National Cancer Institute®
Last Modified: March 1, 2002
UI - 11544830
AU - Zlatnik EIu; Kapkina NN; Zaderin VP; Zakora GI
TI - [Immunocorrective effect of alternating magnetic field in the postoperative period in malignant bladder cancer]
SO - Vopr Onkol 2001;47(3):312-4
AD - Research Institute of Oncology, Ministry of Health of the RF, Rostov-on-Don.
The study deals with immune status of patients operated for bladder cancer and exposed postoperatively to alternating magnetic field (MF) (hypothalamus and operative field). MF application was followed by higher T- and B-lymphocyte and CD4+, CD16+ cell levels as well as enhanced T-cell activity; no postoperative complications were registered and tumor relapse rates were relatively low. The effect was likely to be due to antistressor influence of MF. The procedure may substitute drug therapy for immunocorrection and to avoid recurrence of bladder cancer.
UI - 11776112
AU - Zang Z; Xu H; Yu L; Yang D; Xie S; Shi Y; Li Z; Li J; Wang J; Li M; Guo
TI - Y; Gu F Intravesical immunotoxin as adjuvant therapy to prevent the recurrence of bladder cancer.
SO - Chin Med J (Engl) 2000 Nov;113(11):1002-6
AD - Department of Urology, Second Hospital Affiliated to Kunming Medical College, Kunming 650101, China.
OBJECTIVE: To assess the intravesical application of immunotoxin as adjuvant therapy to prevent recurrence after tumor resection in bladder cancer patients. METHODS: An anti-human immunotoxin against bladder carcinoma, BDI-1-RT, was prepared and its in vitro targeting cytotoxicity estimated. The immunoreactivity of BDI-1-RT with human bladder cancer tissue of different grades and stages was detected by immunohistochemical analysis. After safety test, intravesical administration of BDI-1-RT was performed in 31 patients while mitomycin C (MMC) was used in 36 patients serving as a control group. The recurrence rates and side effects in both groups were recorded. In addition, the development of human anti-mouse antibodies (HAMA) was determined by ELISA, to assess the potential safety of this immunotoxin. RESULTS: In our study, BDI-1-RT had immunoreactivity with 81.6% of bladder transitional cell carcinomas. The immunoreactivity of BDI-1-RT correlated with tumor grade. High-grade carcinoma had stronger staining than low-grade (P < 0.05). There was no significant difference between the BDI-1-RT group (10%) and MMC group (19.3%) in recurrence rate (P > 0.05). Side effects, including systemic and local, were more frequent in the MMC group (11 of 36 patients versus 2 of 31, P < 0.05). HAMA was not detected in any of 7 patients. CONCLUSION: Immunotoxin may have considerable potential in the prophylaxis of bladder transition cell carcinoma.
UI - 11769882
AU - Moyad MA
TI - An introduction to aspirin, NSAids, and COX-2 inhibitors for the primary prevention of cardiovascular events and cancer and their potential preventive role in bladder carcinogenesis: part II.
SO - Semin Urol Oncol 2001 Nov;19(4):306-16
AD - Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109-0330, USA.
Aspirin and the nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) have been commercially available for decades, and their ability to reduce pain and inflammation are well known. The ability of some of these agents to also reduce a primary or secondary cardiovascular event or to potentially reduce the risk of colorectal cancer has also been documented. These observations collectively have initiated a wide variety of investigations to determine whether or not these agents may have an ability to reduce the risk or progression of numerous cancers. Some urologic cancers have been included in these recent studies. For example, prostate cancer may be sensitive to these compounds based on a small number of preliminary studies. Bladder cancer may also be sensitive to the effects of these agents. Older patients and those with more aggressive tumors may benefit most from these initial studies. Many cancers also demonstrate a greater upregulation of cyclooxygenase-2 (COX-2), and this has lead to recent interest, especially in colorectal cancer, to test the ability of these selective agents against the development of precancerous colon polyps. High-risk patients for colorectal cancer may have benefited by taking a selective COX-2 inhibitor in a recent randomized trial, but whether or not this benefit continues to occur after the COX-2 inhibitor is removed remains controversial and needs further study. Prostate and bladder cancer also seem to demonstrate an upregulation of COX-2, and laboratory studies suggest that these selective NSAIDs may have a greater effect on reducing the development of these tumors. Randomized clinical trials are needed, but because numerous individuals are currently using COX-2 inhibitors, a large volume of data should make at least retrospective studies more plausible in the near future. The challenge for researchers and clinicians is to further understand which NSAIDs and what dosage and duration may provide the optimal benefit (if any), and to accurately construe the available current data on these agents for patients inquiring about these compounds.
