Publications by authors named "Subiela J"
Objective: To evaluate the oncological efficacy and safety of sequential intravesical gemcitabine/docetaxel (Gem/Doce) therapy in a European cohort of patients with high-risk and very-high-risk non-muscle-invasive bladder cancer (NMIBC) after previous Bacillus Calmette-Guérin (BCG) treatment.
Materials And Methods: Data were retrospectively collected from 95 patients with NMIBC, treated with Gem/Doce at 12 European centres between 2021 and 2024. Patients previously treated with BCG who had completed a full induction course and received at least one follow-up evaluation were included.
Background: Immune checkpoint inhibitors (ICIs) are an important therapeutic pillar in metastatic urothelial carcinoma (mUC). The occurrence of immune-related adverse events (irAEs) appears to be associated with improved outcomes in observational studies. However, these associations are likely affected by immortal time bias and do not represent causal effects.
View Article and Find Full Text PDFContext: Adjuvant immune checkpoint inhibitors (ICIs) have recently emerged as guideline-recommended treatments of high-risk muscle-invasive urothelial carcinoma (MIUC). However, there is limited evidence regarding the optimal candidates and the differential efficacy of adjuvant ICI regimens.
Objective: To synthesize and compare the efficacy and safety of adjuvant ICIs for high-risk MIUC using updated data from phase III randomized controlled trials.
Article Synopsis
- En bloc resection of bladder tumor (ERBT) is a surgical technique aimed at improving bladder cancer removal compared to conventional transurethral resection (cTURBT), focusing on perioperative and cancer-related outcomes.
- A review of 17 studies found no significant differences in cancer recurrence or progression rates between ERBT and cTURBT, although ERBT was linked to better detection of detrusor muscle (DM) presence, and lower risks of bladder perforation and obturator nerve reflexes.
- ERBT resulted in longer surgery times but shorter catheterization and hospital stays, indicating a safer approach overall, despite the lack of major differences in long-term cancer outcomes.
Article Synopsis
- Upper tract urothelial carcinoma (UTUC) is an aggressive cancer with limited reliable prognostic biomarkers currently available.
- A thorough review of 94 studies assessed the prognostic value of various biomarkers from blood, tissue, and urine in UTUC patients, focusing on 22 blood-based, 13 tissue-based, and 4 urine-based markers.
- While certain biomarkers like the neutrophil-lymphocyte ratio and albumin are well-supported and included in existing guidelines, the clinical significance of many other potential biomarkers needs further investigation due to insufficient research.
Article Synopsis
- Intravesical mitomycin C (MMC) is used to prevent recurrence in intermediate-risk non-muscle-invasive bladder cancer (IR-NMIBC), but there's uncertainty about the best dosage and regimen.
- A review of 14 studies found that MMC can provide good recurrence-free survival (RFS) rates, with a 2-year RFS of 76% for the 40 mg regimen compared to 66% for the 30 mg regimen.
- The findings suggest that MMC is as effective as bacillus Calmette-Guérin (BCG), with 40 mg appearing to be the superior dose; however, the maintenance duration didn't significantly impact RFS outcomes.
Introduction: In recent years, different urinary markers such as the Bladder Epicheck® have been developed in an attempt to reduce the number of cystoscopies in the follow-up of non-muscle invasive bladder cancer (NMIBC).
Aim: To provide a systematic review of Bladder Epicheck® and its current clinical utility in the follow-up and detection of recurrence of NMIBC.
Material And Methods: Systematic review based on a literature search of PubMed, Web of Science and Scopus databases until October 2023, according to PRISMA and Quadas-2 criteria.
In non-muscle invasive bladder cancer, Bacillus Calmette-Guérin (BCG) responders benefit from strong Th1-type inflammatory and T cell responses mediating tumor rejection. However, the corresponding lack of anti-inflammatory Th2-type immunity impairs tissue repair in the bladder wall and facilitates the development of cystitis, causing urinary pain, urgency, incontinence, and frequency. Mechanistically, the leakage of the glycosaminoglycan (GAG) layer enables an influx of potassium ions, bacteria, and urine solutes towards the underlying bladder tissue, promoting chronic inflammation.
View Article and Find Full Text PDFBackground: The European Association of Urology (EAU) recommends discussing upfront radical cystectomy for all patients with very high risk (VHR) non-muscle-invasive bladder carcinoma (NMIBC), but the role of bacillus Calmette-Guérin (BCG) treatment remains controversial.
Objective: To analyze oncological outcomes in VHR NMIBC patients (EAU risk groups) treated with adequate BCG.
Design, Setting, And Participants: A multi-institutional retrospective study involving patients with VHR NMIBC who received adequate BCG therapy from 2007 to 2020 was conducted.
Article Synopsis
- The review compares three different surgical approaches (transvesical, extravesical, endoscopic) for managing the bladder cuff during radical nephroureterectomy (RNU) to determine their efficacy.
