National Cancer Institute®
Last Modified: June 1, 2002
UI - 11955393
AU - Liu B; Zhang Y; Wang Z; Ding Q; Chen B; Wang J; Jiang H
TI - [Single instillation of epirubicin for the prophylaxis of recurrent primary superficial bladder carcinoma]
SO - Zhonghua Wai Ke Za Zhi 2002 Feb;40(2):112-5
AD - Department of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China.
OBJECTIVE: To determine the feasibility of single dose intravesical epirubicin in the prevention of recurrent superficial bladder carcinoma. METHODS: We compared the effect of intravesical epirubicin or mitomycin C on tumor recurrence and disease free interval and their side effects after treatment of superficial bladder tumor. 47 postoperative patients with stages Ta to T1 primary superficial bladder carcinoma of grades 1 or 2 were randomized into groups A: single 80 mg epirubicin; B: 40 mg consecutive epirubicin; C: 40 mg consecutive mitomycin C. Patients were followed up for clinical, analytical, and cystoscopic evaluations every 3 months. RESULTS: The disease free intervals of the three groups were found no significant differences (F = 3.25, P > 0.05). The recurrence rate was 6.25% (1/16), 13.3% (2/15), 12.5% (2/16) (chi(2) = 0.496, P > 0.05) in groups A, B, and C at 1 year, and 33.3% (5/15), 26.7% (4/15), 25% (4/16) (chi(2) = 0.290, P > 0.05) at 3 years after operation, respectively. Side effects of group A (13.3%) were lower than those of group B (46.7%) or C (43.8%) (chi(2) = 14.56, P < 0.01). CONCLUSIONS: Single dose of epirubicin given intravesically immediately after tumor resection is effective in preventing tumor recurrence.
UI - 11957752
AU - Huguet Perez J; Palou J; Millan Rodriguez F; Villavicencio Mavrich H;
TI - Rodriguez JV [Radical cystectomy for superficial tumors in the BCG era]
SO - Arch Esp Urol 2002 Jan-Feb;55(1):50-6
AD - Servicio de Urologia, Fundacion Puigvert, Barcelona, Espana. email@example.com
OBJECTIVE: To analyze the indications and outcome of cystectomy for superficial bladder cancer since the introduction of BCG therapy. cystectomy for transitional cell bladder tumor. A retrospective study was carried out on 43 cases (11.1%) that underwent cystectomy for Tis, Ta, T1 tumors. The characteristics of patients with superficial bladder cancer, correlation between the clinical stage (determined after TUR) and pathological findings (cystectomy specimen) and outcome were analyzed. RESULTS: 36 patients were male and 7 were female; mean age 63 years (range 39-79). Mean follow-up was 48 months (8-120). Twenty-nine patients received BCG therapy prior to surgery. No response to BCG was the main indication for cystectomy. By clinical stage, 79% were high grade, 65% T1 and 65% CIS. A correlation between the clinical stage and the pathological findings was found in 32.5%, overstaging in 28% and understaging in 39.5%. The increase in stage after analysis of the surgical specimen in 13 patients (30%) was due to progression of the superficial bladder tumor to infiltrating or metastatic tumor. Urinary tract tumor was found during follow-up in 8 patients (18.6%). Eleven patients died of bladder cancer, 3 of other causes and 29 (67%) are free of disease. Seven of the 13 patients (53%) that were clinically understaged and had infiltrating tumor or metastasis died. CONCLUSIONS: No response to BCG therapy was the main indication for cystectomy. Before starting conservative treatment for high risk superficial bladder cancer, the possibility of endoscopic understaging should be taken into account. Patients undergoing cystectomy for superficial bladder cancer have a high risk of developing urinary tract tumor.
UI - 12015761
AU - Okamura K; Ono Y; Kinukawa T; Matsuura O; Yamada S; Ando T; Fukatsu T;
TI - Ohno Y; Ohshima S; Nagoya University Urological Oncology Group Randomized study of single early instillation of (2"R)-4'-O-tetrahydropyranyl-doxorubicin for a single superficial bladder carcinoma.
SO - Cancer 2002 May 1;94(9):2363-8
AD - Department of Urology, Chubu National Hospital, Gengo, Morioka-cho, Obu, Japan.
