Should all patients receive single chemotherapeutic agent instillation after bladder tumour resection?

Dobruch, Jakub; Herr, Harry W.

doi:10.1111/j.1464-410x.2009.08654.x

Cited by 32 publications

(21 citation statements)

References 21 publications

(60 reference statements)

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“…Several papers have recently suggested that chemotherapy instillation immediately after TURBT should be abandoned in non-muscle invasive bladder cancer because it prevented only small tumour recurrences; 9 was of limited benefi t in patients with multifocal, rapidly recurrent, high-grade disease, and did not seem to increase the effi cacy of subsequent protracted intravesical regimens; [10][11][12] was effi cacious mainly during the fi rst 2 years of follow-up; 25 and had no eff ect on disease progression. 6,11 In a randomised study, 12 intravesical instillation of gemcitabine immediately after TURBT was no better than placebo in terms of recurrence-free survival.…”

Section: Discussionmentioning

confidence: 99%

“…5 Meta-analyses by the European Organisation for Research and Treatment of Cancer 6 and the American Urological Association 7 reported that a single dose of intravesical chemotherapy a few hours after transurethral resection reduced recurrence in patients with low-risk and intermediate-risk non-muscle invasive bladder cancer, with negligible side-eff ects. Despite level 1 evidence supporting its use, however, disagreement persists, [8][9][10][11][12] and it is rarely given by urologists. Moreover, it has suboptimum effi cacy in intermediate-risk patients and no benefi t in high-risk patients, and there are other diffi culties: the optimum schedule and duration of treatment are not yet standardised.…”

Section: Systematic Reviewmentioning

confidence: 99%

“…The European Association of Urology 2 and, to a lesser extent, the American Urological Association 7 guidelines consequently recommended that this strategy be included in treatment plans for all patients with non-muscle invasive bladder cancer. However, disagreement persists despite level 1 evidence supporting its use, [8][9][10][11][12] and it is rarely given by urologists. 13 In laboratory 14 and clinical studies, 15 intravesical electromotive drug administration (EMDA) increased mitomycin bladder uptake, improving clinical effi cacy in high-risk non-muscle invasive bladder cancer.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Electromotive instillation of mitomycin immediately before transurethral resection for patients with primary urothelial non-muscle invasive bladder cancer: a randomised controlled trial

Stasi

Valenti

Verri

et al. 2011

The Lancet Oncology

122

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SummaryBackground The clinical eff ect of intravesical instillation of chemotherapy immediately after transurethral resection of bladder tumours (TURBT) has recently been questioned, despite its recommendation in guide lines. Our aim was to compare TURBT alone with immediate post-TURBT intravesical passive diff usion (PD) of mitomycin and immediate pre-TURBT intravesical electromotive drug administration (EMDA) of mitomycin in non-muscle invasive bladder cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Systematic Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Electromotive instillation of mitomycin immediately before transurethral resection for patients with primary urothelial non-muscle invasive bladder cancer: a randomised controlled trial

Stasi

Valenti

Verri

et al. 2011

The Lancet Oncology

122

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show abstract

“…Bladder cancer is one of the most common urothelial malignancies (1). Superficial bladder cancer can be treated by the transurethral resection of bladder tumors; however, 50-70% of noninvasive cancers recur and 15-30% of cases progress to invasive muscle disease (1,2).…”

Section: Introductionmentioning

confidence: 99%

“…Superficial bladder cancer can be treated by the transurethral resection of bladder tumors; however, 50-70% of noninvasive cancers recur and 15-30% of cases progress to invasive muscle disease (1,2). Although systemic chemotherapy is typically used in the treatment of the invasive bladder cancer, recurrence and progression rates remain high.…”

Section: Introductionmentioning

confidence: 99%

Overexpression of REIC/Dkk-3 suppresses the expression of CD147 and inhibits the proliferation of human bladder cancer cells

et al. 2017

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Abstract. Our group previously developed an adenoviral vector encoding the REIC/Dkk-3 gene (Ad-REIC), a tumor suppressor, for cancer gene therapy. The Ad-REIC agent induces apoptosis and inhibits invasion in a number of cancer cell lines; however, the molecular mechanisms underlying its effects remain unclear. Cluster of differentiation 147 (CD147), also known as extracellular matrix metalloproteinase inducer (EMMPRIN), is a key molecule that promotes cancer proliferation and invasion. In order to elucidate the therapeutic mechanism of Ad-REIC, its effect on the expression of CD147 in human bladder cancer KK47 cells was investigated. Treatment with Ad-REIC markedly downregulated the expression of CD147 and significantly inhibited cellular proliferation. Since the expression of CD147 is reported to be under the positive control of mitogen-activated protein kinase (MAPK) signaling and the c-Myc protein, the correlations between the expression of CD147 and the activation of MAPKs or the expression of c-Myc were examined. Unexpectedly, no positive correlation was observed between the level of CD147 and the potential regulators that were assessed, indicating that another signaling pathway is responsible for the downregulation of CD147. The results from the present study demonstrate that Ad-REIC treatment can significantly downregulate the expression of CD147 in bladder cancer cells. Downregulation of the cancer-progression factor CD147 may be a novel mechanism that underlies the therapeutic effects of Ad-REIC treatment.

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Compliance with guidelines for patients with bladder cancer

Chamie

Saigal

Lai

et al. 2011

Cancer

139

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Background Clinical practice guidelines for the management of patients with bladder cancer encompass strategies that minimize morbidity and improve survival. We sought to characterize practice patterns in patients with high-grade non-muscle-invasive bladder cancer in relation to established guidelines. Methods We used Surveillance, Epidemiology and End Results (SEER)-Medicare-linked data to identify subjects diagnosed with high-grade non-muscle-invasive bladder cancer in 1992–2002 who survived at least two years without undergoing definitive treatment (n=4,545). We used multilevel modeling to estimate the association and partitioned variation of patient sociodemographic, tumor, and provider characteristics with compliance measures. Results Of 4,545 subjects analyzed, only one received all the recommended measures. Approximately 42% of physicians have not performed on a single patient nested within their practice in a two-year period, at least one cystoscopy, cytology and a single instillation of immunotherapy. After 1997, only utilization of radiographic imaging (OR 1.19; 95% CI 1.03–1.37) and instillation of immunotherapy (OR 1.67; 95% CI 1.39–2.01) significantly increased. Surgeon-attributable variation for individual guideline measures (cystoscopy 25%; cytology 59%; radiographic imaging 10%; intravesical chemotherapy 45%; and intravesical immunotherapy 26%) contributes to this low-compliance rate. Conclusion There is marked underuse of guideline-recommended care in this potentially curable cohort. Unexplained provider-level factors significantly contribute to this low-compliance rate. Future studies that identify barriers and modulators of provider-level adoption of guidelines are critical to improving care for patients with bladder cancer.

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Should all patients receive single chemotherapeutic agent instillation after bladder tumour resection?

Cited by 32 publications

References 21 publications

Electromotive instillation of mitomycin immediately before transurethral resection for patients with primary urothelial non-muscle invasive bladder cancer: a randomised controlled trial

Electromotive instillation of mitomycin immediately before transurethral resection for patients with primary urothelial non-muscle invasive bladder cancer: a randomised controlled trial

Overexpression of REIC/Dkk-3 suppresses the expression of CD147 and inhibits the proliferation of human bladder cancer cells

Compliance with guidelines for patients with bladder cancer

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