOI: https://doi.org/10.4143/crt.2023.962
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The association of physical activity with the risk of bladder cancer remains inconsistent among Asian populations. We aimed to examine the association in a large Japanese cohort.
Materials and Methods
In a population-based prospective cohort study, a total of 50,374 Japanese adults aged 40-79 years without a history of cancer or cardiovascular disease who had information on physical activity from self-administrated questionnaires were used for analysis. We performed Cox proportional hazard models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident bladder cancer after adjusting for several potential confounders.
Results
During the median 17.5 years of follow-up, 153 incident bladder cancers (116 men and 37 women) were identified. After the multivariable adjustment, HRs (95% CI) of bladder cancer concerning those with recreational sports participation of 1-2 hr/wk, 3-4 hr/wk, and 5 hr/wk and more were 0.67 (0.38-1.20), 0.79 (0.36-1.74), and 0.28 (0.09-0.89), respectively (p for trend=0.017). Compared with mostly sitting at the workplace, occupational physical activity of standing and walking were associated with a lower risk of bladder cancer (HR, 0.53 [95% CI, 0.32 to 0.85]). Hours of daily walking were not associated with the risk. The lower risk of bladder cancer was more evident for recreational sports (HR, 0.33 [95% CI, 0.10 to 1.00]), and for occupational standing and walking activity at work (HR, 0.57 [95% CI, 0.33 to 0.98]) among men.
Conclusion
Recreational sports participation and occupational physical activity were inversely associated with the risk of bladder cancer among Japanese, especially in men.
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TNM-Based Head-to-Head Comparison of Urachal Carcinoma and Urothelial Bladder Cancer: Stage-Matched Analysis of a Large Multicenter National Cohort
Sang Hun Song, Jaewon Lee, Young Hwii Ko, Jong Wook Kim, Seung Il Jung, Seok Ho Kang, Jinsung Park, Ho Kyung Seo, Hyung Joon Kim, Byong Chang Jeong, Tae-Hwan Kim, Se Young Choi, Jong Kil Nam, Ja Yoon Ku, Kwan Joong Joo, Won Sik Jang, Young Eun Yoon, Seok Joong Yun, Sung-Hoo Hong, Jong Jin Oh
Cancer Res Treat. 2023;55(4):1337-1345.   Published online April 17, 2023
DOI: https://doi.org/10.4143/crt.2023.417
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Outcome analysis of urachal cancer (UraC) is limited due to the scarcity of cases and different staging methods compared to urothelial bladder cancer (UroBC). We attempted to assess survival outcomes of UraC and compare to UroBC after stage-matched analyses.
Materials and Methods
Total 203 UraC patients from a multicenter database and 373 UroBC patients in single institution from 2000 to 2018 were enrolled (median follow-up, 32 months). Sheldon stage conversion to corresponding TNM staging for UraC was conducted for head-to-head comparison to UroBC. Perioperative clinical variables and pathological results were recorded. Stage-matched analyses for survival by stage were conducted.
Results
UraC patients were younger (mean age, 54 vs. 67 years; p < 0.001), with 163 patients (80.3%) receiving partial cystectomy and 23 patients (11.3%) radical cystectomy. UraC was more likely to harbor ≥ pT3a tumors (78.8% vs. 41.8%). While 5-year recurrence-free survival, cancer-specific survival (CSS) and overall survival were comparable between two groups (63.4%, 67%, and 62.1% in UraC and 61.5%, 75.9%, and 67.8% in UroBC, respectively), generally favorable prognosis for UraC in lower stages (pT1-2) but unfavorable outcomes in higher stages (pT4) compared to UroBC was observed, although only 5-year CSS in ≥ pT4 showed statistical significance (p=0.028). Body mass index (hazard ratio [HR], 0.929), diabetes mellitus (HR, 1.921), pathologic T category (HR, 3.846), and lymphovascular invasion (HR, 1.993) were predictors of CSS for all patients.
Conclusion
Despite differing histology, UraC has comparable prognosis to UroBC with relatively favorable outcome in low stages but worse prognosis in higher stages. The presented system may be useful for future grading and risk stratification of UraC.

