Superficial Bladder Cancer: Progression and Recurrence

Heney, Niall M.; Ahmed, S.N.; Flanagan, Malachi J.; Frable, William J.; Corder, Michael P.; Hafermann, Mark D.; Hawkins, Ileana

doi:10.1016/s0022-5347(17)51695-x

Cited by 860 publications

(346 citation statements)

References 7 publications

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“…Although ted that cyclin Dl is metastasis is less common with superficial bladder cancers, such cell cycle (Xiong et al, tumours may progress and the majority will recur and require s involved in cell cycle additional treatment. It is generally accepted that patients with TI, ) and other cell cyclemultiple, large or high-grade tumours are at greater risk of recurfinds et al, 1992; Xiong rence (Heney et al, 1983;Wolf et al, 1985). In this study, we assessed the probability of disease-free survival in the 53 superostic significance of the ficial tumours according to the overexpression of cyclin Dl.…”

Section: Discussionmentioning

confidence: 99%

Overexpression of cyclin D1 correlates with early recurrence in superficial bladder cancers

Shin

Kong²,

Kim³

et al. 1997

Br J Cancer

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Summary Cyclin Dl is a cell cycle regulator essential for G1 phase progression and is frequently overexpressed in several human tumour types as a consequence of gene amplification or chromosomal rearrangements. We analysed the expression of cyclin Dl in 75 patients with transitional cell carcinoma (TCC) to investigate the possible relationship between its expression and clinical outcome as well as histopathological findings using the immunohistochemical method. We observed strong staining (++, > 50% positive cells) for cyclin Dl in 19 cases (25.3%) and weak staining (+, 5-50% positive cells) in 19 cases (25.3%). Overexpression of cyclin Dl was not associated with tumour invasion. No significant association was found between overexpression of cyclin Dl and tumour grade (P > 0.05). We assessed the differences of disease-free interval in superficial tumours and actuarial survival probability in invasive tumours according to the status of cyclin Dl expression. Tumours with (++) staining for cyclin Dl recurred much more rapidly than (-) and/or (+) staining tumours (P < 0.01 for -vs ++; P < 0.05 for + vs ++). However, overexpression of cyclin Dl was not associated with a shortened overall survival of patients with invasive tumours (P< 0.1). These results suggest that genetic alteration of cyclin Dl appears to be an early event in the tumorigenesis of bladder TCC and is associated with early recurrence in superficial tumours.

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Section: Discussionmentioning

confidence: 99%

Overexpression of cyclin D1 correlates with early recurrence in superficial bladder cancers

Shin

Kong²,

Kim³

et al. 1997

Br J Cancer

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“…However, such tumors infiltrating the lamina propria underwent TUR or cystectomy. 19 In 1983, Heney et al 20 showed progression in 4% of Stage Ta and 30% of Stage T1 tumors, with the progression-free interval significantly shorter for those with Stage T1 than for those with Stage Ta tumors (P Ͻ .001). These investigators also analyzed progression by grade within stage and showed that progression occurred in 21% of T1G2 tumors.…”

Section: Commentmentioning

confidence: 99%

“…The investigators stated that, "our findings also underscore strongly the difference in prognosis between tumors that are confined to the mucosa and those that have already invaded the lamina propria" and observed that such invasion is associated with a decrease in 5-year survival. 20 Holmang et al 21 provided follow-up results obtained from 176 patients with primary Ta or T1 tumor. They were treated by TUR and followed up for 20 years or until death.…”

Section: Commentmentioning

confidence: 99%

“…Although recurrence does not imply progression, some investigators have emphasized the importance of the data relating to recurrence. 3,4,10,20,23 Holmang et al 21 demonstrated that patients with Ն10 recurrences had a high risk of metastatic bladder cancer and a significant risk of dying of this disease, even if the initial diagnosis had been Stage TaG1. These data on recurrence have confirmed an earlier observation reported by Parmar et al 4 for the British Medical Research Council subgroup on non-muscle invasive bladder cancer.…”

Section: Commentmentioning

confidence: 99%

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Recurrence at Three Months and High-grade Recurrence as Prognostic Factor of Progression in Multivariate Analysis of T1G2 Bladder Tumors

