Late Recurrence and Progression after a Long Tumor-Free Period in Primary Ta and T1 Bladder Cancer

Fujii, Yasuhisa; Fukui, Iwao; Kihara, Kazunori; Tsujii, Toshihiko; Kageyama, Yukio; Oshima, Hiroyuki

doi:10.1159/000020010

Cited by 21 publications

(10 citation statements)

References 18 publications

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“…Brain metastases from a number of different primary tumors have been reported to occur months or years after removal of the original tumor. Similar observations are documented for non-cerebral metastases derived from breast, pancreatic, and bladder carcinomas [3][4][5][6][7][8][9]. Several mechanisms have been proposed to explain these observations.…”

Section: Evidence For Endogenous Inhibition and Dormancy In Metastasissupporting

confidence: 79%

Endogenous growth inhibition of angiogenesis in brain tumors

Kirsch

Allende

Black

et al. 2007

Cancer Metastasis Rev

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The growth inhibition of remote metastases by a primary tumor is known as endogenous growth inhibition leading to tumor dormancy. Such a phenotype has not been described in primary malignant gliomas. However, although glioma cells have frequently spread to other parts of the brain at the time of diagnosis, formation of solid secondary tumors is uncommon. We hypothesize that a dormant population of distant glioma cells exist. The purpose of this study was to investigate whether primary gliomas could inhibit secondary tumor formation. Subcutaneous tumors from human gliomas were grown as xenografts in Swiss nude mice. At a tumor size of at least one cm(3), the same amount of cells was injected into the contralateral flank or into the right cerebral hemisphere. Control mice without a primary tumor were injected with tumor cells either into the right flank, the right hemisphere, or bilaterally subcutaneously. Only one of 18 human gliomas demonstrated inhibition at the subcutaneous and intracerebral secondary implantation sites. Growth inhibition of the secondary tumors was accompanied by a significant reduction in microvessel density, upregulation of vascular endothelial growth factor mRNA and downregulation of basic fibroblast growth factor mRNA. Therefore, endogenous inhibition of secondary tumors may represent a rare phenotype in malignant glioma.

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Section: Evidence For Endogenous Inhibition and Dormancy In Metastasissupporting

confidence: 79%

Endogenous growth inhibition of angiogenesis in brain tumors

Kirsch

Allende

Black

et al. 2007

Cancer Metastasis Rev

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“…The clinical and histopathological variables did not predict recurrence or progression with exception of multifocality. Multifocality was significantly related to a high recurrence rate, a shorter recurrence‐free survival therefore being considered a useful parameter to define tumor progression risk, as mentioned by other authors 29. For this reason and despite its low frequency in USPC, it is included when defining a risk group of patients.…”

Section: Discussionmentioning

confidence: 86%

Ki‐67 index enhances the prognostic accuracy of the urothelial superficial bladder carcinoma risk group classification

Santos

Amaro

Costa

et al. 2003

Intl Journal of Cancer

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Approximately 80% of bladder tumors are urothelial superficial papillary carcinomas (USPC). Despite a generally good prognosis, these tumors have a strong propensity to recur and about 1/3 of them compared to disease progression. Histological assessment of these superficial tumors is not sufficiently discriminator in predicting prognosis; therefore, we decided to evaluate the prognostic significance of p53 and Ki-67 immunoexpression in low-grade (GI-II) USPC in order to predict the potential outcome of these tumors. P53 and Ki-67 immunoexpression were studied in function of recurrence-free and progression-free survival in 159 primary superficial bladder tumors. A prognostic risk model based on grade, stage and multifocality was also evaluated. P53 accumulation was significantly related to tumor progression (p‫.)600.0؍‬ High Ki-67 index (>18%) and multifocality were significantly related to recurrence (both p‫)1000.0؍‬ and progression-free survival (both p‫)1000.0؍‬ and were independent prognostic factors in the multivariate analysis. The prognostic risk model based on grade, stage and multifocality was not an efficient discriminator of outcome. Adding the Ki-67 index into the risk model, single pTa/T1-GI Ki-67 positive tumors, usually classified as low risk, were reclassified as of intermediate risk. After this reclassification, the risk group model identified a subgroup of pTa/T1-G1 with a high risk of recurrence and progression. Ki-67 index is a reliable prognostic marker in urothelial superficial bladder carcinoma and, when included into a risk profile classification of the low-grade USPC, the accuracy of the prognostic discrimination is enhanced.

