Current Staging Procedures in Urinary Bladder Cancer

Maurer, Tobias; Horn, Thomas; Heck, Matthias; Gschwend, Jürgen E.; Eiber, Matthias; Beer, Ambros

doi:10.3390/diagnostics3030315

Cited by 9 publications

(6 citation statements)

References 36 publications

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“…The presented accuracy of detecting local advanced disease and LN metastasis with 62% and 72% is in accordance with the literature (14)(15)(16)(17). Therefore, the presented results hold high potential to be widely transferable.…”

Section: Discussionsupporting

confidence: 88%

Computed-tomography based scoring system predicts outcome for clinical lymph node-positive patients undergoing radical cystectomy

et al. 2022

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Purpose: Contrast-enhanced CT scan is the standard staging modality for patients with bladder cancer undergoing radical cystectomy (RC). Involvement of lymph nodes (LN) determines prognosis of patients with bladder cancer. The detection of LN metastasis by CT scan is still insuffi cient. Therefore, we investigated various CT scan characteristics to predict lymph node ratio (LNR) and its impact on survival. Also, pre-operative CT scan characteristics might hold potential to risk stratify cN+ patients. Materials and Methods: We analyzed preoperative CT scans of patients undergoing RC in a tertiary high volume center. Retrospectively, local tumor stage and LN characteristics such as size, morphology (MLN) and number of loco-regional LN (NLN) were investigated and correlation to LNR and survival was analyzed. CT scan characteristics were used to develop a risk stratifi cation using Kaplan-Maier and multivariate analysis. Results: 764 cN0 and 166 cN+ patients with complete follow-up and imaging data were included in the study. Accuracy to detect LN metastasis and locally advanced tumor stage in CT scan was 72% and 62%. LN larger than 15mm in diameter were signifi cantly associated with higher LNR (p=0.002). Increased NLN correlated with decreased CSS and OS (p=0.001: p=0.002). Furthermore, CT scan based scoring system precisely differentiates low-risk and high-risk profi les to predict oncological outcome (p <0.001). Conclusion: In our study, solely LN size >15mm signifi cantly correlated with higher LNR. Identifi cation of increased loco-regional LN was associated with worse survival. For the fi rst time, precise risk stratifi cation based on computed-tomography fi ndings was developed to predict oncological outcome for clinical lymph node-positive patients undergoing RC.

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Section: Discussionsupporting

confidence: 88%

Computed-tomography based scoring system predicts outcome for clinical lymph node-positive patients undergoing radical cystectomy

et al. 2022

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“…However, the decision for the optimal treatment strategy is mainly based on the results from imaging. 5 Unfortunately, current imaging methods, including, computed tomography, magnetic resonance imaging, and positron emission tomography (PET) using metabolic tracers, have difficulty in accurately identifying patients with metastatic disease. 5 The improved understanding of molecular contributions to bladder cancer progression is helping to identify new markers and develop targeted treatments.…”

Section: Introductionmentioning

confidence: 99%

“…5 Unfortunately, current imaging methods, including, computed tomography, magnetic resonance imaging, and positron emission tomography (PET) using metabolic tracers, have difficulty in accurately identifying patients with metastatic disease. 5 The improved understanding of molecular contributions to bladder cancer progression is helping to identify new markers and develop targeted treatments. For example, the association between pro-inflammatory mediators expressed by bladder tumor cells or immune cells and their role in the progression of bladder cancer has been well pointed out.…”

Section: Introductionmentioning

confidence: 99%

Targeting IL-5Rα with antibody-conjugates reveals a strategy for imaging and therapy for invasive bladder cancer

