Radical Cystectomy is the best choice for most patients with muscle-invasive bladder cancer? Opinion: Yes

Monteiro, Larissa Raylane Lucas; Kassouf, Wassim

doi:10.1590/s1677-5538.ibju.2017.02.03

Cited by 11 publications

(11 citation statements)

References 21 publications

(20 reference statements)

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“…There are three main limitations of using CCRT in MIBC. Firstly, there is a significant risk of pelvic recurrence (25–50%) [ 17 ]. Secondly, CCRT treatment may create damage to the bladder wall resulting in undesirable toxicity.…”

Section: Limitations Of Use Of Rt In Mibc In Clinicsmentioning

confidence: 99%

“…Although post-radical cystectomy history can be associated with increased risk of infection, extensive bleeding, affected sexual function and quality of life, it achieves locoregional control and results in 60% of the overall 5-year survival [ 15 , 16 ]. The absence of prospective randomised studies has impeded comparison of radical cystectomy versus other forms of therapy [ 17 ]. The treatment choice for MIBC between radical cystectomy versus bladder preservation largely depends on the specialist expertise in the treatment centre and often varies among countries.…”

Section: Introductionmentioning

confidence: 99%

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Review of Experimental Studies to Improve Radiotherapy Response in Bladder Cancer: Comments and Perspectives

Silina

Maksut

Bernard‐Pierrot

et al. 2020

Cancers

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Bladder cancer is among the top ten most common cancer types in the world. Around 25% of all cases are muscle-invasive bladder cancer, for which the gold standard treatment in the absence of metastasis is the cystectomy. In recent years, trimodality treatment associating maximal transurethral resection and radiotherapy combined with concurrent chemotherapy is increasingly used as an organ-preserving alternative. However, the use of this treatment is still limited by the lack of biomarkers predicting tumour response and by a lack of targeted radiosensitising drugs that can improve the therapeutic index, especially by limiting side effects such as bladder fibrosis. In order to improve the bladder-preserving treatment, experimental studies addressing these main issues ought to be considered (both in vitro and in vivo studies). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews, we conducted a literature search in PubMed on experimental studies investigating how to improve bladder cancer radiotherapy with different radiosensitising agents using a comprehensive search string. We made comments on experimental model selection, experimental design and results, formulating the gaps of knowledge still existing: such as the lack of reliable predictive biomarkers of tumour response to chemoradiation according to the molecular tumour subtype and lack of efficient radiosensitising agents specifically targeting bladder tumour cells. We provided guidance to improve forthcoming studies, such as taking into account molecular characteristics of the preclinical models and highlighted the value of using patient-derived xenografts as well as syngeneic models. Finally, this review could be a useful tool to set up new radiation-based combined treatments with an improved therapeutic index that is needed for bladder preservation.

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Section: Limitations Of Use Of Rt In Mibc In Clinicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Review of Experimental Studies to Improve Radiotherapy Response in Bladder Cancer: Comments and Perspectives

Silina

Maksut

Bernard‐Pierrot

et al. 2020

Cancers

View full text Add to dashboard Cite

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“…The aim of the reconstructive operation is to create a urinary reservoir, which is functionally caOriginal Research Article: full paper (2018), «EUREKA: Health Sciences» Number 1 pable of adapting to the bladder in periods of urine accumulation and emptying, and maintaining renal function [3,4]. The most frequent anatomical organ used for the formation of the urinary conduit is the distal portion of the ileum [5,6].…”