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  • Clinical Presentation and Targeted Interventions in Urachal Adenocarcinoma: A Single-Institution Case Series and Review of Emerging Therapies
    Akshay Mathavan, Akash Mathavan, Rodrigo Murillo-Alvarez, Kriti Gera, Urszula Krekora, Aaron J. Winer, Mohit Mathavan, Ellery Altshuler, Brian Hemendra Ramnaraign
    Clinical Genitourinary Cancer.2024; 22(1): 67.     CrossRef
  • Robotic‐assisted approaches to urachal carcinoma: A comprehensive systematic review of the safety and efficacy outcomes
    Caio Vinícius Suartz, Lucas Motta Martinez, Pedro Henrique Brito, Carlos Victori Neto, Maurício Dener Cordeiro, Luiz Antonio Assan Botelho, Fábio Pescarmona Gallucci, José Maurício Mota, William Carlos Nahas, Leopoldo Alves Ribeiro‐Filho
    BJUI Compass.2024; 5(3): 327.     CrossRef
  • 3,464 View
  • 207 Download
  • 2 Web of Science
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Neoadjuvant Nivolumab Plus Gemcitabine/Cisplatin Chemotherapy in Muscle-Invasive Urothelial Carcinoma of the Bladder
Hongsik Kim, Byong Chang Jeong, Joohyun Hong, Ghee Young Kwon, Chan Kyo Kim, Won Park, Hongryull Pyo, Wan Song, Hyun Hwan Sung, Jung Yong Hong, Se Hoon Park
Cancer Res Treat. 2023;55(2):636-642.   Published online October 6, 2022
DOI: https://doi.org/10.4143/crt.2022.343
AbstractAbstract PDFPubReaderePub
Purpose
The activity and safety of neoadjuvant nivolumab plus gemcitabine/cisplatin (N+GC) were tested in patients with muscle-invasive bladder urothelial carcinoma (MIBC).
Materials and Methods
In a prospective phase II trial, patients with cT2-T4a N0 MIBC who were eligible for cisplatin and medically appropriate to undergo radical cystectomy (RC) were enrolled. Treatment with nivolumab 3 mg/kg on days 1 and 15 plus GC (cisplatin 70 mg/m2 on day 1, and gemcitabine 1,000 mg/m2 on days 1, 8, and 15) was repeated every 28 days up to 3 or 4 cycles, depending on the surgery schedules. The primary endpoint was pathologic complete response (pCR, ypT0). Secondary endpoints included pathologic downstaging (≤ ypT1), disease-free survival (DFS), and safety.
Results
Between September 2019 and October 2020, 51 patients were enrolled. Neoadjuvant N+GC was well tolerated. Among 49 patients who completed neoadjuvant N+GC, clinical complete response (cCR) was achieved in 59% of intent-to-treat (ITT) population. RC was performed in 34 (69%) patients. pCR was achieved in 24% (12/49) of ITT population and 35% (12/34) of RC patients. Median DFS was not reached. Over a median follow-up of 24 months, 12 patients experienced disease recurrence and were treated with palliative therapy or surgery. Although 12 patients declined surgery and were treated with concurrent chemoradiotherapy, DFS was longer in patients with cCR after neoadjuvant therapy than those without. Preoperative programmed death-ligand 1 (PD-L1) did not correlate with pCR or pathologic downstaging rates.
Conclusion
Neoadjuvant N+GC was feasible and provided meaningful pathologic responses in patients with MIBC, regardless of baseline PD-L1 expression (ONO-4538-X41; CRIS.nih.go.kr, KCT0003804).

