Relationship Among Cystectomy, Microvessel Density and Prognosis in Stage T1 Transitional Cell Carcinoma of the Bladder

Dinney, Colin P.N.; Babkowski, Robert; Antelo, M.; Perrotte, Paul; Liebert, Monica; ZHANG, HUA-ZHONG; Palmer, J. Lynn; Veltri, Robert W.; Katz, Ruth L.; Grossman, H. Barton

doi:10.1097/00005392-199810000-00019

Cited by 12 publications

(20 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is a risk in patients not responding to the initial induction course of BCG that further efforts at salvage therapy may result in a delay in definitive treatment that may have an adverse effect on survival probability. Long-term survival rates for patients treated with radical cystectomy for progression to muscle invasive cancer are significantly lower than for patients with ≤ pT1 at cystectomy [9,10].…”

Section: Introductionmentioning

confidence: 93%

Failure to achieve a complete response to induction BCG therapy is associated with increased risk of disease worsening and death in patients with high risk non-muscle invasive bladder cancer

Lerner

Tangen

Sucharew

et al. 2009

Urologic Oncology: Seminars and Original Investigations

View full text Add to dashboard Cite

Purpose-The Southwest Oncology Group conducted a randomized trial of induction BCG with or without maintenance BCG. In these additional retrospective analyses, our goal was to evaluate the association of a complete response (CR) or remaining with no evidence of disease (NED) versus no CR during induction therapy with subsequent survival after adjusting for other potential confounders. Among all patients randomized to maintenance treatment, we also wanted to identify combinations of baseline covariates in order to define prognostic groups for subsequent worseningfree survival.Methods-Outcome measures of worsening-free and overall survival were assessed using Kaplan Meier estimates and proportional hazards regression models. For the Classification and Regression Tree (CART) analysis, 434 patients randomized to maintenance vs. no therapy with complete covariate information were included.Results-Of the 593 evaluable patients, 341 were not randomized to maintenance BCG. Patients who achieved a prior complete response during induction BCG had a 5-year survival probability of 77% compared to 62% for patients who did not [Hazard ratio (HR) 0.60; 95% confidence interval (CI) 0.44, 0.81; p= 0.0008]. Prior CR retained significance when adjusted for age, gender, prior intravesical chemotherapy, and papillary disease versus CIS (HR=0.63; 95% CI: .46, .86; p=0.003). CART analysis identified 4 prognostic groups. Older patients (≥ 62 years old) previously treated with intravesical chemotherapy who failed to achieve a CR had a 5-fold higher risk of a worsening event relative to those who are younger (< 67 years old) and achieve a CR (HR=5.09; 95% CI: 3.37, 7.68; p<0.0001). Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusion-Failure to achieve a complete response after induction BCG is associated with a significant risk of a worsening event and death for patients with CIS or Ta or T1 bladder cancer at increased risk of recurrence. NIH Public Access

show abstract

Section: Introductionmentioning

confidence: 93%

Failure to achieve a complete response to induction BCG therapy is associated with increased risk of disease worsening and death in patients with high risk non-muscle invasive bladder cancer

Lerner

Tangen

Sucharew

et al. 2009

Urologic Oncology: Seminars and Original Investigations

View full text Add to dashboard Cite

show abstract

“…The median follow-up of the whole cohort was 3.8 years (0. [7][8][9][10][11][12][13][14][15][16][17][18][19][20]. One hundred and forty-three patients (83.6%) had undergone open nephroureterectomy and 28 patients laparoscopic nephroureterectomy.…”

Section: Patient Selectionmentioning

confidence: 99%

“…Several studies of urothelial carcinomas have indicated that MVD could be an independent negative prognostic factor (13)(14)(15)(16). However, to date evidence of the prognostic role of MVD in urothelial carcinoma is contradictory (17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Significance of Vasohibin-1 Expression in Patients with Upper Urinary Tract Urothelial Carcinoma