Palou

Rodríguez-Rubio

Millán

et al. 2009

Urology

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OBJECTIVESTo evaluate the risk factors for disease progression in the frequent subgroup of Stage T1G2 (World Health Organization 1973) bladder tumors using an analysis of a large cohort of patients with Stage T1G2 disease. METHODSA cohort of 616 patients with Stage T1G2 were treated with transurethral resection and random bladder biopsies. The mean follow-up was 4.2 years. Univariate and multivariate analyses were done using Cox regression analysis. The independent variables were multiplicity, association with carcinoma in situ (CIS), tumor size, tumor recurrence at 3 or 6 months, tumor grade, and association with CIS at first recurrence. The dependent variable was progression to muscleinvasive disease. RESULTSProgression to muscle-invasive disease was identified in 28 of the 616 patients (4.5%). On multivariate analysis, when considering recurrence at 3 months, this factor was the principal prognostic factor, with a relative risk of 4.0 (95% confidence interval 1.2-13.3), followed by the presence of high-grade disease or CIS at first recurrence (relative risk 2.8, 95% confidence interval 1.3-5.8) and CIS associated with the primary tumor (relative risk 1.8, 95% confidence interval 1.1-2.9). When considering recurrence at 6 months, more prognostic factors were involved for progression, including as multiple tumors, CIS associated with the primary tumor, recurrence at 6 months, and the presence of high-grade disease or CIS at the first recurrence. CONCLUSIONSIn primary urothelial T1G2 bladder cancer, recurrence at 3 months was the main prognostic factor related to progression. Additional factors were the association of CIS with the primary tumor and the presence of high-grade disease and/or CIS at first recurrence. UROLOGY 73: 1313UROLOGY 73: -1317UROLOGY 73: , 2009

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“…1 Approximately 80% of primary bladder cancers are papillary noninvasive or superficially invasive lesions (stage Ta and T1) and can be managed by local endoscopic resection. A special feature of these tumors is the high recurrence rate of about 50% after transurethral resection, 2,3 and patients with recurrent bladder cancer, especially those with high-grade or multifocal lesions, are at significant risk for stage progression and death from the disease. 3,4 On the other hand, papillary bladder cancer comprises different types of tumors with varying biologic potential and distinct pathways of development.…”

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confidence: 99%

Quantitative evaluation of telomerase subunits in urine as biomarkers for noninvasive detection of bladder cancer

Weikert

Krause

Wolff

et al. 2005

Intl Journal of Cancer

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The aim of our study was to prospectively evaluate the potential diagnostic value and clinical applicability of quantitative analysis of telomerase subunits gene expression in urine for noninvasive detection of bladder cancer. Expression levels of human telomerase reverse transcriptase (hTERT) and human telomerase RNA (hTR) were analyzed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) in urine samples from 163 subjects with bladder cancer and 237 controls (163 individuals with benign genitourinary diseases; 74 healthy subjects). The sensitivity, specificity and optimal cutoffs were determined and compared to the corresponding values obtained by voided urine cytology. Quantitative urinary hTR analysis detects bladder cancer with an overall sensitivity of 77.0%, whereas hTERT analysis reached a sensitivity of 55.2%. The majority of undetected tumors were small, lowgrade pTa lesions. Both hTR and hTERT proved to be significantly more sensitive than cytology (34.5%; p < 0.001). Specificities for hTR, hTERT and cytology were 72.1%, 85.0% and 92.7%, respectively, in the total study population and 96.9%, 89.2% and 100%, respectively, in healthy subjects. Higher diagnostic accuracy was achieved by hTR than by hTERT analysis (p < 0.05). The specificity of hTR increased to 85.0% in the total population if urinary leukocyte contamination was excluded. These data suggest that quantitative hTR analysis is the most accurate telomerase-based test for bladder cancer detection and has the potential to replace cytology as a noninvasive biomarker for disease diagnosis and follow-up. ' 2005 Wiley-Liss, Inc.

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Superficial Bladder Cancer: Progression and Recurrence

Cited by 860 publications

References 7 publications

Overexpression of cyclin D1 correlates with early recurrence in superficial bladder cancers

Overexpression of cyclin D1 correlates with early recurrence in superficial bladder cancers

Recurrence at Three Months and High-grade Recurrence as Prognostic Factor of Progression in Multivariate Analysis of T1G2 Bladder Tumors

Quantitative evaluation of telomerase subunits in urine as biomarkers for noninvasive detection of bladder cancer

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