Cancer Research and Treatment

Genitourinary cancer

TNM-Based Head-to-Head Comparison of Urachal Carcinoma and Urothelial Bladder Cancer: Stage-Matched Analysis of a Large Multicenter National Cohort: Sang Hun Song, Jaewon Lee, Young Hwii Ko, Jong Wook Kim, Seung Il Jung, Seok Ho Kang, Jinsung Park, Ho Kyung Seo, Hyung Joon Kim, Byong Chang Jeong, Tae-Hwan Kim, Se Young Choi, Jong Kil Nam, Ja Yoon Ku, Kwan Joong Joo, Won Sik Jang, Young Eun Yoon, Seok Joong Yun, Sung-Hoo Hong, Jong Jin Oh; Cancer Res Treat. 2023;55(4):1337-1345. Published online April 17, 2023; DOI: https://doi.org/10.4143/crt.2023.417

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Purpose
Outcome analysis of urachal cancer (UraC) is limited due to the scarcity of cases and different staging methods compared to urothelial bladder cancer (UroBC). We attempted to assess survival outcomes of UraC and compare to UroBC after stage-matched analyses.
Materials and Methods
Total 203 UraC patients from a multicenter database and 373 UroBC patients in single institution from 2000 to 2018 were enrolled (median follow-up, 32 months). Sheldon stage conversion to corresponding TNM staging for UraC was conducted for head-to-head comparison to UroBC. Perioperative clinical variables and pathological results were recorded. Stage-matched analyses for survival by stage were conducted.
Results
UraC patients were younger (mean age, 54 vs. 67 years; p < 0.001), with 163 patients (80.3%) receiving partial cystectomy and 23 patients (11.3%) radical cystectomy. UraC was more likely to harbor ≥ pT3a tumors (78.8% vs. 41.8%). While 5-year recurrence-free survival, cancer-specific survival (CSS) and overall survival were comparable between two groups (63.4%, 67%, and 62.1% in UraC and 61.5%, 75.9%, and 67.8% in UroBC, respectively), generally favorable prognosis for UraC in lower stages (pT1-2) but unfavorable outcomes in higher stages (pT4) compared to UroBC was observed, although only 5-year CSS in ≥ pT4 showed statistical significance (p=0.028). Body mass index (hazard ratio [HR], 0.929), diabetes mellitus (HR, 1.921), pathologic T category (HR, 3.846), and lymphovascular invasion (HR, 1.993) were predictors of CSS for all patients.
Conclusion
Despite differing histology, UraC has comparable prognosis to UroBC with relatively favorable outcome in low stages but worse prognosis in higher stages. The presented system may be useful for future grading and risk stratification of UraC.

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Clinical Presentation and Targeted Interventions in Urachal Adenocarcinoma: A Single-Institution Case Series and Review of Emerging Therapies
Akshay Mathavan, Akash Mathavan, Rodrigo Murillo-Alvarez, Kriti Gera, Urszula Krekora, Aaron J. Winer, Mohit Mathavan, Ellery Altshuler, Brian Hemendra Ramnaraign
Clinical Genitourinary Cancer.2024; 22(1): 67. CrossRef
Robotic‐assisted approaches to urachal carcinoma: A comprehensive systematic review of the safety and efficacy outcomes
Caio Vinícius Suartz, Lucas Motta Martinez, Pedro Henrique Brito, Carlos Victori Neto, Maurício Dener Cordeiro, Luiz Antonio Assan Botelho, Fábio Pescarmona Gallucci, José Maurício Mota, William Carlos Nahas, Leopoldo Alves Ribeiro‐Filho
BJUI Compass.2024; 5(3): 327. CrossRef

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Diffuse Large B-Cell Lymphoma Arising within Ileal Neobladder: An Expanding Spectrum of Diffuse Large B-Cell Lymphoma Associated with Chronic Inflammation: Hyekyung Lee, Hyunbin Shin, Nae Yu Kim, Hyun Sik Park, Jinsung Park; Cancer Res Treat. 2019;51(4):1666-1670. Published online March 22, 2019; DOI: https://doi.org/10.4143/crt.2019.022