Citations

Citations to this article as recorded by  
  • Evaluating Neoadjuvant Immunochemotherapeutic Response for Bladder Carcinoma Using Amide Proton Transfer-Weighted MRI
    Lingmin Kong, Bei Weng, Qian Cai, Ling Ma, Wenxin Cao, Yanling Chen, Long Qian, Yan Guo, Junxing Chen, Huanjun Wang
    Academic Radiology.2025;[Epub]     CrossRef
  • Efficacy and safety of neoadjuvant PD-1 inhibitors or PD-L1 inhibitors for muscle invasive bladder cancer: a systematic review and meta-analysis
    Shibo Huang, Yanping Huang, Chunyan Li, Yiwen Liang, Miaoyan Huang, Raoshan Luo, Weiming Liang
    Frontiers in Immunology.2024;[Epub]     CrossRef
  • What’s new about the tumor microenvironment of urothelial carcinoma?
    João Queirós Coelho, Maria João Ramos, Ridhi Ranchor, Rita Pichel, Laura Guerra, Hugo Miranda, Joana Simões, Sérgio Xavier Azevedo, Joana Febra, António Araújo
    Clinical and Translational Oncology.2024; 26(7): 1549.     CrossRef
  • A bibliometric insight into neoadjuvant chemotherapy in bladder cancer: trends, collaborations, and future avenues
    Yi Huang, Chengxiao Liao, Zefeng Shen, Yitong Zou, Weibin Xie, Qinghua Gan, Yuhui Yao, JunJiong Zheng, Jianqiu Kong
    Frontiers in Immunology.2024;[Epub]     CrossRef
  • Bladder-sparing treatment using tislelizumab combined with gemcitabine/cisplatin in selected patients with muscle-invasive bladder cancer: a real-world study
    Cheng Luo, Shuhang Luo, Wumier Wusimanjiang, Zongren Wang, Ping Liu, Bin Wang, Dan Yuan, Hao Lin, Abai Xu, Nan Deng, Kaihui Wu, Xuejin Zhu, Peng Xu, Junxing Chen, Bin Huang
    Clinical and Translational Oncology.2024; 26(7): 1759.     CrossRef
  • Neoadjuvant Cisplatin-Based Chemotherapy Followed by Selective Bladder Preservation Chemoradiotherapy in Muscle-Invasive Urothelial Carcinoma of the Bladder: Post Hoc Analysis of Two Prospective Studies
    Sung Wook Cho, Sung Hee Lim, Ghee Young Kwon, Chan Kyo Kim, Won Park, Hongryull Pyo, Jae Hoon Chung, Wan Song, Hyun Hwan Sung, Byong Chang Jeong, Se Hoon Park
    Cancer Research and Treatment.2024; 56(3): 893.     CrossRef
  • Perioperative Durvalumab with Neoadjuvant Chemotherapy in Operable Bladder Cancer
    Thomas Powles, James W.F. Catto, Matthew D. Galsky, Hikmat Al-Ahmadie, Joshua J. Meeks, Hiroyuki Nishiyama, Toan Quang Vu, Lorenzo Antonuzzo, Pawel Wiechno, Vagif Atduev, Ariel G. Kann, Tae-Hwan Kim, Cristina Suárez, Chao-Hsiang Chang, Florian Roghmann, M
    New England Journal of Medicine.2024; 391(19): 1773.     CrossRef
  • Klassische Chemotherapie, Immuntherapie oder adjuvante Strahlentherapie – Wie können wir die onkologischen Ergebnisse der radikalen Zystektomie verbessern?
    Pia Paffenholz, Stefanie Zschäbitz
    Die Urologie.2024; 63(10): 994.     CrossRef
  • Recent developments in perioperative combination therapy in muscle-invasive bladder cancer
    Jan-Jaap J. Mellema, Bas W.G. van Rhijn, Michiel S. van der Heijden
    Current Opinion in Urology.2023; 33(5): 404.     CrossRef
  • 5,883 View
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  • 6 Web of Science
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Genomic Sequencing for Bladder Urothelial Carcinoma and Its Clinical Implications for Immunotherapy
Ryul Kim, Jung Yong Hong, Jeeyun Lee, Ghee Young Kwon, Byong Chang Jeong, Se Hoon Park
Cancer Res Treat. 2022;54(3):894-906.   Published online November 17, 2021
DOI: https://doi.org/10.4143/crt.2021.854
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to explore the genomic and transcriptomic landscape of bladder cancer (BC) and its implication for treatment with an immune checkpoint inhibitor (ICI).
Materials and Methods
We analyzed whole-exome and -transcriptome sequences of tumor samples from 64 BC patients who underwent surgical resection with either transurethral resection or radical cystectomy. For exploratory purposes, programmed death-ligand 1 (PD-L1) expression was evaluated in a subset of patients (n=57) including those treated with ICI (n=8).
Results
We identified frequent molecular dysregulations in chromatin regulatory genes (KDM6A, ARID1A, MLL2, and STAG2) and recurrent copy number alterations. Thirty-five samples (54.7%) were PD-L1–positive (PD-L1 combined positive score ≥ 1) with a significantly higher exonic tumor mutational burden (TMB) compared to PD-L1–negative BC samples (p=0.010). We observed that various immune-responsive pathways, including the PD-L1 signaling pathway, were enriched significantly in PD-L1–positive BCs. Interestingly, genes in the CTLA4 pathway were enriched significantly in PD-L1–positive BC as well. Among eight patients who received ICI, progressive disease was confirmed in one patient, whose tumor had low exonic TMB, negative PD-L1 status, and a relatively colder microenvironment.
Conclusion
Gaining new insights into the molecular landscape of BC will improve treatment strategies. Our analysis suggests a rationale for studying dual checkpoint inhibition against BC.

