The health economics of bladder cancer

Botteman, Marc; Pashos, Chris L.; Redaelli, Alberto; Laskin, Benjamin L.; Hauser, Robert

doi:10.1007/bf03262330

Cited by 676 publications

(228 citation statements)

References 43 publications

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“…32 Although the price of surveillance for early bladder cancer recurrence is high, it is less costly in terms of patient survival, quality of life, and treatment expenses than detection of malignancy at a later stage. The 5-year survival rates for patients with regional and metastatic disease are 49% and 6%, respectively, compared with 94% for noninvasive disease, 1 and typical treatment for advanced tumors is cystectomy rather than bladdersparing therapy.…”

mentioning

confidence: 99%

Surveillance for Recurrent Bladder Cancer Using a Point-of-Care Proteomic Assay

Grossman

Soloway

Messing

et al. 2006

JAMA

237

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mentioning

confidence: 99%

Surveillance for Recurrent Bladder Cancer Using a Point-of-Care Proteomic Assay

Grossman

Soloway

Messing

et al. 2006

JAMA

237

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“…Cystoscopy is an uncomfortable, invasive, and expensive procedure, but currently remains the gold standard for detection of recurrences. Because patients have to be monitored perpetually and have a long-term survival, bladder cancer is the most expensive cancer when calculated on a per patient basis (4).…”

mentioning

confidence: 99%

A Simple and Fast Method for the Simultaneous Detection of Nine Fibroblast Growth Factor Receptor 3 Mutations in Bladder Cancer and Voided Urine

Oers

Lurkin

Exsel

et al. 2005

Clinical Cancer Research

147

107

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Purpose: Mutations in the fibroblast growth factor receptor 3 (FGFR3) occur in 50% of primary bladder tumors. An FGFR3 mutation is associated with good prognosis, illustrated by significantly lower percentage of patients with progression and disease-specific mortality. FGFR3 mutations are especially prevalent in low grade/stage tumors, with pTa tumors harboring mutations in 85% of the cases. These tumors recur in 70% of patients. Efficient FGFR3 mutation detection for prognostic purposes and for detection of recurrences in urine is an important clinical issue. In this paper, we describe a simple assay for the simultaneous detection of nine different FGFR3 mutations. Experimental Design: The assay consists of one multiplex PCR, followed by extension of primers for each mutation with a labeled dideoxynucleotide. The extended primers are separated by capillary electrophoresis, and the identity of the incorporated nucleotide indicates the presence or absence of a mutation. Results: The assay was found to be more sensitive than single-strand conformation polymorphism analysis. Mutations could still be detected with an input of only 1ng of genomic DNA and in a 20-fold excess of wild-type DNA. Moreover, in urine samples from patients with a mutant tumor, the sensitivity of mutation detection was 62%. Conclusions: We have developed a fast, easy to use assay for the simultaneous detection of FGFR3 mutations, which can be of assistance in clinical decision-making and as an alternative for the follow-up of patients by invasive cystoscopy for the detection of recurrences in urine.Bladder cancer is the fifth most common cancer in the western world with an incidence of 20 new cases per year per 100,000 people in the U.S. (1). Unfortunately, these statistics do not include superficial pTa bladder cancer, which represents the most common type of bladder cancer. In the Netherlands, the incidence of both superficial and invasive bladder cancer is estimated as about 30 new cases per year per 100,000 people. This is in accordance with data from global cancer statistics for the western world (2). Superficial bladder tumors are removed by transurethral resection. However, up to 70% of these patients will develop one or more recurrences, and it has been estimated that 1 in 1,450 people is under surveillance for bladder cancer in the United Kingdom (3). Cystoscopy is an uncomfortable, invasive, and expensive procedure, but currently remains the gold standard for detection of recurrences. Because patients have to be monitored perpetually and have a long-term survival, bladder cancer is the most expensive cancer when calculated on a per patient basis (4).Activating mutations in the fibroblast growth factor receptor 3 (FGFR3) gene have been reported in >50% of primary bladder tumors (5, 6).1 Most of the somatic mutations found in bladder cancer are identical to germ line mutations responsible for skeletal disorders such as thanatophoric dysplasia and achondroplasia (7). It has been reported that FGFR3 mutations are very frequent ...

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“…Bladder cancer is the most expensive tumor for public health services from the time of diagnosis to the patient's death [91].…”

Section: Pharmacoeconomic Evaluationmentioning

confidence: 99%

Intravesical Chemohyperthermia for NMIBC: Rationale and Results of This Developing Treatment

Alejandro¹,

Javier²,

Daniel³

et al. 2017

Bladder Cancer - Management of NMI and Muscle-Invasive Cancer

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Bladder cancer is the fourth most common cancer in men, and the lifetime risk of getting bladder cancer is 2.4%. Approximately 75% of newly diagnosed cases of bladder cancer are non-muscle-invasive bladder cancer (NMIBC), and half of them will show recurrence and/or progression after transurethral resection. Therefore, after transurethral resection, in high-risk patients, intravesical therapy is mandatory. However, bacillus CalmetteGuérin (BCG) is associated with important side effects such as systemic tuberculosis and bladder retraction. Chemohyperthermia (CHT) has shown a 60% lower recurrence rate than standard mitomycin C (MMC). However, its effectiveness in high-risk patients, especially CIS and BCG refractory patients, is even more important. CHT will probably be an option for patients unsuitable for radical cystectomy or those on whom BCG can't be used. Two main technologies are currently available for intravesical CHT: microwaves and recirculating heated fluids. Both of them have pros and cons that should be known and evaluated by a urologist. In this chapter, we will speak about rationale, technical options, clinical results, ongoing studies, and future perspective for this interesting treatment option for intermediate and high-risk patients with NMIBC.Keywords: NMIBC, MMC, BCG, chemohyperthermia, radio frequency, recirculant systems, adjuvant, neoadjuvant BackgroundIn 2002, the world-adjusted incidence rate of bladder cancer was 33 new cases/100,000 inhabitants/year. That makes it the fourth tumor with the highest incidence in men, after lung, prostate, and colorectal cancers [1].© 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Each body tumor has unique characteristics in terms of its presentation, histological types, surgical approaches, and sensitivity to different types of treatment (surgery, chemotherapy,Approximately, 95% of bladder neoplasms are urothelial carcinomas, and 75% of them will be diagnosed as non-muscle-invasive tumors. However, they have a high tendency to recur, and one-third of them will reappear during the first 5 years after transurethral resection. Incidence of recurrence and progression is directly related to the tumoral grade and stage, being higher in carcinoma in situ and T1G3 tumors.Most recidives have similar grade and stage to the original tumor. However, a significant number of bladder cancers progress to invasive tumors whose prognosis and treatment are completely different. Therefore, intravesical postoperative therapy is mandatory, especially in those with medium and high-risk tumors.The urethra allows ease of access from the outside, which generally allows a resection of the tumor and the application of chemo-and/or immunotherapy locally with minimal systemic toxicity.Intravesical chemotherapy, with single postoperat...

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The health economics of bladder cancer

Cited by 676 publications

References 43 publications

Surveillance for Recurrent Bladder Cancer Using a Point-of-Care Proteomic Assay

Surveillance for Recurrent Bladder Cancer Using a Point-of-Care Proteomic Assay

A Simple and Fast Method for the Simultaneous Detection of Nine Fibroblast Growth Factor Receptor 3 Mutations in Bladder Cancer and Voided Urine

Intravesical Chemohyperthermia for NMIBC: Rationale and Results of This Developing Treatment

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