Miyazaki

Kosaka

Mikami

et al. 2012

Clinical Cancer Research

View full text Add to dashboard Cite

Purpose: Vasohibin-1 (VASH1) is a novel angiogenic molecule that is specifically expressed in activated vascular endothelial cells, and the status of VASH1 expression has been documented in cancer angiogenesis. The aim of this study was to address the prognostic value of VASH1 expression in upper urinary tract urothelial carcinomas (UTUC).Experimental Design: We retrospectively analyzed the clinical records of 171 patients with locally advanced UTUC (Ta-3N0M0). The median follow-up period was 3.8 years. We immunohistochemically examined the accomplished microvessels with anti-CD34 as microvessel density (MVD) and the microvessels with activated endothelial cells as VASH1 density. Then, we analyzed the association between immunohistochemical expression and clinical outcomes.Results: Forty-two patients experienced tumor recurrence and of these 34 died of the disease during follow-up. VASH1 density was significantly associated with tumor grade, pathologic T stage, and MVD. The 5-year recurrence-free and cancer-specific survival rates were 66.1% and 72.8% in patients with VASH1 density (! 40/mm 2 ) and 81.0% and 86.5% in their counterparts, respectively (P < 0.05). MVD was not an independent predictor of tumor recurrence or cancer-specific survival. Multivariate analyses revealed that high VASH1 density was an independent prognostic indicator of both tumor recurrence (P ¼ 0.024, HR ¼ 2.10) and cancer-specific survival (P ¼ 0.031, HR ¼ 2.23) as well as other standard prognostic factors including high tumor grade and lymphovascular invasion. Conclusions: VASH1 density represents a clinically relevant predictor of patient prognosis in UTUC. The results suggest that VASH1 density could become a new biomarker and provide additional prognostic information in patients with UTUC. Clin Cancer Res; 18(15); 4145-53. Ó2012 AACR.

show abstract

“…han utilizado 2 modos de determinar la densidad microvascular: en el primero,o "estándar", se buscan las zonas de inmunotinción "calientes" o de mayor densidad de microvasos; en el segundo método, y para evitar el problema de la disposición papilar del núcleo fibrovascular, se realiza el contaje de los microvasos inmunoreactivos localizados entre la interfase del tumor y la lámina propia, o sea en la zona de invasión y probablemente de mayor actividad angiogénica. En su serie, el cálculo de las densidades mostró valores muy diferentes según el método utilizado, siendo mayores los recuentos netos de microvasos usando el método de la interfase tumor-lámina propia; pero no encontró correlación ni con la recidiva ni con la progresión tumoral, con ninguno de los dos métodos de análisis 28 .…”

Section: Valor Pronóstico De La Densidad Microvascularunclassified

“…analizaron la capacidad predictiva de la densidad microvascular en relación a la identificación de los pacientes en estadio T1 que deberían someterse a una cistectomía temprana; sobre una serie de 54 pacientes T1 la densidad microvascular no predijo ni recidiva ni la progresión, considerando por tanto que no constituye un marcador pronóstico y no tiene validez para seleccionar a estos pacientes 28 . Sin embargo una serie más amplia y reciente, de Goddard JC y cols.…”

Section: Valor Pronóstico De La Densidad Microvascularunclassified

Estudio de la angiogénesis como factor pronóstico de los tumores vesicales pT1G3

et al. 2004

View full text Add to dashboard Cite

Relationship Among Cystectomy, Microvessel Density and Prognosis in Stage T1 Transitional Cell Carcinoma of the Bladder

Cited by 12 publications

References 27 publications

Failure to achieve a complete response to induction BCG therapy is associated with increased risk of disease worsening and death in patients with high risk non-muscle invasive bladder cancer

Failure to achieve a complete response to induction BCG therapy is associated with increased risk of disease worsening and death in patients with high risk non-muscle invasive bladder cancer

The Prognostic Significance of Vasohibin-1 Expression in Patients with Upper Urinary Tract Urothelial Carcinoma

Estudio de la angiogénesis como factor pronóstico de los tumores vesicales pT1G3

Contact Info

Product

Resources

About