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Diffuse large B-cell lymphoma associated with chronic inflammation (DLBCL-CI), specifically arising in ileal neobladder, is a rare neoplasm. We present an unusual case of Epstein– Barr virus (EBV)–positive DLBCL-CI arising within neobladder with detailed clinical, histological, and immunophenotypical features in an immunocompetent patient. An 88-year-old male was admitted for gross hematuria. He had undergone radical cystectomy and ileal neobladder 17 years ago for invasive bladder cancer. Computed tomography showed enhancing lesions on dome and posterior wall of neobladder with mucosal thickening and multiple enlarged retroperitoneal lymphadenopathies. Transurethralresection of neobladder lesion revealed the diffuse infiltration of large lymphoid cells which were positive for CD20, CD30, and multiple myeloma oncogen-1 with EBV-encoded small RNAs co-localizing, and diagnosis of EBV-positive DLBCL-CI was made. After multi-agent chemotherapy, the lesion disappeared. We suggest that clinicians should consider the possibility of DLBCL-CI in patients presented with hematuria during follow-up after bladder reconstruction.

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Advances in the Pathogenesis of EBV-Associated Diffuse Large B Cell Lymphoma
Paola Chabay
Cancers.2021; 13(11): 2717. CrossRef

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Oncologic, Perioperative Outcomes of Female Radical Cystectomy: Results from a Multicenter Study in Korea: Ji Sung Shim, Ho Kyung Seo, Ja Hyeon Ku, Byong Chang Jeong, Bumsik Hong, Seok Ho Kang, UCART (Urothelial Cancer-Advanced Research and Treatment Group in Korea) Group; Cancer Res Treat. 2019;51(3):1064-1072. Published online October 30, 2018; DOI: https://doi.org/10.4143/crt.2018.515

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Purpose
The lower incidence of bladder cancer among women has led to a lack of information on female radical cystectomy (RC). This study aimed to analyze the characteristics related with female RC in a cohort from multiple academic institutions.
Materials and Methods
This was a retrospective review of 384 female patients who underwent RC for bladder cancer. Epidemiologic, perioperative variables including urologic referral periodwith consequent pathologic stage distributions were assessed. The changes in surgical techniques over time were illustrated. Also, we evaluated recurrence-free survival (RFS) at 2 and 5 years and overall survival (OS) at 5 years with stage-specific analyses using the Kaplan-Meier method.
Results
The mean follow-up time was 35 months (interquartile rage [IQR], 9 to 55). The average time to urologic referral with initial symptoms was 5.5 (IQR, 1 to 6) months and over 20% of patients visited clinics after 6 months. In subsequent stage distributions according to referral period, T2 or higher stage distributions were abruptly increased after 1 year. Overall 2-year/5-year RFS rates were 0.72/0.57 and 5-year OS was 0.61. Notable surgical descriptions were as follows: 91% of patients underwent open RC; 80% of patients underwent an ileal conduit; and 83% of patients received anterior exenteration. However, the proportions of robotic surgery, orthotopic neobladder and organ sparing cystectomy have increased recen-tly.
Conclusion
We identified the general characteristics and changes in pattern of female RC. Our results also suggest that women are susceptible to delays in referral to an urologist and are at greater risk for worse prognosis.

