The Role of Metastasectomy in Urothelial Carcinoma: Where Are We in 2020?

Lemke, Emily; Sahasrabudhe, Deepak M.; Guancial, Elizabeth A.; Bylow, Kathryn A.; Johnson, Scott; Messing, Edward M.; Kilari, Deepak

doi:10.1016/j.clgc.2020.01.003

Cited by 5 publications

(9 citation statements)

References 25 publications

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“…Urothelial carcinoma (UC) represents the fourth and twelfth most common malignancy in men and women, respectively, with the bladder being the usual site of occurrence [1][2][3][4][5]. Despite radical therapies, a significant percentage of patients diagnosed with UC develop metastases during follow-up.…”

Section: Introductionmentioning

confidence: 99%

“…Despite radical therapies, a significant percentage of patients diagnosed with UC develop metastases during follow-up. In detail, metastatic disease is detected in about 50% of patients with bladder cancer undergoing radical cystectomy and most of these patients experience distant recurrence [1][2][3]6]. Moreover, 10 to 15% of patients are already metastatic at diagnosis [2].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, 10 to 15% of patients are already metastatic at diagnosis [2]. Before the development of effective chemotherapy, patients with metastatic UC had a median survival rarely exceeding three to six months [1][2][3]. Although the treatment landscape of metastatic UC has been revolutionized in recent years with the advent of immune checkpoint inhibitors, available therapeutic options remain limited, and overall response rates remain suboptimal [1].…”

Section: Introductionmentioning

confidence: 99%

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Metastasis-Directed Radiation Therapy with Consolidative Intent for Oligometastatic Urothelial Carcinoma: A Systematic Review and Meta-Analysis

Longo

Celentano

Napolitano

et al. 2022

Cancers

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The management of patients with oligometastatic urothelial carcinoma (UC) represents an evolving field in uro-oncology, and the role of metastasis-directed therapies, including metastasectomy and metastasis-directed radiation therapy (MDRT), is gaining increasing attention. Herein, we summarize available evidence about the role of MDRT with consolidative intent in oligometastatic UC patients. A systematic review was performed in December 2021. Six studies involving 158 patients were identified. Most patients (n = 120, 90.2%) had a history of bladder cancer and the most frequent sites of metastases were lymph nodes (n= 61, 52.1%) followed by the lungs (n = 34, 29%). Overall, 144 metastases were treated with MDRT. Median follow-up ranged from 17.2 to 25 months. Local control rates ranged from 57% to 100%. Median Overall Survival (OS) ranged from 14.9 to 51.0 months and median progression-free survival ranged from 2.9 to 10.1 months. Rates of OS at one and two years ranged from 78.9% to 96% and from 26% to 63%, respectively. Treatment-related toxicity was recorded in few patients and in most cases a low-grade toxicity was evident. MDRT with consolidative intent represents a potential treatment option for selected patients with oligometastatic UC.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Metastasis-Directed Radiation Therapy with Consolidative Intent for Oligometastatic Urothelial Carcinoma: A Systematic Review and Meta-Analysis

Longo

Celentano

Napolitano

et al. 2022

Cancers

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“…immunotherapy and Nectin-4 directed antibody-drug conjugates) opens new uncharted therapeutical opportunities that deserve trials in the oligometastatic setting [5 & ]. A 2020 review investigating the role of metastasectomy concluded in favour of a possible oncological benefit for nodal or lung metastases, based on retrospective studies with high heterogeneity [39]. Longo et al [40 & ] have performed a systematic review and a meta-analysis on six retrospective studies including radiotherapy-based MDT, performed mainly in the oligorecurrent setting (nodal, 52%, lung, 32%) with previous radical surgery; they reported local control rates (i.e.…”

Section: Role Of Metastasis-directed Therapy For Oligorecurrent/ Olig...mentioning

confidence: 99%

“…A 2020 review investigating the role of metastasectomy concluded in favour of a possible oncological benefit for nodal or lung metastases, based on retrospective studies with high heterogeneity [39]. Longo et al .…”

Section: Role Of Metastasis-directed Therapy For Oligorecurrent/oligo...mentioning

confidence: 99%

Definitions, outcomes and perspectives for oligometastatic bladder cancer: towards a standardized terminology

Calleris,

von Deimling,

Kesch

et al. 2024

Current Opinion in Urology

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Purpose of review Oligometastatic (om) cancer is considered as a transitional state in between locally confined disease and widespread metastases, accessible to a multimodal treatment, combining systemic and local therapy. In urothelial bladder cancer (BCa), the definitions and the approaches to this condition are poorly standardised and mainly based on retrospective data. We aim to portray the framework for uro-oncologic terminology in omBCa and go through the latest evidence and the future perspectives. Recent findings Retrospective and registry data support the potential benefits of multimodality treatment for carefully selected omBCa patients, especially following a good response to systemic treatment. In 2023, a Delphi consensus has defined omBCa, allowing maximum three metastatic lesions, theoretically amenable to radical local treatment. In de-novo omBCa, surgical treatment of primary tumour might improve overall survival (OS), according to a matched registry analysis; also, consolidative radiotherapy was associated with better OS in two recent cohorts. Furthermore, metastasis-directed therapy (MDT) has shown high local control rates and promising OS (14.9–51 months) in a meta-analysis; benefits might be more pronounced for single-site omBCa and nodal or lung lesions. Summary From a clinical perspective, in de-novo omBCa, the local treatment of primary and metastatic sites might improve disease control and survival, in selected patients; in the oligorecurrent setting, MDT achieves good local symptom control with limited side effects; in selected cases, it could convey a survival benefit, too. From a research perspective, well designed prospective evidence is eagerly awaited, based on recently adopted shared definitions for omBCa.

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A pathological complete response and adrenal insufficiency in a patient with advanced renal pelvic cancer treated with pembrolizumab

Suzuki,

Murata,

Wakita

et al. 2024

Int Canc Conf J

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The Role of Metastasectomy in Urothelial Carcinoma: Where Are We in 2020?

Cited by 5 publications

References 25 publications

Metastasis-Directed Radiation Therapy with Consolidative Intent for Oligometastatic Urothelial Carcinoma: A Systematic Review and Meta-Analysis

Metastasis-Directed Radiation Therapy with Consolidative Intent for Oligometastatic Urothelial Carcinoma: A Systematic Review and Meta-Analysis

Definitions, outcomes and perspectives for oligometastatic bladder cancer: towards a standardized terminology

A pathological complete response and adrenal insufficiency in a patient with advanced renal pelvic cancer treated with pembrolizumab

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