Citations

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  • The role of lysine-specific demethylase 6A (KDM6A) in tumorigenesis and its therapeutic potentials in cancer therapy
    Li-Juan Chen, Xin-Yang Xu, Xiao-Dan Zhong, Yan-Jun Liu, Ming-Hui Zhu, Fan Tao, Chang-Yun Li, Qiu-Sheng She, Guan-Jun Yang, Jiong Chen
    Bioorganic Chemistry.2023; 133: 106409.     CrossRef
  • A novel cuproptosis-related lncRNAs signature predicts prognostic and immune of bladder urothelial carcinoma
    Zheng Zhou, Yusong Zhou, Wei Liu, Jing Dai
    Frontiers in Genetics.2023;[Epub]     CrossRef
  • Implication of KDM6A in Bladder Cancer
    Marianne Matar, Gilles Prince, Ibrahim Hamati, Maria Baalbaky, Jonas Fares, Marc Aoude, Charbel Matar, Hampig Raphael Kourie
    Pharmacogenomics.2023; 24(9): 509.     CrossRef
  • Subsequent Systemic Therapy following Platinum and Immune Checkpoint Inhibitors in Metastatic Urothelial Carcinoma
    Joohyun Hong, Hyun Hwan Sung, Byong Chang Jeong, Se Hoon Park
    Biomedicines.2022; 10(8): 2005.     CrossRef
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    Reactions Weekly.2022; 1933(1): 61.     CrossRef
  • Cuproptosis-related lncRNA signatures predict prognosis and immune relevance of kidney renal papillary cell carcinoma
    Tongjin Xie, Bin Liu, Dongbo Liu, Yusong Zhou, Qingping Yang, Dai Wang, Mengjie Tang, Wei Liu
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • 7,490 View
  • 245 Download
  • 5 Web of Science
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Next-generation Proteomics-Based Discovery, Verification, and Validation of Urine Biomarkers for Bladder Cancer Diagnosis
Jungyo Suh, Dohyun Han, Ja Hyeon Ku, Hyeon Hoe Kim, Cheol Kwak, Chang Wook Jeong
Cancer Res Treat. 2022;54(3):882-893.   Published online October 9, 2021
DOI: https://doi.org/10.4143/crt.2021.642
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We aimed to identify, verify, and validate a multiplex urinary biomarker-based prediction model for diagnosis and surveillance of urothelial carcinoma of bladder, using high-throughput proteomics methods.
Materials and Methods
Label-free quantification of data-dependent and data-independent acquisition of 12 and 24 individuals was performed in each of the discovery and verification phases using mass spectrometry, simultaneously using urinary exosome and proteins. Based on five scoring system based on proteomics data and statistical methods, we selected eight proteins. Enzyme-linked immunosorbent assay on urine from 120 patients with bladder mass lesions used for validation. Using multivariable logistic regression, we selected final candidate models for predicting bladder cancer.
Results
Comparing the discovery and verification cohorts, 38% (50/132 exosomal differentially expressed proteins [DEPs]) and 44% (109/248 urinary DEPs) are consistent at statistically significance, respectively. The 20 out of 50 exosome proteins and 27 out of 109 urinary proteins were upregulated in cancer patients. From eight selected proteins, we developed two diagnostic models for bladder cancer. The area under the receiver operating characteristic curve (AUROC) of two models were 0.845 and 0.842, which outperformed AUROC of urine cytology.
Conclusion
The results showed that the two diagnostic models developed here were more accurate than urine cytology. We successfully developed and validated a multiplex urinary protein-based prediction, which will have wide applications for the rapid diagnosis of urothelial carcinoma of the bladder. External validation for this biomarker panel in large population is required.

Citations

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  • A novel machine learning algorithm selects proteome signature to specifically identify cancer exosomes
    Bingrui Li, Fernanda G Kugeratski, Raghu Kalluri
    eLife.2024;[Epub]     CrossRef
  • A novel machine learning algorithm selects proteome signature to specifically identify cancer exosomes
    Bingrui Li, Fernanda G Kugeratski, Raghu Kalluri
    eLife.2024;[Epub]     CrossRef
  • Comprehensive Urinary Proteome Profiling Analysis Identifies Diagnosis and Relapse Surveillance Biomarkers for Bladder Cancer
    Qi Chang, Yongqiang Chen, Jianjian Yin, Tao Wang, Yuanheng Dai, Zixin Wu, Yufeng Guo, Lingang Wang, Yufen Zhao, Hang Yuan, Dongkui Song, Lirong Zhang
    Journal of Proteome Research.2024; 23(6): 2241.     CrossRef
  • Construction of noninvasive prognostic model of bladder cancer patients based on urine proteomics and screening of natural compounds
    Shun Wan, Jinlong Cao, Siyu Chen, Jianwei Yang, Huabin Wang, Chenyang Wang, Kunpeng Li, Li Yang
    Journal of Cancer Research and Clinical Oncology.2023; 149(1): 281.     CrossRef
  • Extracellular Vesicles as Potential Bladder Cancer Biomarkers: Take It or Leave It?
    Ana Teixeira-Marques, Catarina Lourenço, Miguel Carlos Oliveira, Rui Henrique, Carmen Jerónimo
    International Journal of Molecular Sciences.2023; 24(7): 6757.     CrossRef
  • Advances in the application of label‐free quantitative proteomics techniques in malignancy research
    Xiao Meng, Dong Liu, Yan Guan
    Biomedical Chromatography.2023;[Epub]     CrossRef
  • Off the fog to find the optimal choice: Research advances in biomarkers for early diagnosis and recurrence monitoring of bladder cancer
    Jiaxin Zhao, Jinming Li, Rui Zhang
    Biochimica et Biophysica Acta (BBA) - Reviews on Cancer.2023; 1878(4): 188926.     CrossRef
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    Henrique Caracho Ribeiro, Flávia da Silva Zandonadi, Alessandra Sussulini
    Expert Review of Proteomics.2023; 20(11): 267.     CrossRef
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    Younggap Lim, Hyun Young Kim, Dohyun Han, Bong‐Kyu Choi
    Journal of Extracellular Vesicles.2023;[Epub]     CrossRef
  • A Liquid Biopsy in Bladder Cancer—The Current Landscape in Urinary Biomarkers
    Milena Matuszczak, Adam Kiljańczyk, Maciej Salagierski
    International Journal of Molecular Sciences.2022; 23(15): 8597.     CrossRef
  • Next-generation proteomics of serum extracellular vesicles combined with single-cell RNA sequencing identifies MACROH2A1 associated with refractory COVID-19
    Takahiro Kawasaki, Yoshito Takeda, Ryuya Edahiro, Yuya Shirai, Mari Nogami-Itoh, Takanori Matsuki, Hiroshi Kida, Takatoshi Enomoto, Reina Hara, Yoshimi Noda, Yuichi Adachi, Takayuki Niitsu, Saori Amiya, Yuta Yamaguchi, Teruaki Murakami, Yasuhiro Kato, Tak
    Inflammation and Regeneration.2022;[Epub]     CrossRef
  • 8,247 View
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  • 10 Web of Science
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The Prognosis and the Role of Adjuvant Chemotherapy for Node-Positive Bladder Cancer Treated with Neoadjuvant Chemotherapy Followed by Surgery
Hyehyun Jeong, Kye Jin Park, Yongjune Lee, Hyung-Don Kim, Jwa Hoon Kim, Shinkyo Yoon, Bumsik Hong, Jae Lyun Lee
Cancer Res Treat. 2022;54(1):226-233.   Published online May 6, 2021
DOI: https://doi.org/10.4143/crt.2021.365
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aims to evaluate the prognosis of pathologically node-positive bladder cancer after neoadjuvant chemotherapy, the role of adjuvant chemotherapy in these patients, and the value of preoperative clinical evaluation for lymph node metastases.
Materials and Methods
Patients who received neoadjuvant chemotherapy followed by partial/radical cystectomy and had pathologically confirmed lymph node metastases between January 2007 and December 2019 were identified and analyzed.
Results
A total of 53 patients were included in the study. The median age was 61 years (range, 34 to 81 years) with males comprising 86.8%. Among the 52 patients with post-neoadjuvant/pre-operative computed tomography results, only 33 patients (63.5%) were considered positive for lymph node metastasis. Sixteen patients (30.2%) received adjuvant chemotherapy (AC group), and 37 patients did not (no AC group). With the median follow-up duration of 67.7 months, the median recurrence-free survival (RFS) and the median overall survival (OS) was 8.5 months and 16.2 months, respectively. The 2-year RFS and OS rates were 23.3% and 34.6%, respectively. RFS and OS did not differ between the AC group and no AC group (median RFS, 8.8 months vs. 6.8 months, p=0.772; median OS, 16.1 months vs. 16.3 months, p=0.479). Thirty-eight patients (71.7%) experienced recurrence. Distant metastases were the dominant pattern of failure in both the AC group (91.7%) and no AC group (76.9%).
Conclusion
Patients with lymph node-positive disease after neoadjuvant chemotherapy followed by surgery showed high recurrence rates with limited survival outcomes. Little benefit was observed with the addition of adjuvant chemotherapy.

