Extent of surgery and pathology evaluation has an impact on bladder cancer outcomes after radical cystectomy

Objectives

To evaluate whether the extent of surgery and of the pathology evaluation affects the outcome of patients with bladder cancer after radical cystectomy.

Methods

The data from 637 patients with invasive bladder cancer who underwent radical cystectomy and pelvic lymph node dissection were analyzed. Associations between surgical and pathologic variables and 5-year disease-specific survival and local recurrence outcomes were investigated.

Results

The pathologic tumor stage and node status were significant variables for survival. For both node-negative and node-positive patients, improved survival and a reduced local recurrence rate was associated with negative surgical margins and a greater number of lymph nodes removed.

Conclusions

The extent of surgery and of the pathology evaluation has an impact on the outcome of patients with bladder cancer after cystectomy. Such information is important not only for therapy and the prognosis of individuals, but also for identifying candidates for adjuvant chemotherapy. [1]

Bacillus calmette-Guérin plus intravesical interferon alpha-2b in patients with superficial bladder cancer

Objectives

Bacillus Calmette-Guérin (BCG) and interferon alpha-2b (IFNα2b) have been used individually for the treatment of bladder cancer. We used a low dose of BCG combined with IFNα2b to determine the safety and to assess the efficacy of this combination therapy.

Methods

A study of 12 patients with superficial bladder cancer evaluated the safety and efficacy of a combination of low-dose BCG and IFNα2b, given weekly for 6 weeks. Three patients were assigned to each of four groups in which 60 mg of BCG was combined with 10, 30, 60, or 100 × 106 ILJ of IFNα2b.

Results

The combination BCG/IFNα2b therapy was well tolerated, with adverse effects being mild to moderate and resolved at the end of treatment. At 12 months post-treatment there has been no tumor progression. Two patients with previous multifocal transitional cell carcinoma have had solitary recurrences. One patient has had recurrent carcinoma in situ.

Conclusions

This preliminary study found combination BCG/IFNα2b induction therapy to be safe and well tolerated. These early results show a high response rate, but efficacy can only be determined with Phase II and III studies. [2]

Prospective Randomized Comparison of Intravesical with Percutaneous Bacillus Calmette-Guerin Versus Intravesical Bacillus Calmette-Guerin in Superficial Bladder Cancer

Conflicting reports of the necessity for percutaneous bacillus Calmette-Guerin (BCG) administration with intravesical BCG prompted us to evaluate its benefit in a randomized prospective comparison of intravesical versus intravesical with percutaneous BCG therapy. Intravesical Tice BCG was given in a dose of 50 mg. with or without percutaneous BCG weekly for 6 weeks, at 8, 10 and 12 weeks, at 6 months and every 6 months thereafter. Tumor recurrence was documented in 13 of 30 patients (43%) receiving only intravesical BCG and in 15 of 36 patients (42%) receiving intravesical plus percutaneous BCG. The addition of percutaneous BCG to intravesical therapy did not increase treatment efficacy in this study. [3]

Risk Factors of Urinary Bladder Cancer in Islamabad, Federal Area of Pakistan

It is retrospective and hospital based case control study which was conducted in the federal city of Islamabad in Pakistan in order to assess the risk factors of the urinary bladder cancer. This study was based on the 100 controls and 50 cases comprising 150 subjects which were selected for interview from the two hospitals and required information like gender, age, smoking habits, family history of cancer, etc., was achieved. Both the descriptive and analytical approaches were used to find out the dominating risk factors of the disease. Odds ratios and 95 % Confidence Intervals were obtained for analytical purpose by using the binary logistic regression model. Three factors including cigarette smoking, source of drinking water and fried items were found to be significant having odds ratios and 95% confidence intervals of (17.158, 6.244- 47.147), (0.192, 0.061- 0.603) and (12.206, 3.291- 45.275), respectively. The study revealed that cigarette smoking, consumption of tap water and high use of fried items increases the risk of developing bladder cancer. On the other hand, the use of government provided for drinking purpose is a protection against the urinary bladder cancer as compared to tap water. [4]

Reference

[1] Herr, H.W., 2003. Extent of surgery and pathology evaluation has an impact on bladder cancer outcomes after radical cystectomy. Urology, 61(1), pp.105-108.

[2] Stricker, P., Pryor, K., Nicholson, T., Goldstein, D., Golovsky, D., Ferguson, R., Nash, P., Ehsman, S., Rumma, J., Mammen, G. and Penny, R., 1996. Bacillus Calmette-Guerin plus intravesical interferon alpha-2b in patients with superficial bladder cancer. Urology, 48(6), pp.957-962.

[3] Lamm, D.L., DeHaven, J.I., Shriver, J. and Sarosdy, M.F., 1991. Prospective randomized comparison of intravesical with percutaneous bacillus Calmette-Guerin versus intravesical bacillus Calmette-Guerin in superficial bladder cancer. The Journal of urology, 145(4), pp.738-740.

[4] Ahmad, M. and Pervaiz, M. (2011) “Risk Factors of Urinary Bladder Cancer in Islamabad, Federal Area of Pakistan”, Journal of Advances in Medicine and Medical Research, 1(3), pp. 96-104. doi: 10.9734/BJMMR/2011/186.

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