BACKGROUND: Although transurethral resection of a bladder tumor (TUR-Bt) alone has been standard treatment for single superficial bladder carcinoma, some authors reported a certain prophylactic effect of a single immediate intravesical instillation of chemotherapeutic agent after TUR-Bt. A prospective randomized study was conducted to determine whether a single (2"R)-4'-O-tetrahydropyranyl-doxorubicin (THP) instillation immediately after TUR-Bt is beneficial to patients with a single superficial bladder carcinoma. METHODS: One hundred seventy patients with a single resectable superficial bladder carcinoma (Ta-1, primary or recurrent with no recurrence during the last 1 year) were enrolled in this study. THP (30 mg/30 mL of normal saline) was administered into the bladder within 6 hours after TUR-Bt in arm A, while TUR-Bt alone was done in arm B. RESULTS: Of the 170 patients, 160 (94.1%) were eligible and were followed up for a median time of 40.8 months. There was a significant difference in the recurrence free curve between the 2 arms (log-rank test; P = 0.0026), with 92.4% recurrence free rate at 1 year, 82.7% at 2 years, and 78.8% at 3 years in arm A (84 patients) and 67.0%, 55.7%, and 52.6%, respectively, in arm B. The recurrence rate per year was 0.11 +/- 0.22 in arm A and 0.24 +/- 0.36 in arm B, with a significant difference (P = 0.007). Toxicity included pain with micturition in 9 patients (10.7%), urinary frequency/urgency in 5 patients (6.0%), and macroscopic hematuria in 7 patients (8.3%). CONCLUSIONS: These data indicate that a single THP instillation immediately after TUR reduces the recurrence of superficial bladder carcinoma. Copyright 2002 American Cancer Society.DOI 10.1002/cncr.10496
UI - 11992047
AU - Griffiths TR; Charlton M; Neal DE; Powell PH
TI - Treatment of carcinoma in situ with intravesical bacillus Calmette-Guerin without maintenance.
SO - J Urol 2002 Jun;167(6):2408-12
AD - University Urology Unit, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
PURPOSE: Data concerning the relative efficacy of intravesical bacillus Calmette-Guerin (BCG) on subgroups of carcinoma in situ of the bladder are limited. We report the outcome of primary carcinoma in situ and carcinoma in situ associated with Ta or T1 transitional cell carcinoma of the bladder treated with BCG. MATERIALS AND METHODS: Between 1987 and 1997, 135 patients (median age 70 years) with biopsy proven bladder carcinoma in situ underwent a standard course of 6 BCG instillations. Patients were divided into group 1-23 patients with primary carcinoma in situ, group 2-37 with carcinoma in situ associated with Ta transitional cell carcinoma and group 3-75 with carcinoma in situ associated with T1 transitional cell carcinoma. RESULTS: Median followup was 41 months. For groups 1 to 3, complete response rates at 3 months were 74% (17 of 23 cases), 70% (26 of 37) and 75% (56 of 75), respectively. The overall progression rates at 5 years were 20% (3 of 15 cases), 18% (4 of 22) and 49% (25 of 51). Cancer specific survival rates were 83% (10 of 12 patients), 86% (12 of 14) and 59% (17 of 29), and the numbers of patients alive with the bladder intact were 60% (9 of 15), 58% (11 of 19) and 30% (12 of 40). Patients in group 3 treated with BCG had progression significantly earlier than those in groups 1 and 2 (log-rank test p = 0.013). A complete response to BCG in group 3 patients significantly delayed time to progression (Cox regression p = 0.001) but did not reduce death from transitional cell carcinoma. Indeed, only 38% (8 of 21) of complete responders were alive with the bladder intact at 5 years. CONCLUSIONS: A single course of BCG is remarkably effective for primary carcinoma in situ and carcinoma in situ associated with Ta transitional cell carcinoma but is suboptimal in patients with carcinoma in situ associated with T1 transitional cell carcinoma. Better outcomes in each of the 3 groups may have occurred with maintenance BCG.
UI - 11992048
AU - de la Rosa F; Garcia-Carbonero R; Passas J; Rosino A; Lianes P; Paz-Ares
TI - L Primary cisplatin, methotrexate and vinblastine chemotherapy with selective bladder preservation for muscle invasive carcinoma of the bladder: long-term followup of a prospective study.