Citations

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  • A Predictive Nomogram for Development of Lymph Node Metastasis in Muscle-Invasive Bladder Cancer Following Neoadjuvant Therapy
    Garrett K. Harada, Steven N. Seyedin, Olivia Heutlinger, Armon Azizi, Audree Hsu, Arash Rezazadeh, Michael Daneshvar, Greg E. Gin, Edward M. Uchio, Giovanna A. Giannico, Jeremy P. Harris, Aaron B. Simon, Jeffrey V. Kuo, Nataliya Mar
    Advances in Radiation Oncology.2025; 10(1): 101671.     CrossRef
  • Influence of Neoadjuvant Chemotherapy on Survival Outcomes of Radical Cystectomy in Pathologically Proven Positive and Negative Lymph Nodes
    Krystian Kaczmarek, Bartosz Małkiewicz, Karolina Skonieczna-Żydecka, Artur Lemiński
    Cancers.2023; 15(19): 4901.     CrossRef
  • Comparison of responses to neoadjuvant and adjuvant chemotherapies in muscle-invasive bladder cancer
    Serhat Sekmek, Gökhan Ucar, Irfan Karahan, Dogan Bayram, Selin Aktürk Esen, Ismet Seven, Mehmet Ali Nahit Sendur, Dogan Uncu
    African Journal of Urology.2023;[Epub]     CrossRef
  • 5,405 View
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  • 3 Web of Science
  • 3 Crossref
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Case Report
Seminal Vesicle Involvement by Carcinoma In Situ of the Bladder: Clonal Analysis Using Next-Generation Sequencing to Elucidate the Mechanism of Tumor Spread
Hyun Sik Park, Hyun Bin Shin, Myung-Shin Lee, Joo Heon Kim, Seon-Young Kim, Jinsung Park
Cancer Res Treat. 2020;52(4):1283-1287.   Published online March 19, 2020
DOI: https://doi.org/10.4143/crt.2020.002
AbstractAbstract PDFSupplementary MaterialPubReaderePub
We present a rare case of urothelial carcinoma in situ (CIS), which invades the prostate and seminal vesicle (SV). A 70-year-old man underwent transurethral resection of bladder (TURB), and the pathologic examination revealed multiple CIS. Although the patient received intravesical bacillus Calmette-Guerin (BCG) therapy following TURB, recurrence of CIS was confirmed in the bladder and left distal ureter at 3 months following BCG. Radical cystectomy was performed due to BCG-refractory CIS. Microscopically, CIS was found throughout the mucosa of the bladder, left ureter, prostatic duct, and both SVs. Next-generation sequencing revealed significant differences in tumor clonality between bladder and SV CIS cells. Among 101 (bladder CIS) and 95 (SV CIS) somatic mutations, only two were shared, and only one gene (ARHGAP23) was common exon coding region gene. In conclusion, multicentric genetic changes, in line with the field-cancerization effect, may result in SV involvement by CIS of the bladder.
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Original Articles
Oncologic, Perioperative Outcomes of Female Radical Cystectomy: Results from a Multicenter Study in Korea
Ji Sung Shim, Ho Kyung Seo, Ja Hyeon Ku, Byong Chang Jeong, Bumsik Hong, Seok Ho Kang, UCART (Urothelial Cancer-Advanced Research and Treatment Group in Korea) Group
Cancer Res Treat. 2019;51(3):1064-1072.   Published online October 30, 2018
DOI: https://doi.org/10.4143/crt.2018.515
AbstractAbstract PDFPubReaderePub
Purpose
The lower incidence of bladder cancer among women has led to a lack of information on female radical cystectomy (RC). This study aimed to analyze the characteristics related with female RC in a cohort from multiple academic institutions.
Materials and Methods
This was a retrospective review of 384 female patients who underwent RC for bladder cancer. Epidemiologic, perioperative variables including urologic referral periodwith consequent pathologic stage distributions were assessed. The changes in surgical techniques over time were illustrated. Also, we evaluated recurrence-free survival (RFS) at 2 and 5 years and overall survival (OS) at 5 years with stage-specific analyses using the Kaplan-Meier method.
Results
The mean follow-up time was 35 months (interquartile rage [IQR], 9 to 55). The average time to urologic referral with initial symptoms was 5.5 (IQR, 1 to 6) months and over 20% of patients visited clinics after 6 months. In subsequent stage distributions according to referral period, T2 or higher stage distributions were abruptly increased after 1 year. Overall 2-year/5-year RFS rates were 0.72/0.57 and 5-year OS was 0.61. Notable surgical descriptions were as follows: 91% of patients underwent open RC; 80% of patients underwent an ileal conduit; and 83% of patients received anterior exenteration. However, the proportions of robotic surgery, orthotopic neobladder and organ sparing cystectomy have increased recen-tly.
Conclusion
We identified the general characteristics and changes in pattern of female RC. Our results also suggest that women are susceptible to delays in referral to an urologist and are at greater risk for worse prognosis.