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“…Fujii et al demuestran que el seguimiento de las neoplasias superficiales de vejiga debe ser prolongado, debido a la aparición de recidivas y progresiones tardías, incluso en estos pacientes 21 . c) Grupo de bajo riesgo.…”

Section: Grupo De Buen Pronóstico (Bajo Riesgo) -Tag1 úNicosunclassified

Factores pronósticos en la recidiva y progresión del cáncer superficial vesical: Grupos de riesgo (Parte II)

et al. 2006

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RESUMEN FACTORES PRONÓSTICOS EN LA RECIDIVA Y PROGRESIÓN DEL CÁNCER SUPERFICIAL VESICAL. GRUPOS DERIESGO (PARTE II) Introducción: Intentamos establecer grupos de riesgo en función de la combinación de las características de cada tumor vesical, para un mejor seguimiento de estos pacientes.Material y Métodos: Una vez conocidas las variables implicadas en recurrencia y progresión analizamos los datos para establecer los grupos extremos, es decir, los de peor y mejor pronóstico, quedando un grupo residual que correspondería al de los tumores de pronóstico intermedio.Resultados: A partir de los resultados obtenidos, nos hemos planteado establecer tres grupos de riesgo: Grupo de mal pronóstico (alto riesgo): Tumores de alto grado (G3), Tis aislado o asociado y tumores de grado 2 múltiples o recurrentes que hubieran recidivado en menos de 6 meses; Grupo de pronóstico intermedio: Tumores TaG1 múltiples, así como neoplasias Ta-1G2 y T1G1 no múltiples (menos de 3 tumores) y Grupo de bajo riesgo: Tumores TaG1 únicos.Discusión: De acuerdo con estos resultados el grupo de mal pronóstico, conlleva un alto riesgo de recidiva y progresión. El tratamiento más efectivo resultó la BCG (bacilo Calmette-Guerin) con mantenimiento, exigiendo, un seguimiento prolongado, más intenso en los 2 primeros años tras la RTU. En el grupo de pronóstico intermedio, las tasas de recidiva superficial a largo plazo fueron tan altas como las de alto riesgo, requiriéndose un seguimiento largo, en éste resultó efectivo el empleo de quimioterapia o BCG siendo preferible el mantenimiento. Por último, en el grupo de buen pronóstico no objetivamos progresiones, siendo el tiempo hasta la recidiva el más largo, con estabilización de la tasa de recurrencias tras 1 año.Palabras clave: Cáncer vesical. Superficial. Grupos de riesgo. ABSTRACT PRONOSTIC FACTORS ON RECURRENCE AND PROGRESSION OF SUPERFICIAL BLADDER CANCER.RISK GROUPS (PART II) Introduction: We try to establish risk groups combining the characteristics of each bladder tumour, for a better monitoring of these patients. Material and Methods: Once known the variables implied in recurrence and progression we analyze the data to establish the extreme groups, so, the one with the worse and the one with the better prognostic, remaining a residual group that would correspond of the tumours of intermediate prognostic.Results: From the results obtained, we can establish three risk groups: Bad prognostic group (high risk) : High grade tumours (G3), isolated or associated Tis and multiple or recurrent grade 2 tumours that were recurred in less than 6 months; Intermediate prognostic group: multiple TaG1 tumours, as well as not multiple Ta-1G2 and T1G1 (less than 3 tumours) and Group of low risk: Single TaG1 tumours. Discussion: According to these results the group of badly risk, involves a high risk of recurrence and progression. The most effective treatment was the BCG (bacillus Calmette-Guerin) with maintenance, requiring a long-term control, more intense in the 2 first years after the RTU. In the group of inte...

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Late Recurrence and Progression after a Long Tumor-Free Period in Primary Ta and T1 Bladder Cancer

Cited by 21 publications

References 18 publications

Endogenous growth inhibition of angiogenesis in brain tumors

Endogenous growth inhibition of angiogenesis in brain tumors

Ki‐67 index enhances the prognostic accuracy of the urothelial superficial bladder carcinoma risk group classification

Factores pronósticos en la recidiva y progresión del cáncer superficial vesical: Grupos de riesgo (Parte II)

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