Paquette

Vilera-Perez²,

Beaudoin

et al. 2017

OncoImmunology

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Despite the high interest and concern due to an increasing incidence and death rate, patients who develop muscle invasive bladder cancer (MIBC) have few options available. However, the past decade has produced many candidate bladder tumor-specific markers but further development of these markers is still needed for creating effective targeted medications to solve this urgent need. Interleukin-5 receptor α-subunit (IL-5Rα) has recently been reported to be involved in MIBC progression. Thus, we aimed to validate IL-5Rα as a target for antibody-conjugates to better manage patients with MIBC. Patients were recruited and their tumors were processed for IL-5Rα immunohistochemical analysis. NOD/SCID mice were also heterotopically implanted with the human MIBC HT-1376 and HT-B9 cell lines and established xenografts immunohistochemically evaluated for IL-5Rα and compared against patient tumors. Using the mAb A14, an antibody-drug conjugate (ADC) and a radiolabeled immunoconjugate (RIC) were developed by conjugating to vinblastine and to the positron emitter copper-64 (Cu), respectively. As a proof-of-concept for ADC and RIC efficacy, cytotoxicity and positron emission tomography (PET) imaging in tumor-bearing mice were performed, respectively. In addition, as rapid internalization and accumulation are important components for effective antibody-conjugates, we evaluated these aspects in response to IL-5 and Cu-A14 treatments. Our findings suggest that although IL-5Rα protein expression is preferentially increased in MIBC, it is rapid IL-5Rα-mediated internalization allowing vinblastine-A14 to have cytotoxic activity andCu-A14 to detect MIBC tumors . This is the first report to elucidate the potential of IL-5Rα as an attractive MIBC target for antibody-conjugate applications.

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“…Findings present after TURBT and NAC, including desmoplastic reaction, infection, scar tissue, and necrosis, are difficult to distinguish from malignancy and may preclude definitive characterization of response [ 5 ]. Tumors of the bladder neck and prostate may go undetected, and the finding of diffuse bladder wall thickening can be due to benign causes, most notably poor bladder distension [ 3 , 19 ]. Partial response can be challenging to assess due to loss of fat planes between the bladder and adjacent organs, making T3-4 disease difficult to distinguish from less-invasive disease.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Computed Tomography Following Neoadjuvant Chemotherapy for Muscle Invasive Bladder Cancer

Alam

Martin

McLeay

et al. 2023

BLC

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BACKGROUND: Neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC) remains standard treatment for select patients with muscle-invasive bladder cancer (MIBC). Although computed tomography (CT) is often obtained prior to RC, its ability to predict pathologic response is poorly characterized. OBJECTIVE: The purpose of this study is to evaluate the predictive value of CT in assessing disease burden after NAC. METHODS: Patients with MIBC having received NAC prior to RC were identified. Pre- and post-NAC CT scans were reviewed by an abdominal radiologist. The correlation between pathologic complete response (PCR) and radiologic complete response (RCR) was determined as the primary aim. As a secondary aim, the correlation between pathologic partial response (PPR) and radiologic partial response (RPR) was determined. Logistic regression analysis was utilized to determine the predictive value of CT in determining disease burden at RC. RESULTS: A total of 141 patients were identified for analysis. PCR and PPR was achieved in 34% and 16% of patients, respectively. The positive predictive value of post-NAC CT was 53.5% for PCR and 28.8% for PPR. The negative predictive value of post-NAC CT was 73.5% for PCR and 46.2% for PPR. There was no significant association between RCR and PCR (OR 1.13, p = 0.67). Similarly, there was no meaningful association between RPR and PPR, lymph node involvement, or presence of extravesical disease. CONCLUSIONS: CT findings correlate poorly with final pathology at RC and should not be used to evaluate local disease burden.

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Current Staging Procedures in Urinary Bladder Cancer

Cited by 9 publications

References 36 publications

Computed-tomography based scoring system predicts outcome for clinical lymph node-positive patients undergoing radical cystectomy

Computed-tomography based scoring system predicts outcome for clinical lymph node-positive patients undergoing radical cystectomy

Targeting IL-5Rα with antibody-conjugates reveals a strategy for imaging and therapy for invasive bladder cancer

Predictive Value of Computed Tomography Following Neoadjuvant Chemotherapy for Muscle Invasive Bladder Cancer

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