SO - J Urol 2002 Jun;167(6):2413-8
AD - Urology Department, Hospital Universitario Doce de Octubre, Av. Cordoba Km. 5.4, 28041 Madrid, Spain.
PURPOSE: We evaluate the efficacy and bladder preservation rate of combined modality therapy consisting of deep transurethral resection of the primary bladder tumor followed by cisplatin, methotrexate and vinblastine chemotherapy in patients with muscle invasive transitional cell carcinoma of the bladder. MATERIALS AND METHODS: A total of 40 consecutive patients with clinical stage T2-T4 NX M0 bladder cancer were included in the study and treated with transurethral resection followed by 3 courses of chemotherapy. Chemotherapy consisted of 100 mg./m.2 cisplatin intravenously on day 1, 30 mg./m.2 methotrexate intravenously on days 1 and 8, and 4 mg./m.2 vinblastine intravenously on days 1 and 8 administered every 21 days. Patients with disease in complete clinical remission after cycle 3 of therapy received 3 additional chemotherapy courses. Patients in whom complete clinical remission persisted after cycle 6 were closely followed with no further therapy until disease progression. RESULTS: A complete clinical remission was achieved in 21 patients (53%) after the first 3 cycles of therapy and a partial response occurred in 10 (25%), for an overall response rate of 78% (95% confidence interval [CI] 62% to 89%). With a median followup of 78 months (range 70 to 109) the estimated 7-year progression-free and overall survival rates were 40% (95% CI 25% to 55%) and 35% (95% CI 20% to 50%), respectively. The 7-year survival rate with a functional bladder for complete clinical remission cases was 52% (95% CI 30% to 74%). Low grade, small tumor, absence of concomitant carcinoma in situ and response to therapy were all significant predictors for an increased probability of bladder preservation in univariate analysis. However, response to therapy was the only variable with independent prognostic value in the multivariate analysis (p = 0.002). CONCLUSIONS: Transurethral resection of bladder tumor followed by cisplatin, methotrexate and vinblastine chemotherapy results in long-term bladder preservation in a significant proportion of responding patients, and may be an acceptable alternative to radical surgery in select patients with muscle invasive bladder cancer.
UI - 12029884
AU - Roodhouse A
TI - Management of bladder cancer: a nursing view.
SO - Prof Nurse 2000 Dec;16(3):987-90
AD - Ashford and St Peters NHS Trust, Ashford, Middlesex.
More than 13,000 new cases of bladder cancer are diagnosed in the UK each year. Haematuria is the most common presenting symptom and should always be investigated. Superficial cancers are usually treated with transurethral resection and intravesical therapy. Radical cystectomy, radiotherapy, chemotherapy are used to treat invasive disease.
UI - 11998112
AU - Randall S
TI - Valrubicin: an alternative to radical cystectomy for carcinoma in situ of the bladder.
SO - Urol Nurs 2001 Feb;21(1):30-1, 34-6
AD - Urology Health Center, New Port Richey, FL, USA.
Treatment options for patients who fail BCG therapy are limited. While cystectomy may be curative, not all patients can withstand the medical and/or psychologic stresses associated with surgery or resection. Valrubicin represents a safe and effective second-line intravesical therapy.
UI - 11957800
AU - Kaczmarek P; Blaszczyk J; Kowalski J; Niemirowicz J
TI - [Evaluation of side effects after intrabladder instillations of preparations in patients with superficial bladder carcinoma]
SO - Pol Merkuriusz Lek 2002 Jan;12(67):39-42
AD - Oddzial Urologii Szpitala MSWiA, lodzi.