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Perioperative, oncological, and survival outcomes of robotic radical cystectomy with urinary diversion in females
Varun V. Agarwal, B. Yuvaraja Thyavihally, Santosh Subhash Waigankar, Preetham Dev, Abhinav P. Pednekar, Diptiman Roy, Nevitha Athikari, Meenal Hastak, Naresh Badlani, D. Harshwardhan Pokharkar, Nagaraja Sekhar Ayyalasomayajula, Archan Khandekar, Ashish A
Indian Journal of Urology.2023; 39(1): 27. CrossRef
Safety and Efficacy of Reproductive Organ-Sparing Radical Cystectomy in Women With Variant Histology and Advanced Stage
Sunil H. Patel, Shirley Wang, Meredith R. Metcalf, Natasha Gupta, Andrew Gabrielson, Esther Lee, Mary Rostom, Phil Pierorazio, Armine Smith, Noah Hahn, Mark Schoenberg, Max Kates, Jean Hoffman-Censits, Trinity J. Bivalacqua
Clinical Genitourinary Cancer.2022; 20(1): 60. CrossRef
The learning curve for robot-assisted radical cystectomy with total intracorporeal urinary diversion based on radical cystectomy pentafecta
Tae Il Noh, Ji Sung Shim, Sung Gu Kang, Jun Cheon, Jong Hyun Pyun, Seok Ho Kang
Frontiers in Oncology.2022;[Epub] CrossRef

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Clinical Prognostic Factors for Radical Cystectomy in Bladder Cancer: Seung Hyun Jeon, Sung-Hyun Jeon, Sung-Goo Chang; Cancer Res Treat. 2005;37(1):48-53. Published online February 28, 2005; DOI: https://doi.org/10.4143/crt.2005.37.1.48

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Purpose

We investigated the effects of radical cystectomy and the prognostic factors that affect the survival of bladder cancer patients.

Materials and Methods

From 1979 to 2002, 59 patients with long-term follow up results of at least 2 years were enrolled in this study. Indications for surgery included muscle invasive bladder cancer and high-risk superficial bladder cancer. The cancer specific and recurrence free survival rates with respect to the possible prognostic factors were determined using Kaplan-Meier statistics.

Results

The mean patient age was 62.8 years (M: 48, F: 11), and the estimated 5- and 10-year survival rates were 62% and 39.4%, respectively. The median time to local or systemic recurrence was 16 months (range: 5~100), and the average survival durations after local and systemic recurrence were 14.4 months and 12.7 months, respectively. Pathologic stage, tumor grade, mean nuclear area, sex and lymphatic invasion were significant factors by univariate analysis (p<0.05). The disease related survival rate in patients having progression from an initial superficial tumor was lower than for those patients who displayed muscle invasive disease at the initial treatment. Multivariate analysis identified pathologic stage and lymphatic invasion as independent prognostic factors.

Conclusions

Radical cystectomy for organ-confined cancer showed favorable 5- and 10-year survival rates. The survival rate for patients with progression from an initial superficial tumor was worse than for those patients with invasive tumor at the initial presentation. The most significant independent prognostic factors were the pathologic stage and the presence of lymphatic invasion, which were highly correlated with all the investigated disease endpoints.

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Development of robust artificial neural networks for prediction of 5-year survival in bladder cancer
Hriday P. Bhambhvani, Alvaro Zamora, Eugene Shkolyar, Kris Prado, Daniel R. Greenberg, Alex M. Kasman, Joseph Liao, Sumit Shah, Sandy Srinivas, Eila C. Skinner, Jay B. Shah
Urologic Oncology: Seminars and Original Investigations.2021; 39(3): 193.e7. CrossRef
Alterations of Global Histone H3K9 and H3K27 Methylation Levels in Bladder Cancer
Jörg Ellinger, Anne Bachmann, Friederike Göke, Turang E. Behbahani, Claudia Baumann, Lukas C. Heukamp, Sebastian Rogenhofer, Stefan C. Müller
Urologia Internationalis.2014; 93(1): 113. CrossRef
Global histone H4K20 trimethylation predicts cancer-specific survival in patients with muscle-invasive bladder cancer
Ann-Christin Schneider, Lukas C. Heukamp, Sebastian Rogenhofer, Guido Fechner, Patrick J. Bastian, Alexander von Ruecker, Stefan C. Müller, Jörg Ellinger
BJU International.2011; 108(8b): E290. CrossRef

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