Metastatic Urothelial Cancer: Evaluation of Prognostic Factors and Change in Prognosis during the Last Twenty Years

Sengeløv, Lisa; Kamby, Claus; Maase, Hans von der

doi:10.1159/000052520

Cited by 37 publications

(4 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Conversely, in two studies, the presence of liver metastases alone conferred worse outcomes, with bone metastases not influencing survival. [15, 16] Taken together, these studies suggest that the number of sites of metastases and possibly the presence of liver metastases drive the poor prognosis in metastatic urothelial cancer and bone involvement may not negatively affect prognosis.…”

Section: Discussionmentioning

confidence: 94%

Long-Term Survival in Bone-Predominant Metastatic Urothelial Carcinoma

Ramos

Cheng

2014

Clinical Genitourinary Cancer

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 94%

Long-Term Survival in Bone-Predominant Metastatic Urothelial Carcinoma

Ramos

Cheng

2014

Clinical Genitourinary Cancer

View full text Add to dashboard Cite

“…Therefore, clinical prognostic factors, which are easy to use based on reliable, widely available parameters, are crucial for assessing the result of clinical trials and guiding clinical decision-making. In patients treated with first-line chemotherapy for metastatic UCs, poor performance status (PS), visceral metastases, number of visceral metastases, leukocyte count, and low hemoglobin have been demonstrated as independent prognostic factors [ 25 – 30 ]. For patients treated with salvage chemotherapy-refractory after platinum-based combination chemotherapy, prognostic factors were consistent with the previous report [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

Pretreatment clinical and hematologic prognostic factors of metastatic urothelial carcinoma treated with pembrolizumab: a systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

Pembrolizumab is the standard for the first and second lines in treating metastatic urothelial carcinoma (UC). This systematic review and meta-analysis aimed to assess the value of pretreatment clinical characteristics and hematologic biomarkers for prognosticating response to pembrolizumab in patients with metastatic UC. PUBMED®, Web of Science™, and Scopus® databases were searched for articles published before May 2021 according to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement. Studies were deemed eligible if they evaluated overall survival (OS) in patients with metastatic urothelial carcinoma treated with pembrolizumab and pretreatment clinical characteristics or laboratory examination. Overall, 13 studies comprising 1311 patients were eligible for the meta-analysis. Several pretreatment patients’ demographics and hematologic biomarkers were significantly associated with worse OS as follows: Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ≥ 2 (Pooled hazard ratio [HR]: 3.24, 95% confidence interval [CI] 2.57–4.09), presence of visceral metastasis (Pooled HR: 1.84, 95% CI 1.42–2.38), presence of liver metastasis (Pooled HR: 4.23, 95% CI 2.18–8.20), higher neutrophil–lymphocyte ratio (NLR) (Pooled HR: 1.29, 95% CI 1.07–1.55) and, higher c-reactive protein (CRP) (Pooled HR: 2.49, 95% CI 1.52–4.07). Metastatic UC patients with poor PS, liver metastasis, higher pretreatment NLR and/or CRP have a worse survival despite pembrolizumab treatment. These findings might help to guide the prognostic tools for clinical decision-making; however, they should be interpreted carefully, owing to limitations regarding the retrospective nature of primary data.

show abstract

“…The median OS for UC metastasis varied from 5.4 to 15 months, 25 , 26 , 31 10.8 months for bone as the only metastatic site 9 and 6.2 months for bone as a related metastatic site. 7 In our study, the median OS for UC spinal metastasis is 14 months, a little longer than that reported in previous studies.…”

Section: Discussionmentioning

confidence: 99%

<p>Role of Multimodal Treatment in Urothelial Carcinoma Spinal Metastasis: 15 Patients’ Experiences in a Single Center</p>

Wang¹,

Gào²,

Zhang³

et al. 2020

CMAR

View full text Add to dashboard Cite

Spinal metastasis from urothelial carcinoma (UC) is relatively uncommon. The aim of the present study is to explore the clinicopathological features, surgical treatments and outcomes of this rare disease. Patients and Methods: Fifteen patients with UC spinal metastasis who received surgery in our center between 2009 and 2018 were retrospectively investigated. Clinical data, treatment options, and outcomes were analyzed. Results: For the 15 patients (9 men and 6 women), the primary tumors were located in the upper urothelial tract in ten and lower urothelial tract in five. UC mainly metastasized to the lumbar spine in seven cases, followed by the thoracic spine in five. Pathologic fracture and soft tissue mass with dura mater compression were observed in 66.7% and 93.3% cases, respectively. Palliative resection was performed in nine cases and excisional resection in six. Eleven patients received postoperative chemotherapy, including three with a preoperative ECOG score >2. Bisphosphonates were administered in all patients. Pain was relieved remarkably in all patients, and both the neurological function and general status were improved significantly after surgery. The median overall survival was 14 months. Log rank test showed that patients receiving postoperative chemotherapy survived longer than those without chemotherapy (p=0.037). WHO grade 3 was also correlated with poorer prognosis (p=0.012). Conclusion: Pathological fracture and soft tissue mass with dura mater compression is frequently observed on radiological images in patients with UC spinal metastasis. Surgery is useful to prevent deterioration of performance status and improve quality of life, which provide an opportunity for further systematic therapy. Multimodal treatments, including surgery, postoperative chemotherapy and bisphosphonates are recommended. WHO grade 2 and receiving postoperative chemotherapy were favorable prognostic factors for the overall survival of patients with UC spinal metastasis.

show abstract

Metastatic Urothelial Cancer: Evaluation of Prognostic Factors and Change in Prognosis during the Last Twenty Years

Cited by 37 publications

References 30 publications

Long-Term Survival in Bone-Predominant Metastatic Urothelial Carcinoma

Long-Term Survival in Bone-Predominant Metastatic Urothelial Carcinoma

Pretreatment clinical and hematologic prognostic factors of metastatic urothelial carcinoma treated with pembrolizumab: a systematic review and meta-analysis

<p>Role of Multimodal Treatment in Urothelial Carcinoma Spinal Metastasis: 15 Patients’ Experiences in a Single Center</p>

Contact Info

Product

Resources

About