UI - 11852763
AU - Lebret T
TI - [Treatment of bladder tumors]
SO - Rev Prat 2002 Jan 1;52(1):36-42
AD - Service d'urologie Hopital Foch 92151 Suresnes. email@example.com
The bladder tumour treatment closely depends on initial diagnosis. For superficial bladder tumour a conservative treatment is required using endoscopic resection. Adjuvant instillations (BCG or mitomycine C) can be proposed for high grade tumour. In case of muscular layer invasion or in case of frequent non controlled recurrence, cystectomy is necessary. Progress in anaesthesia, surgery and postoperative care permitted to enteroplasty to be much less morbid, it must be considered as the urinary diversion of choice. To prevent recurrence, both (superficial or infiltrating) tumour require very strict follow-up for many years.
UI - 11849152
AU - Hara I; Miyake H; Hara S; Gotoh A; Nakamura I; Okada H; Arakawa S;
TI - Kamidono S Health-related quality of life after radical cystectomy for bladder cancer: a comparison of ileal conduit and orthotopic bladder replacement.
SO - BJU Int 2002 Jan;89(1):10-3
AD - Department of Urology, Kobe University School of Medicine, Kobe, Japan. firstname.lastname@example.org
OBJECTIVE: To compare the health-related quality of life (HRQoL) after radical cystectomy in patients with an ileal conduit or an orthotopic neobladder. PATIENTS AND METHODS: The study included 85 men who underwent radical cystectomy for bladder cancer, comprising 48 with an orthotopic neobladder (26 with an ileal and 22 with a colon neobladder) and 37 with an ileal conduit. HRQoL was evaluated using the Short Form-36 survey containing 36 questions assessing eight aspects, including physical functioning, role-physical functioning, bodily pain, general health, vitality, social functioning, role-emotional functioning and mental health. RESULTS: The mean follow-up periods for patients with a neobladder (ileal and sigmoid) and with an ileal conduit was 45.9 (38.2 and 53.1, respectively) and 130.9 months, respectively. Scale scores were not affected by the duration of follow-up in either group. There was no significant difference in any scale scores between the neobladder and ileal conduit groups. However, general health and social functioning in both the neobladder and ileal conduit groups appeared to be significantly lower than those in the general population in the USA. Furthermore, patients with a colon neobladder had a significantly higher score for role-emotional functioning than those with an ileal neobladder, while there was no significant difference in the remaining seven scores between patients with ileal and colon neobladders. CONCLUSIONS: Six of the eight scales of HRQoL were favourable in both patients with a neobladder or an ileal conduit, and there was no significant difference between these groups. In addition, the HRQoL of patients with an orthotopic neobladder (except for role-emotional functioning) was unaffected by the segment of the intestine used for neobladder construction. Therefore, patients with both types of urinary diversion were generally satisfied with their overall health and quality of life.
UI - 11564036
AU - Dryhurst DJ; Fowler CG
TI - Flexible cystodiathermy can be rendered painless by using 2% lignocaine solution to provide intravesical anaesthesia.
SO - BJU Int 2001 Sep;88(4):437-8
AD - Academic Urological Unit, The Royal London Hospital, London, UK. email@example.com
UI - 11844814
AU - Vaughn DJ; Broome CM; Hussain M; Gutheil JC; Markowitz AB
TI - Phase II trial of weekly paclitaxel in patients with previously treated advanced urothelial cancer.
SO - J Clin Oncol 2002 Feb 15;20(4):937-40
AD - University of Pennsylvania Cancer Center, Philadelphia, PA 19104, USA. firstname.lastname@example.org
PURPOSE: We evaluated the efficacy and toxicity of weekly paclitaxel in patients with previously treated advanced urothelial cancer. PATIENTS AND METHODS: Patients with urothelial cancer who had received one prior systemic chemotherapy regimen for advanced disease and had evidence of disease progression were eligible for enrollment. Patients received paclitaxel 80 mg/m(2) by 1-hour intravenous infusion weekly. A cycle of therapy consisted of four weekly treatments. RESULTS: The study enrolled 31 patients. Mean age was 66 years, and 45% of patients had three or more involved metastatic sites. Only 26% of patients had responded to prior chemotherapy. The median number of cycles delivered was three (range, one to eight) at a mean weekly paclitaxel dose of 79 mg/m(2). Three patients achieved a partial response (10%; 95% confidence interval, 0% to 20%). Median time to progression was 2.2 months, and median overall survival time was 7.2 months. Therapy was well tolerated with minimal hematologic toxicity. Grade 3 nonhematologic toxicities were also uncommon. CONCLUSION: Although the overall response rate to weekly paclitaxel in patients with previously treated advanced urothelial cancer was modest, the chemotherapy-refractory nature of the study population should be considered.
