The role of endoscopic bladder tumour assessment in the management of patients subjected to transurethral bladder tumour resection

Skrzypczyk, M.; Nyk, Łukasz; Szostek, P.; Szempliński, Stanisław; Borówka, Andrzej; Dobruch, Jakub

doi:10.1111/ecc.12431

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…From a biological and clinical standpoint, BC is classified into non-muscle invasive (NMIBC), representing 70% to 80% of BC cases, and muscle invasive bladder cancer (MIBC) [50]. These two entities differ in terms of incidence, gene mutations, morphology, and aggressiveness [51][52][53][54]. Cases of NMIBC are further divided into three risk groups (low, intermediate, high) depending on the risk of recurrence and progression after resection [55,56].…”

Section: Bladder Cancermentioning

confidence: 99%

TGF-β and microRNA Interplay in Genitourinary Cancers

Bogusławska¹,

Kryst

Poletajew

et al. 2019

Cells

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Genitourinary cancers (GCs) include a large group of different types of tumors localizing to the kidney, bladder, prostate, testis, and penis. Despite highly divergent molecular patterns, most GCs share commonly disturbed signaling pathways that involve the activity of TGF-β (transforming growth factor beta). TGF-β is a pleiotropic cytokine that regulates key cancer-related molecular and cellular processes, including proliferation, migration, invasion, apoptosis, and chemoresistance. The understanding of the mechanisms of TGF-β actions in cancer is hindered by the “TGF-β paradox” in which early stages of cancerogenic process are suppressed by TGF-β while advanced stages are stimulated by its activity. A growing body of evidence suggests that these paradoxical TGF-β actions could result from the interplay with microRNAs: Short, non-coding RNAs that regulate gene expression by binding to target transcripts and inducing mRNA degradation or inhibition of translation. Here, we discuss the current knowledge of TGF-β signaling in GCs. Importantly, TGF-β signaling and microRNA-mediated regulation of gene expression often act in complicated feedback circuits that involve other crucial regulators of cancer progression (e.g., androgen receptor). Furthermore, recently published in vitro and in vivo studies clearly indicate that the interplay between microRNAs and the TGF-β signaling pathway offers new potential treatment options for GC patients.

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Section: Bladder Cancermentioning

confidence: 99%

TGF-β and microRNA Interplay in Genitourinary Cancers

Bogusławska¹,

Kryst

Poletajew

et al. 2019

Cells

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“…A PubMed search of “transurethral resection” (of) “bladder” and “morbidity” or “complication”, or “mortality” or “death” yielded 585, 664, 9 and 95 articles, respectively. Of these, 89 articles relevant to the process of defining complexity were analysed, obtaining 36 articles ( Table S1 ) which were instrumental in highlighting adequacy, operative time and morbidity as the three drivers that characterize a complex surgery, as opposed to an uneventful procedure [ 4 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

Consensus Definition and Prediction of Complexity in Transurethral Resection or Bladder Endoscopic Dissection of Bladder Tumours

Roumiguié¹,

Xylinas

Brisuda

et al. 2020

Cancers

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Ten senior urologists were interrogated to develop a predictive model based on factors from which they could anticipate complex transurethral resection of bladder tumours (TURBT). Complexity was defined by consensus. Panel members then used a five-point Likert scale to grade those factors that, in their opinion, drove complexity. Consensual factors were highlighted through two Delphi rounds. Respective contributions to complexity were quantitated by the median values of their scores. Multivariate analysis with complexity as a dependent variable tested their independence in clinical scenarios obtained by random allocation of the factors. The consensus definition of complexity was “any TURBT/En-bloc dissection that results in incomplete resection and/or prolonged surgery (>1 hour) and/or significant (Clavien-Dindo ≥ 3) perioperative complications”. Logistic regression highlighted five domains as independent predictors: patient’s history, tumour number, location, and size and access to the bladder. Receiver operating characteristic (ROC) analysis confirmed good discrimination (AUC = 0.92). The sum of the scores of the five domains adjusted to their regression coefficients or Bladder Complexity Score yielded comparable performance (AUC = 0.91, C-statistics, p = 0.94) and good calibration. As a whole, preoperative factors identified by expert judgement were organized to quantitate the risk of a complex TURBT, a crucial requisite to personalise patient information, adapt human and technical resources to individual situations and address TURBT variability in clinical trials.

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“…We believe that it can be regarded as a simple and universally available urine-based biomarker. Together with clinical staging based on imaging [ 5 ], endoscopic appearance of the tumor [ 6 , 7 , 8 ] and urine cytology [ 9 ], it can help to adequately plan the surgery and postoperative management. In case high-grade tumor is suspected, one can consider multiple site mucosa biopsies to increase a chance for proper diagnosis of concomitant carcinoma in situ [ 10 , 11 ], while single postoperative intravesical instillation of chemotherapy could be omitted in favor of intravesical Bacillus Calmette-Guérin (BCG) therapy or radical cystectomy [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Preoperative pyuria predicts the presence of high-grade bladder carcinoma in patients with bladder tumors

Poletajew

Gajewska

Kaczmarek

et al. 2020

Cent european J Urol

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Introduction Preoperative identification of high-grade bladder cancer presence can optimize patient management. The aim of this study was to assess the association between preoperative pyuria and the pathological features of bladder cancer. Material and methods This retrospective analysis enrolled 943 patients undergoing transurethral resection of a bladder tumor. Patients were divided into two study groups based on the presence of pyuria in preoperative urine analysis, defined as the presence of >5 leukocytes in the high power field. Pyuria status as a potential predictive factor was then confronted with pathological features based on standard microscopic examination of the surgical specimen. Results Among 943 recruited patients, 294 (31.2%) presented with pyuria. Patients with pyuria were older (71 vs. 68 years, p <0.05), had higher rates of large (≥3 cm) tumors (37% vs. 26%, p <0.05), and more frequently presented concomitant hematuria (58% vs. 24%, p <0.05). In case of recurrent tumors patients with pyuria more often received intravesical chemotherapy in the past (4.8% vs. 1.4%, p <0.05). Regarding oncological data, patients with pyuria had significantly higher tumor stage and grade. On multivariable analysis pyuria was independently associated with high-grade tumors (OR 1.97, 95% CI 1.45–2.67). Specificity and negative predictive value of pyuria as a biomarker of high-grade tumors were 76% and 68%, respectively. Conclusions Preoperative pyuria can be regarded as a predictor of the presence of high-grade bladder carcinoma in patients with bladder tumors.

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The role of endoscopic bladder tumour assessment in the management of patients subjected to transurethral bladder tumour resection

Cited by 5 publications

References 17 publications

TGF-β and microRNA Interplay in Genitourinary Cancers

TGF-β and microRNA Interplay in Genitourinary Cancers

Consensus Definition and Prediction of Complexity in Transurethral Resection or Bladder Endoscopic Dissection of Bladder Tumours

Preoperative pyuria predicts the presence of high-grade bladder carcinoma in patients with bladder tumors

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