Permanent increase in neoplasm incidence including also bladder neoplasms makes physicians to search for new forms and methods of treatment. Application of new preparations entails in many cases appearance of side effects which are difficult to fight off and thus must be monitored constantly. To avoid complications which in case of BCG application are very burdensome and sometimes dangerous for patient it is necessary to intervene in due time. In the years 1990-1998 in Department of urology, Ministry of Internal Affairs and Administration Hospital in Lodz, 241 patients were treated due to superficial bladder carcinoma. In this group in 145 cases after carcinoma electroresection BCG suspension intrabladder infusion were applied. In 42 patients epirubicin, in 16 adriblastin intrabladder instillations were performed; 32 patients did not receive any preparation. A detailed history was taken from the patients before each next infusion, whereas blood was collected for testing before the first infusion and on the seventh day after completion of the therapy. Material for studies was collected before the first intrabladder infusion and on the seventh day after 4-week cycle completion. Side effects of the applied preparations were presented basing on toxicity grades acc. to WHO and divided into subjective and objective ones. The observation period comprised the time from the first infusion to the seventh day after the last infusion. In the group of 145 patients with applied BCG suspension 836 intrabladder instillations were performed. In 17 (12%) cases the treatment was stopped after 4 infusions due to intense dysuric symptoms. In the investigated group of patients strongly marked symptoms like polyuria (in 98% of patients), burning in urethra during miction (in 86%), haematuria and ill-being were observed. Objective symptoms were significantly marked and were not of importance in further management. In group II (epirubicin) and III (adriblastin) both subjective and objective effects were of insignificant percentage and were not of importance in the continuation of the treatment of superficial bladder carcinoma. Accurate subjective examination, careful analysis of the observed unfavourable symptoms, their intensity, close co-operation of the physician with the patient concerning full information on possible complications and side effects and personal procedure with them allow for safe and effective treatment of superficial bladder carcinomas with both BCG suspension and anthracycline antibiotics (in the form of intrabladder infusions).
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 - 11966622
AU - Shackley DC; Briggs C; Gilhooley A; Whitehurst C; O'Flynn KJ; Betts CD;
TI - Moore JV; Clarke NW Photodynamic therapy for superficial bladder cancer under local anaesthetic.
SO - BJU Int 2002 May;89(7):665-70
AD - Department of Urology, Hope Hospital, Salford Royal Hospitals Trust, Salford, UK. firstname.lastname@example.org
OBJECTIVES: To evaluate the use of local anaesthesia (LA) in 5-aminolaevulinic acid (ALA) photodynamic therapy (PDT) for superficial transitional cell carcinoma (TCC) of the bladder, and to provide further toxicity and tolerability data on this new method within the context of a phase 1 trial. PATIENTS AND METHODS: ALA PDT was administered to 19 patients with recurrent superficial TCC (stage Ta/carcinoma in situ, grades 1-3) using escalating doses of ALA (3-6%) and 633 nm laser light (25-50 J/cm2) under various LA (lignocaine) protocols. Pain was assessed using a linear analogue scale from 0 to 10. The endpoints of tolerability and toxicity were assessed for the different LA, light and ALA doses, with lignocaine levels. RESULTS: ALA PDT is painful and requires some form of anaesthesia. The discomfort was immediate, associated with bladder spasm, and was a function of the ALA concentration rather than the total light dose given. Simple passive diffusion (PD) of 2% lignocaine instilled for 40 min before PDT gave adequate anaesthesia with 3% ALA (n=8; median pain score 1, range 0-2). With 6% ALA the pain was dramatically increased using PD (n=6; median pain score 8, range 5-10) and therefore the more potent LA technique of electromotive drug administration (EMDA) of 2% lignocaine was used, with excellent results (n=3; median pain score 1, range 0-2). All patients had transient bladder irritability that typically lasted 9-12 days, with no subjective/objective change in long-term bladder function. No other toxicity was reported. Serum lignocaine levels were minimal. CONCLUSION: Bladder ALA PDT is both safe and feasible under LA. At a dose of 3% ALA, the procedure was well-tolerated using PD of lignocaine. At higher doses (6% ALA) more effective anaesthesia is required and this can be obtained satisfactorily with EMDA of lignocaine. With refinement, ALA PDT may be feasible as an outpatient treatment for superficial bladder TCC.
UI - 11966623
AU - Martinez-Pineiro JA; Flores N; Isorna S; Solsona E; Sebastian JL;
TI - Pertusa C; Rioja LA; Martinez-Pineiro L; Vela R; Camacho JE; Nogueira JL; Pereira I; Resel L; Muntanola P; Galvis F; Chesa N; De Torres JA; Carballido J; Bernuy C; Arribas S; Madero R; for CUETO (Club Urologico Espanol de Tratamiento Oncologico) Long-term follow-up of a randomized prospective trial comparing a standard 81 mg dose of intravesical bacille Calmette-Guerin with a reduced dose of 27 mg in superficial bladder cancer.