UI - 11844817
AU - Kuball J; Wen SF; Leissner J; Atkins D; Meinhardt P; Quijano E; Engler
TI - H; Hutchins B; Maneval DC; Grace MJ; Fritz MA; Storkel S; Thuroff JW; Huber C; Schuler M Successful adenovirus-mediated wild-type p53 gene transfer in patients with bladder cancer by intravesical vector instillation.
SO - J Clin Oncol 2002 Feb 15;20(4):957-65
AD - Department of Medicine III, Johannes Gutenberg University, Mainz, Germany.
PURPOSE: To study safety, feasibility, and biologic activity of adenovirus-mediated p53 gene transfer in patients with bladder cancer. PATIENTS AND METHODS: Twelve patients with histologically confirmed bladder cancer scheduled for cystectomy were treated on day 1 with a single intratumoral injection of SCH 58500 (rAd/p53) at cystoscopy at one dose level (7.5 x 10(11) particles) or a single intravesical instillation of SCH 58500 with a transduction-enhancing agent (Big CHAP) at three dose levels (7.5 x 10(11) to 7.5 x 10(13) particles). Cystectomies were performed in 11 patients on day 3, and transgene expression, vector distribution, and biologic markers of transgene activity were assessed by molecular and immunohistochemical methods in tumors and normal bladder samples. RESULTS: Specific transgene expression was detected in tissues from seven of eight assessable patients treated with intravesical instillation of SCH 58500 but in none of three assessable patients treated with intratumoral injection of SCH 58500. Induction of RNA and protein expression of the p53 target gene p21/WAF1 was demonstrated in samples from patients treated with SCH 58500 instillation at higher dose levels. Distribution studies after intravesical instillation of SCH 58500 revealed both high transduction efficacy and vector penetration throughout the whole urothelium and into submucosal tumor cells. No dose-limiting toxicity was observed, and side effects were local and of transient nature. CONCLUSION: Intravesical instillation of SCH 58500 combined with a transduction-enhancing agent is safe, feasible, and biologically active in patients with bladder cancer. Studies to evaluate the clinical efficacy of this treatment in patients with localized high-risk bladder cancer are warranted.
UI - 11880082
AU - Peyromaure M; Weibing S; Sebe P; Verpillat P; Toublanc M; Dauge MC;
TI - Boccon-Gibod L; Ravery V Prognostic value of p53 overexpression in T1G3 bladder tumors treated with bacillus Calmette-Guerin therapy.
SO - Urology 2002 Mar;59(3):409-13
AD - Department of Urology, Bichat-Claude Bernard Hospital, Paris, France.
OBJECTIVES: To evaluate the correlation between the overexpression of mutant protein p53 and disease recurrence and progression in patients treated with bacillus Calmette-Guerin (BCG) intravesical therapy for T1G3 bladder cancer. METHODS: We analyzed the outcome of 29 consecutive patients treated for T1G3 bladder tumor with transurethral resection. Patients previously treated for a bladder tumor, those who underwent incomplete resection, and those in whom no assessment of the muscle cell layer was possible were excluded from the study. p53 overexpression was determined using monoclonal p53-DO7 antibody, with a 20% cutoff for definition of positivity. After the initial transurethral resection, all patients were treated with Pasteur BCG (75 mg in 50 mL saline), weekly for 6 weeks. The correlation between p53 overexpression and disease recurrence and progression was assessed by the Fisher exact test. RESULTS: The median follow-up was 36.7 months (range 1 to 108). Of the 29 patients, 18 (62.1%) were p53 positive and 11 (37.9%) were p53 negative. Both groups were similar according to age, tumoral substage (T1a/T1b), association with carcinoma in situ, multifocality, and length of follow-up. The recurrence rate was 54.4% in the p53-negative group versus 38.9% in the p53-positive group (P = 0.47). The progression rate was 18.2% in the p53-negative group versus 33.3% in the p53-positive group (P = 0.67). CONCLUSIONS: These findings suggest that overexpression of p53, as determined immunohistochemically, has no predictive value for recurrence and progression in T1G3 bladder cancers treated with intravesical BCG.
