Changes produced in the urothelium by traditional and newer therapeutic procedures for bladder cancer

López-Beltrán, Antonio

doi:10.1136/jcp.55.9.641

Cited by 81 publications

(60 citation statements)

References 76 publications

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“…It is well known that mechanical irritation (e.g., due to TURB), infection and especially BCG treatment leads to reactive urothelial changes that are equivocal by morphology alone or can even be misinterpreted as false positive. 10 This is in line with the results of an international study on urinary cytology, where we found a considerable interobserver variability in the cytological categories below G3. 15 As there is strong evidence that BCG treatment by itself does not give rise to chromosomal alterations, FISH might help to avoid false-positive diagnosis.…”

Section: Discussionsupporting

confidence: 79%

“…9,10 Fluorescence in situ hybridization (FISH) in urinary cytology using the multiprobe UroVysion 1 FISH assay for detection of chromosomal aberrations is a sensitive and objective method for improved diagnosis of urothelial carcinoma as it can detect chromosomal changes characteristic for cancer cells before they become morphologically apparent. 11,12 The usefulness of FISH relative to conventional cytology in monitoring NMIBC after BCG treatment has not been investigated so far.…”

Section: Uiccmentioning

confidence: 99%

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The prognostic value of cytology and fluorescence in situ hybridization in the follow‐up of nonmuscle‐invasive bladder cancer after intravesical Bacillus Calmette‐Guérin therapy

Savic

Zlobec

Thalmann

et al. 2009

Intl Journal of Cancer

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Molecular markers reliably predicting failure or success of Bacillus Calmette-Guerin (BCG) in the treatment of nonmuscle-invasive urothelial bladder cancer (NMIBC) are lacking. The aim of our study was to evaluate the value of cytology and chromosomal aberrations detected by fluorescence in situ hybridization (FISH) in predicting failure to BCG therapy. Sixty-eight patients with NMIBC were prospectively recruited. Bladder washings collected before and after BCG instillation were analyzed by conventional cytology and by multitarget FISH assay (UroVysion 1 , Abbott/ Vysis, Des Plaines, IL) for aberrations of chromosomes 3, 7, 17 and 9p21. Persistent and recurrent bladder cancers were defined as positive events during follow-up. Twenty-six of 68 (38%) NMIBC failed to BCG. Both positive post-BCG cytology and positive post-BCG FISH were significantly associated with failure of BCG (hazard ratio (HR)5 5.1 and HR5 5.6, respectively; p < 0.001 each) when compared to those with negative results. In the subgroup of nondefinitive cytology (all except those with unequivocally positive cytology), FISH was superior to cytology as a marker of relapse (HR5 6.2 and 1.4, respectively). Cytology and FISH in post-BCG bladder washings are highly interrelated and a positive result predicts failure to BCG therapy in patients with NMIBC equally well. FISH is most useful in the diagnostically less certain cytology categories but does not provide additional information in clearly malignant cytology. ' UICCKey words: nonmuscle-invasive urothelial bladder cancer; Bacillus Calmette-Guerin; cytology; fluorescence in situ hybridization High-and intermediate risk nonmuscle-invasive urothelial bladder cancers (NMIBC) frequently recur and, more importantly, can progress to potentially life-threatening muscle-invasive carcinomas. Intravesical instillation of Bacillus Calmette-Guerin (BCG) after transurethral resection of bladder cancer (TURB) is the most effective treatment. However, 50% of NMIBC do not respond to BCG treatment. [1][2][3] The progression rate has been estimated to be 9.8%, and 5.6% of patients with NMIBC die from bladder cancer. 4 Although an early cystectomy provides an excellent chance of cure, 50% of patients are overtreated with this aggressive approach. 5,6 Decision on therapy strategy of bladder cancer is based on clinicopathological tumor characteristics (number of tumors, tumor size, prior recurrence rate, tumor category, presence of pTis and tumor grade). Several clinicopathological tumor characteristics have recently been suggested as predictors for recurrence and progression after BCG therapy. 7 However, clinicopathological or molecular markers that can reliably predict failure or success of BCG therapy are still lacking. 8 Such markers would be of great value to individually tailor the follow-up schedule and stratify patients at high risk of tumor recurrence or progression.Although conventional cytology has a very high diagnostic accuracy for high-grade urothelial carcinomas, false-positive results have been repor...

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Section: Discussionsupporting

confidence: 79%

Section: Uiccmentioning

confidence: 99%

The prognostic value of cytology and fluorescence in situ hybridization in the follow‐up of nonmuscle‐invasive bladder cancer after intravesical Bacillus Calmette‐Guérin therapy

Savic

Zlobec

Thalmann

et al. 2009

Intl Journal of Cancer

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“…Patients with AUS usually present with hematuria or irritative symptoms. In contrast to reactive atypia, patients with AUS often have a previous diagnosis of urothelial dysplasia or have undergone various types of treatment such as intravesicular chemotherapy or radiotherapy [5,24]. Microscopically, one sees inflammation of the lamina propria and variable degrees of nuclear atypia.…”

Section: Reactive Atypiamentioning

confidence: 96%

Urothelial dysplasia and other flat lesions of the urinary bladder: clinicopathologic and molecular features

et al. 2010

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“…Proliferation of the bladder epithelium is associated with hemorrhage, fibrin deposits, fibroid vascular changes, and multinucleated stromal cells. 10 Fibrotic lesions may, in turn, impair tissue oxygenation, and revascularization. Other potential changes include interstitial hemorrhage, squamous metaplasia, and perineural inflammation.…”

Section: Radiation-induced Toxicity In the Lower Urinary Tractmentioning

confidence: 99%

The Role of α-Blockers in the Management of Lower Urinary Tract Symptoms in Prostate Cancer Patients Treated With Radiation Therapy

Crawford

Kavanagh²

2006

American Journal of Clinical Oncology

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Changes produced in the urothelium by traditional and newer therapeutic procedures for bladder cancer

Cited by 81 publications

References 76 publications

The prognostic value of cytology and fluorescence in situ hybridization in the follow‐up of nonmuscle‐invasive bladder cancer after intravesical Bacillus Calmette‐Guérin therapy

The prognostic value of cytology and fluorescence in situ hybridization in the follow‐up of nonmuscle‐invasive bladder cancer after intravesical Bacillus Calmette‐Guérin therapy

Urothelial dysplasia and other flat lesions of the urinary bladder: clinicopathologic and molecular features

The Role of α-Blockers in the Management of Lower Urinary Tract Symptoms in Prostate Cancer Patients Treated With Radiation Therapy

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