SO - BJU Int 2002 May;89(7):671-80
AD - Hospital La Paz, Avenida San Luis 95, 28033 Madrid, Spain. email@example.com
OBJECTIVES: To determine the efficacy of a three-fold reduced dose (RD, 27 mg) of intravesical bacille Calmette-Guerin (BCG) against the standard dose (81 mg) in patients with superficial bladder cancer, assessing recurrence, progression and differences in toxicity. PATIENTS AND METHODS: Five hundred patients with superficial bladder cancer (Ta, T1, Tis) were enrolled and randomly assigned to be treated after transurethral resection of all visible lesions with intravesical BCG Connaught strain (weekly x six and thereafter fortnightly x six) either with the standard or RD instillation. RESULTS: All but one of the 500 patients were evaluable for efficacy and toxicity (252 in the standard arm and 247 in the RD arm). The median follow-up was 69 months (maximum 104); 71 (28%) patients in the standard arm and 76 (31%) in the RD arm developed recurrences; the median time to recurrence has not yet been attained, but at 5 years the mean (sd) percentage of recurrence-free patients was 70.5 (3.12) and 70.4 (3.1) for the standard and RD arms, respectively. In patients presenting with multifocal tumours, the standard dose was more effective against recurrences than the RD (P=0.0151). In those with G3 and high-risk tumours overall, the superiority of the standard dose was marginal (P=0.060 and P=0.082). Twenty-nine (11.5%) tumours in the standard arm and 33 (13.3%) in the RD arm progressed to invasive disease; the median time to progression has not yet been attained, but the percentage of progression-free patients at 5 years was 88.8 (2.23) and 86.9 (2.31) for the standard and RD arms, respectively. The standard dose was more effective than the RD against progression only in patients with multifocal disease (P=0.048). Twelve (4.8%) cystectomies were performed in the standard and 15 (6.1%) in the RD arm. Currently, 106 (21.2%) patients have died, but only 38 (7.6%) from bladder cancer, i.e. 20 (7.9%) in the standard and 18 (7.5%) in RD arm. Overall the disease-specific death rate was lower for those patients who completed the scheduled treatment. The cause-specific survival at 5 years did not differ between the arms (P=0.76) but there was a trend toward better cause-specific survival for patients with multifocal tumours in the standard arm. Toxicity differed between the arms, significantly more patients having no toxicity in the RD arm, and fewer having delayed instillations or withdrawing. However, severe systemic toxicity occurred even in patients treated with the RD, in a similar proportion to those receiving the standard dose. CONCLUSION: Overall, the RD gave similar results for recurrence and progression but with significantly less toxicity. However, patients with multifocal tumours fared better with the standard dose and there was a trend towards better recurrence rates in patients with high-risk tumours. We recommend continuing to use the standard dose for high-risk tumours, while we consider the reduced dose safe and effective for intermediate-risk lesions and for maintenance schedules.
UI - 11966624
AU - Malmstrom PU
TI - A randomized comparative dose-ranging study of interferon-alpha and mitomycin-C as an internal control in primary or recurrent superficial transitional cell carcinoma of the bladder.