Section: Introductionmentioning

confidence: 99%

Energy Homeostasis of the Artificial Bladder in Experimental Conditions

Савчук

Kostyev

Dekhtiar

et al. 2018

EUREKA: Health Sciences

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Patients with malignant neoplasms of the bladder or severe anatomical and functional bladder abnormalities are the candidates for cystectomy and orthotopic urine diversion. The distal portion of the ileum is the most frequent anatomical organ, which is used for the formation of the urinary conduit. The formation of a urinary reservoir from the ileum that is unable to perform new functions, and mainly programmed to isolate enzymes, digest food and absorb nutrients, salts and minerals changes the energy exchange in the ileum wall under the influence of urine. The aim of the research is the examination of energy metabolism changes in the ileum wall during the formation of artificial bladder in experimental conditions conducted on mini-pigs. Experimental studies were performed on 21 female mini-pigs with an average age of 6 to 14 months. The duration of the experiment was 12 months. An imbalance of the ATP-ADP-AMP system was observed in the transplant tissue of the graft in different postoperative periods. Changes in the level of ATP are characteristics of the development of tissue ischemia. Results. The values of the adenosine nucleotides sum (the energy potential indicative of the respiration rate of mitochondria) and the phosphorylation index were lower at different times of observation in the transplant tissue. The energy charge value was lower to a lesser extent relative to the control. Conclusion. The revealed changes in the level of adenosine nucleotides confirm the severity of the disturbances of the energy homeostasis in the transplant tissue at all stages of the observation.

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“…Bladder disease with loss of reservoir capacity and function, damage by the tumor process, as well as the complication of specific and non-specific inflammatory diseases requiring its complete removal or resection, led to rapid development of reconstructive surgery of bladder [4,7,8,20]. The main material for restoring the functional capabilities of the bladder (accumulative and evacuator) are different sections of the gastrointestinal tract [3,5,15]. Many studies have been conducted on the effectiveness and safety of the use of the stomach, the area of the large and small intestines, but the best transplant was recognized area of iliac intestine, due to the smallest electrolyte disturbances and possible adaptive abilities [9,12,19].…”

Section: Introductionmentioning

confidence: 99%

Structural and Functional Transformation of the Small Intestine Wall in the Conditions of the Functioning of the Artificial Urinary Reservoir in the Experiment

et al. 2018

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Morphological changes of the wall of the artificial urinary bladder are various and its investigation continues from the moment of the creation of the first conduit on the ileum’s section. The aim of the work is to explore the structural-functional transformation of the mucous and the neobladder wall in 12 months after ileocystoplasty in the experimental conditions on mini-pigs. The results of the neobladder’s experimental model, created by the execution of cystectomy and ileocystoplasty in 9 experimental mini-pigs are the material of this work. 12 months after the operation of modeling the urinary bladder, animals were removed from the experiment of nembutal overdosing, following the provisions of “The European convention for the Protection of vertebrate animals being in use for experiments or for other scientific purposes”. Our morphological changes of the artificial urinary bladder, formed from the segment ileum 12 months after the orthotopic ileoplasty proved significant ultra-structural changes in the neobladder’s epithelial layer. Ileum’s villi within the conditions of the artificial urinary bladder are decreased and smoothed, epithelial cells are similar to the interjacent epithelium. The connective-tissue plate is thickened and becomes callous, the muscular layer is also thickened. The samples of the ileum, that remained in the normal environment without the compatibility with urine, did not undergo the significant morphological transformations and did not differ from the samples of the intact ileum. The transplantation of the ileum segment for performing new, not-programmed functions causes it to adapt to new conditions, although the urinary bladder and the ileum have different origins and structures from the very beginning. New aggressive conditions and constant contact with urine lead to the transformation of the mucous of the ileum and acquire new features necessary for performing new functions.

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Radical Cystectomy is the best choice for most patients with muscle-invasive bladder cancer? Opinion: Yes

Cited by 11 publications

References 21 publications

Review of Experimental Studies to Improve Radiotherapy Response in Bladder Cancer: Comments and Perspectives

Review of Experimental Studies to Improve Radiotherapy Response in Bladder Cancer: Comments and Perspectives

Energy Homeostasis of the Artificial Bladder in Experimental Conditions

Structural and Functional Transformation of the Small Intestine Wall in the Conditions of the Functioning of the Artificial Urinary Reservoir in the Experiment

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