Citations

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  • Perioperative, oncological, and survival outcomes of robotic radical cystectomy with urinary diversion in females
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Health-Related Quality of Life, Perceived Social Support, and Depression in Disease-Free Survivors Who Underwent Curative Surgery Only for Prostate, Kidney and Bladder Cancer: Comparison among Survivors and with the General Population
Dong Wook Shin, Hyun Sik Park, Sang Hyub Lee, Seung Hyun Jeon, Seok Cho, Seok Ho Kang, Seung Chol Park, Jong Hyock Park, Jinsung Park
Cancer Res Treat. 2019;51(1):289-299.   Published online May 4, 2018
DOI: https://doi.org/10.4143/crt.2018.053
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to compare health-related quality of life (HRQoL) of disease-free prostate (PC), kidney (KC), and bladder cancer (BC) survivors with that of the general population.
Materials and Methods
Our study included 331 urological cancer (UC) survivors (114 PC, 108 KC, and 109 BC) aged ≥ 50 years disease-free for at least 1 year after surgery. The control group included 1,177 subjects without a history of cancer. The HRQoL was assessed using the European Organization for Research and Treatment of Cancer QLQ-C30, the Duke-UNC Functional Social Support Questionnaire, and the Patient Health Questionnaire-9.
Results
There was no significant difference between the groups in terms of any of the functioning sub-scales and symptoms, except significantly lower social functioning observed in BC survivors than that observed in KC survivors. Although the three groups of UC survivors showed essentially similar functioning sub-scales and symptoms when compared to the general population, PC and BC survivors showed significantly lower social functioning and a lower appetite than that observed in controls. KC survivors showed lower physical functioning, as well as higher pain and dyspnea. Although all three groups of UC survivors reported higher financial difficulties, they also reported higher perceived social support than that reported by the non-cancer control group. No statistically significant difference was observed in terms of depressive symptoms between each group of UC survivors and the general population.
Conclusion
Disease-free survivors of the three major types of UCs showed generally similar HRQoL compared to the general population, as well as compared to each other.