SO - BJU Int 2002 May;89(7):681-6
AD - Department of Urology, University Hospital, Uppsala University, Akademiska sjukhuset, SE-75185 Uppsala, Sweden. firstname.lastname@example.org
OBJECTIVE: To compare, in a phase II study, the activity and toxicity of three dose levels of interferon-alpha, and of mitomycin-C given intravesically (as an internal control to validate the results), the primary objective being to investigate the percentage of complete responses (complete disappearance of a marker lesion) induced by the three interferon-alpha dose levels on a marker lesion; a secondary objective was to compare the interferon-alpha doses for toxicity. PATIENTS AND METHODS: In all, 115 patients were enrolled, with the inclusion criteria being multiple grade 1 or 2, stage Ta or T1, primary or recurrent transitional cell carcinoma of the bladder. Interferon-alpha (30, 50 and 80 MU) and mitomycin-C (40 mg) intravesical treatments were given as follows. Patients randomized to one of three interferon-alpha dose levels were treated weekly for 12 weeks. However, in week 9 (first cystoscopy after baseline) interferon-alpha treatment was stopped if there was a complete response or disease progression. Patients randomized to mitomycin-C were treated weekly for 8 weeks only and in week 9 underwent follow-up cystoscopy. RESULTS: Interferon-alpha at doses of 30, 50 and 80 MU gave response rates at 13 weeks of 19%, 33% and 41%, respectively. Although the response rates were higher for 50 and 80 MU than for 30 MU, the differences were not statistically significant. All three interferon-alpha groups had significantly lower response rates than the internal control, mitomycin-C (72%). The safety analysis showed that most of the adverse events were of mild to moderate severity. Adverse events were experienced by 37%, 37% and 48% of patients receiving 30, 50 and 80 MU interferon-alpha, respectively, and by 55% of patients receiving mitomycin-C. The corresponding rates for severe adverse events related to treatment were 9% for interferon-alpha and 10% for mitomycin-C. CONCLUSION: Ablative therapy with interferon-alpha was less effective than mitomycin-C in patients with superficial bladder cancer. Both drugs were well tolerated, although interferon-alpha appeared to have a slightly better overall safety profile.
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. email@example.com
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.
UI - 11692800
AU - Sanchez Zalabardo D; Rodriguez Gonzalez J; Fernandez Montero JM; Lopez
TI - Ferrandis J; Arocena Garcia-Tapia J; Sanz Perez G; Rosell Costa D; Zudaire Bergera JJ; de Alava Casado E; Berian Polo JM [Primary bladder adenocarcinoma: our experience in the last 10 years]
SO - Actas Urol Esp 2001 Sep;25(8):573-7
AD - Servicio de Urologia, Clinica Universitaria de Navarra.
Adenocarcinoma of the bladder is an uncommon neoplasm corresponding as usual to a metastases and with a lower frequency to a primary vesical tumour. We present the primary adenocarcinoma treated in our hospital in the last 10 years. The moment at the diagnosis is related to the prognosis because of its tendency to muscle infiltration. The most accepted treatment is the radical cistectomy and if recurrence occurs complementary proceedings must be consider.
UI - 12014645
AU - Marquez M; Du J; Edgren M; Nilsson S; Lennartsson L; Hiltunen J; Westlin
TI - JE; Tammela T; Raitanen M; Laato M; Jonsson G; Holmberg AR Development of dextran derivatives with cytotoxic effects in human urinary bladder cancer cell lines.
SO - Anticancer Res 2002 Mar-Apr;22(2A):741-4
AD - Karolinska Institute, Cancer Center Karolinska, Stockholm, Sweden.
BACKGROUND: In a previous study we reported on a new approach describing intravesical instillation of charged dextran in patients with superficial bladder carcinoma. The cationic derivative showed a strong tumor-selective accumulation. To develop this approach, the present study investigates the cytotoxic effect of cationic dextran derivatives on two urinary bladder cancer cell lines (J82 and 5637). METHODS: The dextran conjugates were prepared by periodate activation and subsequent coupling by reductive amination. A fluorimetric cytotoxicity assay (FMCA) was used for the cytotoxicity assay. The tumor cells were seeded into 96-well microtiter plates and different cationic dextran derivatives were added and incubated for 72 hours. RESULTS: The results showed that cationic epirubicin-dextran had a clear inhibitory effect on the growth in both cell lines (40-95% growth inhibition). The corresponding values for epirubicin (the reference) was 90-100% inhibition. Interestingly, cationic dextran had, by itself, a growth inhibitory effect. This cytotoxic effect could be strongly enhanced to be almost equal to the reference by changing the cationic sidegroup to aminohexane. Dextran alone showed no effect. CONCLUSION: The finding that cationic dextran by itself can be made cytotoxic, together with its capacity to accumulate in superficial bladder cancer, suggests possibilities for new therapeutic constructs. Cationic dextran with different cationic side-groups and in combination with cytotoxic drugs will be studied further. The cytotoxic mechanism needs to be elucidated.
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.