Aggressive treatment for urothelial cancer-complete urinary tract extirpation: Operative feasibility in two cases

Akand, Murat; Kılıç, Özcan; Harmankaya, Ísmail; Karabağlı, Pınar; Yavaş, Çağdaş; Ata, Ozlem

doi:10.5152/tud.2018.55453

Cited by 4 publications

(4 citation statements)

References 17 publications

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Section: Resultsmentioning

confidence: 99%

“…In two cases, a combined approach using open radical cystectomy and laparoscopic nephroureterectomy was done. 12 In 11 cases, bilateral hand-assisted retroperineoscopic nephroureterectomy (HARN) and open extraperitoneal cystectomy were the approaches of choice. 17 For patients requiring urinary diversion, an ileal conduit was the most common diversion method, accounting for nearly 82% of diversions.…”

Section: Surgical Approach and Diversion Typementioning

confidence: 99%

“…9 This highlights the multifocal nature of urothelial carcinoma and that any primary urothelial tumor is an important risk factor for developing another tumor along the rest of the urinary tract. 10 The management of concurrent UTUC and MIBC is challenging, but in certain instances, a combined one-step nephroureterectomy and radical cystectomy is needed [11][12][13] since it allows for decreasing the morbidity of a staged procedure and avoiding the anesthetic risk of multiple surgeries. In other instances, patients with endstage renal disease (ESRD) and urothelial carcinoma could be considered for a combined procedure involving both upper tracts known as complete urinary tract extirpation (CUTE).…”

Section: Introductionmentioning

confidence: 99%

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Concurrent radical cystectomy and nephroureterectomy indications and outcomes: a systematic review and comparative analysis

Zein

Nasrallah

Heidar

et al. 2023

Therapeutic Advances in Urology

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Introduction: Urothelial carcinoma can arise from the urinary bladder or from the upper urinary tract. In some instances, urinary bladder cancer (UBC) and upper tract urothelial carcinoma (UTUC) can be concurrently diagnosed, necessitating a combined radical cystectomy (RC) with radical nephroureterectomy (RNU). A systematic review was done on the combined procedure exploring outcomes and indications, in addition to a comparative analysis between the combined procedure and cystectomy alone. Methods: For the systematic review, three databases (Embase, PubMed, and Cochrane) were queried, selecting only studies that included intraoperative and perioperative data. For the comparative analysis, using the NSQIP database, CPT codes for RC and RNU were used to identify two cohorts, one with RC and RNU and one with RC alone. A descriptive analysis was performed on all preoperative variables, and propensity score matching (PSM) was performed. Postoperative events were then compared between the two matched cohorts. Results: For the systematic review, 28 relevant articles were included amounting to 947 patients who underwent the combined procedure. The most common indication was synchronous multifocal disease, the most common approach was open surgery, and the most common diversion technique was using an ileal conduit. Almost 28% of patients required blood transfusion and remained in the hospital for an average of 13 days. The most common postoperative complication was prolonged paralytic ileus. For the comparative analysis, 11,759 patients were included of which 97.5% underwent RC only and 2.5% underwent the combined procedure. After PSM, the cohort that had undergone the combined procedure showed an increased risk of renal injury, increased readmission rates, and increased reoperation rates. Whereas the cohort that had undergone RC only showed an increased risk of deep venous thrombosis (DVT), sepsis, or septic shock. Conclusion: A combined RC and RNU is a treatment option for concurrent UCB and UTUC that should be cautiously utilized as it is associated with high morbidity and mortality. Patient selection, discussion of the risks and benefits of the procedure, and explanation of the available treatment options remain the most important pillars in managing patients with this complex disease.

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Section: Resultsmentioning

confidence: 99%

Section: Surgical Approach and Diversion Typementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Concurrent radical cystectomy and nephroureterectomy indications and outcomes: a systematic review and comparative analysis

Zein

Nasrallah

Heidar

et al. 2023

Therapeutic Advances in Urology

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“…However, nearly 25% of newly diagnosed BCa patients have muscle invasive bladder cancer (MIBC), and approximately half of the patients with MIBC recurrence eventually die from BCa because of the lack of treatment options (4,5). Radical cystectomy followed with pelvic lymphadenectomy is the gold standard treatment for MIBC (6). Bladder preserving trimodal therapies are also evolving as an effective alternate (7), however, combined with current platinum-based chemotherapy (such as MVAC-methotrexate, vinblastine, adriamycin, and cisplatin), 25-30% patients still require salvage cystectomy (8).…”

Section: Introductionmentioning

confidence: 99%

ASR488, a novel small molecule, activates an mRNA binding protein, CPEB1, and inhibits the growth of bladder cancer

et al. 2020

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Due to a lack of mechanistic insights, muscle-invasive bladder cancer (MIBC) remains incurable and is one of the most lethal types of cancer in the United States. The present study investigated changes in the molecular signatures of MIBC cells (TCCSUP and HT1376) after treatment with a novel small molecule, ASR488, to gain knowledge of the mechanisms that inhibited MIBC cell growth. ASR488 treatment initiated apoptotic signaling in MIBC cells. Pathway enrichment analysis was used to analyze the changes in function of differentially expressed genes. Gene Ontology analysis, as well as Kyoto Encyclopedia of Genes and Genomes analysis, was also performed. These analyses along with reactome pathway enrichment analyses indicated that the genes upregulated in the ASR488-treated cells are involved in focal adhesion, neurotrophin signaling, p53 signaling, endoplasmic reticulum functioning in terms of protein processing, and pathways related to bladder cancer. The genes downregulated in ASR488-treated MIBC cells were mainly involved in DNA replication, mismatch repair, RNA degradation, nucleotide excision repair and TGFβ signaling (P<0.05). Furthermore, reverse transcription-quantitative PCR analysis revealed an increase in transcripts of the most upregulated genes in ASR 488-treated MIBC cells: CPEB1 (36-fold), IL11 (30-fold), SFN (20.12-fold) and CYP4F11 (15.8-fold). In conclusion, the analysis of biological functions of the most differentially expressed genes revealed possible mechanisms that may be associated with the aggressiveness of MIBC.

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Urothelial Cancer Surgery

Hanna,

Peak,

García-Perdomo

et al. 2023

Anesthesia for Oncological Surgery

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Aggressive treatment for urothelial cancer-complete urinary tract extirpation: Operative feasibility in two cases

Abstract: Ali Serdar Gözen, et al.; Robot-assisted vasovasostomy and vasoepididymostomy: Current status and review of the literature.

Cited by 4 publications

References 17 publications

Concurrent radical cystectomy and nephroureterectomy indications and outcomes: a systematic review and comparative analysis

Concurrent radical cystectomy and nephroureterectomy indications and outcomes: a systematic review and comparative analysis

ASR488, a novel small molecule, activates an mRNA binding protein, CPEB1, and inhibits the growth of bladder cancer

Urothelial Cancer Surgery

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