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  • Role performance and factors affecting quality of life in bladder cancer survivors with ileal orthotopic neobladder
    So Hee Kim, Eunjung Ryu, Byong Chang Jeong
    Asia-Pacific Journal of Oncology Nursing.2024; 11(6): 100490.     CrossRef
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    Eun A Song, Youngran Kweon, Yoon Young Hwang, Minjeong An
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Development and Validation of the Korean Version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for Patients with Non-muscle Invasive Bladder Cancer: EORTC QLQ-NMIBC24
Jinsung Park, Dong Wook Shin, Tae-Hwan Kim, Seung Il Jung, Jong Kil Nam, Seung Chol Park, Sungwoo Hong, Jae Hung Jung, Hongwook Kim, Won Tae Kim
Cancer Res Treat. 2018;50(1):40-49.   Published online March 10, 2017
DOI: https://doi.org/10.4143/crt.2016.594
AbstractAbstract PDFPubReaderePub
Purpose
We aimed to evaluate psychometric properties of the Korean version of the EORTC QLQ-NMIBC24 when applied to Korean non-muscle invasive bladder cancer (NMIBC) patients.
Materials and Methods
A total of 249 patients who underwent curative transurethral resection of bladder tumor (TURBT) for primary orrecurrentNMIBCwere asked to complete theKorean version of EORTC QLQ-C30 and -NMIBC24 questionnaires three times (preoperative, post-TURBT 3 months and 6 months). Linguistic validation and psychometric evaluation of the questionnaire was conducted.
Results
Multitrait scaling analysis confirmed satisfactory construct validity in five scales except the malaise scale. Internal consistency was good (Cronbach’s alpha ≥ 0.70) for the five scales except the malaise scale at the all three time points. Known-group comparison analyses showed better quality-of-life (QOL) scores in patients with higher performance status as expected, and better sexual function in men than women (p < 0.05). Most of the scales had low correlations (< 0.40) with the scales in QLQ-C30 showing divergent validity, except for malaise scale which showed higher correlations (0.42 to 0.60). Responsiveness to change was consistent with clinical implications over time after TURBT.
Conclusion
The Korean version of the EORTC QLQ-NMIBC24 has good reliability and cross-cultural validity for measuring various QOL aspects that can be self-administered to Korean NMIBC patients undergoing TURBT.

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TRIM29 Overexpression Promotes Proliferation and Survival of Bladder Cancer Cells through NF-κB Signaling
Shu-Tao Tan, Sheng-Ye Liu, Bin Wu
Cancer Res Treat. 2016;48(4):1302-1312.   Published online March 11, 2016
DOI: https://doi.org/10.4143/crt.2015.381
AbstractAbstract PDFPubReaderePub
Purpose
TRIM29 overexpression has been reported in several human malignancies and showed correlation with cancer cell malignancy. The aim of the current study is to examine its clinical significance and biological roles in human bladder cancer tissues and cell lines. Materials and Methods A total of 102 cases of bladder cancer tissues were examined for TRIM29 expression by immunohistochemistry. siRNA and plasmid transfection were performed in 5637 and BIU- 87 cell lines. Cell Counting Kit-8, flow cytometry, western blot, and real-time polymerase chain reaction were performed to examine its biological roles and mechanism in bladder cancer cells.
Results
We found that TRIM29 overexpression showed correlation with invading depth (p=0.0087). Knockdown of TRIM29 expression in bladder cancer cell line 5637 inhibited cell growth rate and cell cycle transition while its overexpression in BIU-87 cells accelerated cell proliferation and cell cycle progression. TRIM29 overexpression also inhibited cell apoptosis induced by cisplatin. In addition, we demonstrated that TRIM29 depletion decreased while its overexpression led to upregulated expression of cyclin D1, cyclin E, and Bcl-2. We also showed that TRIM29 knockdown inhibited protein kinase C (PKC) and nuclear factor κB (NF-κB) signaling while its overexpression stimulated the PKC and NF-κB pathways. BAY 11-7082 (NF-κB inhibitor) partly attenuated the effect of TRIM29 on expression of cyclin and Bcl-2. Treatment with PKC inhibitor staurosporine resulted in ameliorated TRIM29 induced activation of NF-κB. Conclusion The current study demonstrated that TRIM29 upregulates cyclin and Bcl family proteins level to facilitate malignant cell growth and inhibit drug-induced apoptosis in bladder cancer, possibly through PKC–NF-κB signaling pathways.

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Decision Based on Narrow Band Imaging Cystoscopy without a Referential Normal Standard Rather Increases Unnecessary Biopsy in Detection of Recurrent Bladder Urothelial Carcinoma Early after Intravesical Instillation
Phil Hyun Song, Seok Cho, Young Hwii Ko
Cancer Res Treat. 2016;48(1):273-280.   Published online March 2, 2015
DOI: https://doi.org/10.4143/crt.2014.190
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to calculate the operating characteristics of narrowband imaging (NBI) cystoscopy versus traditional white light cystoscopy (WLC) in common clinical scenarios involving suspicion of bladder urothelial carcinoma (UC). Materials and Methods Sixty-three consecutive patients initially underwent WLC and then NBI in a single session for evaluation of microscopic hematuria (group I, n=20), gross hematuria (group II, n=19), and follow-up for prior UC (group III, n=24), by an experienced urologist. All lesions that were abnormal in contrast with adjacent normal mucosa were diagnosed as positive and biopsied.
Results
Sixty-six biopsies from 47 patients were performed. Pathologic examination showed 17 cases of UC from 21 sites. While the overall sensitivity of NBI was similar to that of WLC (100% vs. 94.1%), the specificity of NBI was significantly lower than that of WLC (50% vs. 86.9%, p < 0.001), particularly in group III (38.9% vs. 88.9%, p=0.004). Based on identification by NBI only, 23 additional biopsies from 18 cases were performed for identification of one patient with UC, who belonged to group III. In this group, to identify this specific patient, 15 additional biopsies were performed from 10 patients. All seven cases with positive findings from NBI within 2 months after the last intravesical therapy were histologically proven as negative. Conclusion In evaluation for recurrence early after intravesical instillation, the decision based on NBI increased unnecessary biopsy in the absence of an established standard for judging NBI.