UI - 11880083
AU - Iori F; Di Seri M; De Nunzio C; Leonardo C; Franco G; Spalletta B;
TI - Laurenti C Long-term maintenance bacille Calmette-Guerin therapy in high-grade superficial bladder cancer.
SO - Urology 2002 Mar;59(3):414-8
AD - Department of Urology, Division III, University of Rome La Sapienza, Rome, Italy.
OBJECTIVES: To assess the long-term results of intravesical bacille Calmette-Guerin (BCG) induction plus long-term maintenance treatment for high-grade superficial bladder cancer. METHODS: Between 1994 and 2000, 41 patients who presented to our clinic with superficial urothelial carcinoma of the bladder (T1G3, T1G3 plus carcinoma in situ, or recurrent TaG2-3) were treated by transurethral resection of all visible tumor and an induction cycle of BCG plus a long-term maintenance BCG course consisting of 11 monthly instillations followed by 4 quarterly instillations and then by 6 six-monthly instillations. The median follow-up was 40 months. RESULTS: Thirty patients remained tumor free throughout the follow-up period. Ten patients had a recurrence of superficial tumor, 9 patients during the monthly instillation course and 1 patient during the quarterly instillation course. One patient presented with progression. CONCLUSIONS: Adjuvant immunotherapy with BCG after complete transurethral resection of bladder tumor represents a highly effective primary treatment for high-grade superficial bladder cancer. Our maintenance course of BCG seemed to improve the worldwide accepted effectiveness of the BCG induction course without any important side effects.
UI - 11751531
AU - Gazzaniga P; Gradilone A; Frati L; Agliano AM
TI - Epidermal growth factor receptor mRNA expression in peripheral blood of bladder cancer patients: a potential marker to detect treatment failure.
SO - Clin Cancer Res 2001 Dec;7(12):4288-9
UI - 11687012
AU - Shelley MD; Barber J; Mason MD
TI - Surgery versus radiotherapy for muscle invasive bladder cancer.
SO - Cochrane Database Syst Rev 2001;(3):CD002079
AD - Research Laboratories, Velindre NHS Trust, Velindre Road, Whitchurch, Cardiff, Wales, UK, CF4 7XL. email@example.com
BACKGROUND: Muscle invasive bladder cancer is a serious clinical problem and is fatal for the majority of patients. Alternative treatments for this condition are radical cystectomy or radical radiotherapy. The choice of treatment varies according to the resident country. The ideal treatment would be a bladder preserving therapy with total eradication of the tumour without compromising survival. OBJECTIVES: The objective of this review was to compare the survival after radical surgery (cystectomy) versus radical radiotherapy in patients with muscle invasive cancer. SEARCH STRATEGY: We searched the Cochrane Controlled authors of unpublished data were undertaken. SELECTION CRITERIA: Randomised trials comparing surgery versus radiotherapy were eligible for assessment. DATA COLLECTION AND ANALYSIS: Three reviewers assessed trial quality based on the Cochrane Guidelines. Data was extracted from the text of the article or extrapolated from the Kaplan-Meier plot. The Peto odds ratio was determined to compare the overall-survival and disease-specific survival. Analysis was performed on an intention-to-treat basis and treatment actually received. MAIN RESULTS: Three randomised trials comparing pre-operative radiotherapy followed by radical cystectomy (surgery) versus radical radiotherapy with salvage cystectomy (radical radiotherapy) were eligible for assessment. These trials represented a total of 439 patients, 221 randomised to surgery and 218 to radical radiotherapy. Peto odds ratio analysis consistently favoured surgery in terms of survival. It was significant at 3 (OR = 2.11, 95% CI 1.10,4.07) and 5 years (OR = 2.40, 95% CI 1.35, 4.29) for overall survival and at 3 years (OR = 1.96, 95% CI 1.06,3.65) for disease-specific survival for patients that actually received the protocol treatment. On an intention-to-treat analysis for disease-specific survival, the results were significantly in favour of surgery at 3 years (OR = 1.96, 95% CI 1.06,3.65) but not at 5 years. REVIEWER'S CONCLUSIONS: The evidence from this review suggests that there is no overall statistically significant benefit to radiotherapy or surgery ( with pre-operative radiotherapy) in muscle invasive bladder cancer in terms of survival, but the trends consistently favour surgery.
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