Challenging dilemmas of low grade, non-invasive bladder cancer: a narrative review

Korkes, Fernando; Spiess, Phillippe E.; García‐Perdomo, Herney Andrés; Necchi, Andrea

doi:10.1590/s1677-5538.ibju.2021.0259

Cited by 3 publications

(3 citation statements)

References 28 publications

(25 reference statements)

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“…Some studies reported that ureteroscopy with or without biopsy may increase the risk of IVR ( 25 , 26 ). However, the 29.6% IVR rate in our series is not higher than other series that did not routinely perform ureteroscopy for diagnosis ( 1 , 8 – 12 ). Meanwhile, ureteroscopic biopsy is our routine practice; thus, no biases were introduced.…”

Section: Discussioncontrasting

confidence: 78%

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Effects of different combinations of radical nephroureterectomy and bladder cuff excision procedures for upper tract urothelial carcinoma on bladder recurrence

et al. 2023

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Purpose: To compare the effects of different combinations of radical nephroureterectomy (RNU) and bladder cuff excision (BCE) surgical procedures on intravesical recurrence (IVR) in patients with upper tract urothelial carcinoma (UTUC). Materials and Methods: This retrospective observational study included 452 patients who underwent RNU with BCE for UTUC between January 2010 and December 2020. The patients were classified into three groups based on different combinations of RNU and BCE surgical procedures: open RNU with open BCE (group 1, n=104), minimally invasive (MIS) RNU with open BCE (group 2, n=196), and MIS RNU with intracorporeal BCE (group 3, n=152). Data on demographics, body mass index, history, preoperative renal function, perioperative status, tumor characteristics, histopathology, and recurrence conditions were collected. Multivariate Cox regression analyses were performed to determine the impact of the surgical procedures on IVR. P-values <0.05 were considered statistically significant. Results: After a median follow-up of 29.5 months, the IVR rate was 29.6% and the IVR-free survival rate was the lowest in group 2 (group 1 vs. group 2 vs. group 3: 69.0% vs. 55.1% vs. 67.5%; log-rank P=0.048). The overall survival rate was comparable among the three groups. Multivariate analysis revealed that group 2 had a significantly higher risk of IVR than group 1 (hazard ratio=1.949, 95% confidence interval=1.082–3.511, P=0.026), while groups 1 and 3 had similar risks. Conclusions: For patients with UTUC, MIS RNU with open BCE is associated with a higher risk of IVR than open RNU with open BCE and MIS RNU with intracorporeal BCE.

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Section: Discussioncontrasting

confidence: 78%

“…Intravesical recurrence (IVR) after RNU BCE occurs in as high as 22–47% of patients ( 1 , 8 – 12 ). IVR usually occurs within 2 years following the treatment of UTUC ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

Effects of different combinations of radical nephroureterectomy and bladder cuff excision procedures for upper tract urothelial carcinoma on bladder recurrence

et al. 2023

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“…There is comparatively less data about how the risk of BC changes after quitting smoking. Still, there is evidence that the risk of BC might persist up to several decades ( 9 – 12 ). Thus, we hypothesized that the risk of BC might persist over several decades even after quitting smoking.…”

Section: Introductionmentioning

confidence: 99%

Smoking characteristics and years since quitting smoking of US adults diagnosed with lung and bladder cancer: A national health and nutrition examination survey analysis

Beatrici,

Labban,

Filipas

et al. 2024

Int. braz j urol.

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Purpose: Smoking is a recognized risk factor for bladder BC and lung cancer LC. We investigated the enduring risk of BC after smoking cessation using U.S. national survey data. Our analysis focused on comparing characteristics of LC and BC patients, emphasizing smoking status and the latency period from smoking cessation to cancer diagnosis in former smokers. Materials and Methods: We analyzed data from the National Health and Examination Survey (2003-2016), identifying adults with LC or BC history. Smoking status (never, active, former) and the interval between quitting smoking and cancer diagnosis for former smokers were assessed. We reported descriptive statistics using frequencies and percentages for categorical variables and median with interquartile ranges (IQR) for continuous variables. Results: Among LC patients, 8.9% never smoked, 18.9% active smokers, and 72.2% former smokers. Former smokers had a median interval of 8 years (IQR 2-12) between quitting and LC diagnosis, with 88.3% quitting within 0-19 years before diagnosis. For BC patients, 26.8% never smoked, 22.4% were active smokers, and 50.8% former smokers. Former smokers had a median interval of 21 years (IQR 14-33) between quitting and BC diagnosis, with 49.3% quitting within 0-19 years before diagnosis. Conclusions: BC patients exhibit a prolonged latency period between smoking cessation and cancer diagnosis compared to LC patients. Despite smoking status evaluation in microhematuria, current risk stratification models for urothelial cancer do not incorporate it. Our findings emphasize the significance of long-term post-smoking cessation surveillance and advocate for integrating smoking history into future risk stratification guidelines.

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Upper tract urothelial carcinoma and bladder cancer in review in this number of International Brazilian Journal of Urology

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2022

Int. braz j urol.

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and Egypt, and as usual the editor´s comment highlights some of them.In the present issue we present two important reviews about upper urothelial carcinoma (UUC) and bladder cancer. The paper about UUC of the group of Dr. Sharma from India in page 406 shows a very complete systematic review about the topic (1). The authors shows that the tumor grade, stage, presence of lymphovascular invasion, lymph node metastasis, hydronephrosis, variant histology, sessile architecture, margin positivity and multifocality were associated with poor recurrence free survival (RFS), cancer-specific survival (CSS) and overall survival (OS). Presence of carcinoma in situ was associated with poor RFS and CSS but not OS. Tumor necrosis was associated with worst CSS and OS but not RFS. Tumor location was not a predictor of any of the survival parameters. Dr. Korkes and colleagues from Brazil and USA in page 397 (2) in a interesting narrative review about bladder cancer shows that patients with low-grade-non-muscle-invasive bladder cancer that TURBTs, chemoablation, BCG immunoablation, partial cystectomy, radical cystectomy, radiotherapy, and chemotherapy are attractive modalities to treat them effectively and proposes an algorithm to overcome these challenges. The editor in chief would like to highlight the following works too:Dr. Mazzucchi and colleagues from Brazil and Canada, presented in page 456 (3) a nice review about the single use flexible ureteroscopes and concluded that these ureteroscopes are lighter and have superior quality of image when compared to fiberoptic ones and that there are no definite data showing a higher stone-free rate or less complications with the use of single-use flexible ureteroscopes.Dr. Sobrinho and colleagues from the Urogenital Research Unit from Brazil performed in page 561 (4) a interesting translational study about the lower pole anatomy in anomalous kidneys and concluded that the knowledge of spatial anatomy of lower pole is of utmost importance during endourologic procedures in patients with kidney anomalies. The horseshoe kidneys had more restrictive anatomic factors in lower pole than the complete ureteral duplication.

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Challenging dilemmas of low grade, non-invasive bladder cancer: a narrative review

Cited by 3 publications

References 28 publications

Effects of different combinations of radical nephroureterectomy and bladder cuff excision procedures for upper tract urothelial carcinoma on bladder recurrence

Effects of different combinations of radical nephroureterectomy and bladder cuff excision procedures for upper tract urothelial carcinoma on bladder recurrence

Smoking characteristics and years since quitting smoking of US adults diagnosed with lung and bladder cancer: A national health and nutrition examination survey analysis

Upper tract urothelial carcinoma and bladder cancer in review in this number of International Brazilian Journal of Urology

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