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Detecting Metastatic Bladder Cancer Using 18F-Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography
Hakan Öztürk
Cancer Res Treat. 2015;47(4):834-843.   Published online February 12, 2015
DOI: https://doi.org/10.4143/crt.2014.157
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to retrospectively investigate the contribution of 18F-fluorodeoxyglucose- positron emission tomography/computed tomography (18F-FDG-PET/CT) to detection of metastatic bladder cancer. Materials and Methods The present study included 79 patients (69 men and 10 women) undergoing 18F-FDGPET/ CT upon suspicion of metastatic bladder cancer between July 2007 and April 2013. The mean age was 66.1 years with a standard deviation of 10.7 years (range, 21 to 85 years). Patients were required to fast for 6 hours prior to scanning, and whole-body PET scanning from the skull base to the upper thighs was performed approximately 1 hour after intravenous injection of 555 MBq of 18F-FDG. Whole body CT scanning was performed in the cranio-caudal direction. FDG-PET images were reconstructed using CT data for attenuation correction. Suspicious recurrent or metastatic lesions were confirmed by histopathology or clinical follow-up. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 18F-FDG-PET/CT were 89%, 78%, 90%, 75%, and 86%, respectively. Conclusion 18F-FDG-PET/CT can detect metastases with high sensitivity and positive predictive values in patients with metastatic bladder carcinoma.

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APE1/Ref-1 as a Serological Biomarker for the Detection of Bladder Cancer
Ju Hyun Shin, Sunga Choi, Yu Ran Lee, Myoung Soo Park, Yong Gil Na, Kaikobad Irani, Sang Do Lee, Jin Bong Park, Jin Man Kim, Jae Sung Lim, Byeong Hwa Jeon
Cancer Res Treat. 2015;47(4):823-833.   Published online January 2, 2015
DOI: https://doi.org/10.4143/crt.2014.074
AbstractAbstract PDFPubReaderePub
Purpose
Apurinic/apyrimidinic endonuclease 1/redox factor-1 (APE1/Ref-1) is a multifunctional protein that shows elevated expression in a number of cancers. We attempted to determine whether serum APE1/Ref-1 is elevated in patients with bladder cancer.
Materials and Methods
Serum APE1/Ref-1 levels were determined using enzyme-linked immunosorbent assay in serum from patients with bladder cancer who had not received chemotherapy or radiotherapy (n=51) and non-tumor controls (n=55). The area under the receiver operating characteristic area under the curve was applied to determine the correlation between clinical factors and the serum levels of APE1/Ref-1.
Results
Serum levels of APE1/Ref-1 in bladder cancer patients were significantly elevated compared to those of the control group (3.548±0.333 ng/100 μL [n=51] for bladder cancer vs. 1.547±0.319 ng/100 μL [n=55] for the control group), with a sensitivity and specificity of 93% and 59%, respectively. Serum APE1/Ref-1 levels are associated with tumor stage, grade, muscle invasion, and recurrence.
Conclusion
Serum APE1/Ref-1 might be useful as a potential serologic biomarker for bladder cancer.

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Case Report
A Case of Synchronous Double Primary Cancer of the Penis and Urinary Bladder
Yong Soo Cho, Jung-Ae Lee, Si Bum Kim, Soo Jung Gong, Joo Heon Kim, Seon Min Youn, Eun Tak Kim
Cancer Res Treat. 2010;42(1):53-56.   Published online March 31, 2010
DOI: https://doi.org/10.4143/crt.2010.42.1.53
AbstractAbstract PDFPubReaderePub

Multiple primary cancers are the occurrence of more than two cancers of different origin in an individual. Penile cancer is a rare disease, and finding it combined with other cancers is even rarer. A 64-year-old man with a painful penile mass was referred to us from a primary urological clinic. We performed a biopsy of the penile mass and the histology revealed a well-differentiated squamous cell carcinoma. Abdominal computed tomography showed a localized bladder tumor with inguinal lymphadenopathy. The patient underwent a partial penectomy, transurethral resection of the bladder tumor and inguinal lymph node dissection. The histology of the bladder tumor was high-grade papillary carcinoma, and that of the lymph node was squamous cell carcinoma. The penile and bladder tumors were in stage II (T1N1M0) and stage I (T1N0M0), respectively. We successfully treated the patient with adjuvant radiotherapy and systemic chemotherapy.

Citations

Citations to this article as recorded by  
  • Synchronous Double Primary Cancer of the Penisand Urinary Bladder
    Deora H
    MOJ Surgery.2017;[Epub]     CrossRef
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Cancer Res Treat : Cancer Research and Treatment
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