- A total of 19 studies involving 6,581 patients were analyzed, revealing that rates of bladder recurrence, metastasis, and cancer-related deaths were not significantly different among the approaches.
- The study concludes that there is no high-level evidence favoring one technique over the others, indicating that the extravesical approach is as effective as the transvesical approach regarding oncological and perioperative outcomes.
Article Synopsis
- This study looked at how a type of kidney tumor called AML behaves over a long time, following 111 patients with 145 tumors between 2001 and 2019.
- Most patients didn't have any symptoms, and only a small number needed surgery because their tumors were big.
- The research found that AML tumors usually grow slowly, and doctors might not need to check them as often or use complex imaging tests.
Clinical Usefulness of Prostate-specific Membrane Antigen-ligand Positron Emission Tomography/Computed Tomography for the Detection of Prostate Cancer Biochemical Recurrence after Primary Radiation Therapy in Patients with Prostate-specific Antigen Below the Phoenix Threshold: Systematic Review and Meta-analysis.
Clin Oncol (R Coll Radiol)
December 2023
Aims: After primary radiotherapy, biochemical recurrence is defined according to the Phoenix criteria as a prostate-specific antigen (PSA) value >2 ng/ml relative to the nadir. Several studies have shown that prostate-specific membrane antigen (PSMA)-ligand positron emission tomography/computed tomography (PET/CT) can help in detecting recurrence in patients with low PSA values. This study aimed to assess the detection rate and patterns of PSMA-ligand PET/CT uptake in patients with suspected biochemical recurrence after primary radiotherapy and with PSA levels below the Phoenix threshold.
View Article and Find Full Text PDFBackground: The existence and prognosis of T1LG (T1 low-grade) bladder cancer is controversial. Also, because of data paucity, it remains unclear what is the clinical history of bacillus Calmette-Guérin (BCG) treated T1LG tumors and if it differs from other NMIBC (non-muscle-invasive bladder cancer) representatives. The aim of this study was to analyse recurrence-free survival (RFS) and progression-free survival (PFS) in patients with T1LG bladder cancers treated with BCG immunotherapy.
View Article and Find Full Text PDFSeminal vesicles can be affected by tumours originating in other locations. However, primary tumours of the seminal vesicle are extremely rare, with less than 100 cases reported in literature. Seminal vesicle adenocarcinoma is the most common type, but there are also other malign lesions.
View Article and Find Full Text PDFWhile PARP inhibitors such as rucaparib and olaparib have shown activity in metastatic castration-resistant prostate cancer, they have failed to show a clear improvement in hard outcomes such as overall survival or quality of life. Because of methodological limitations, we suggest caution before implementing these treatments in routine clinical practice; offering them to patients without a BRCA1/2 mutation is probably inappropriate.
View Article and Find Full Text PDFAim: To measure the temperature dynamics at the renal surface and within the urinary tract when using Ho:YAG and Tm:YAG lasers for tissue ablation.
Materials And Methods: Porcine kidneys were used. Both types of lasers with different configurations and fiber sizes were used through a flexible ureteroscope.
Article Synopsis
- The study addresses the rising number of kidney transplants in patients over 70 years old, acknowledging the complexity of choosing between dialysis and transplantation in older patients.
- It systematically reviewed and analyzed data from 19 studies involving over 293,000 kidney transplant patients to compare outcomes between elderly and younger recipients.
- Results indicated that elderly patients experience significantly poorer overall survival and long-term graft survival compared to those under 70, while short-term graft survival and rates of complications appeared similar across age groups.
Article Synopsis
- - Cisplatin-based neoadjuvant chemotherapy followed by radical cystectomy is the standard treatment for muscle-invasive bladder cancer (MIBC), but fewer than half of patients qualify for it and half may develop metastatic cancer.
- - For patients who haven't received neoadjuvant therapy, adjuvant chemotherapy is an option to reduce the risk of cancer returning and to improve outcomes in localized MIBC.
- - New treatments like immune checkpoint inhibitors and targeted agents are being tested in clinical trials for advanced urothelial carcinoma, with some showing promising results in neoadjuvant and adjuvant therapies; predictive biomarkers may also help determine which patients will respond best to these treatments.
Background: Several classifications have been reported to stratify non-muscle-invasive bladder cancer (NMIBC) in risk groups according to the probability of recurrence and progression.
Objective: To systematically review the current evidence regarding risk stratification of NMIBC.
Methods: The systematic review was performed in accordance with the PRISMA statement.
Objective: To assess clinical outcomes of patients who underwent simultaneous radical cystectomy (RC) and radical nephroureterectomy (RNU) for panurothelial carcinoma (PanUC).
Materials And Methods: A retrospective analysis of 67 patients who underwent simultaneous RC and unilateral RNU for PanUC, from 1996 to 2017. Kaplan-Meier estimates for remnant urothelium recurrence-free survival, metastasis-free survival, overall survival (OS), and cancer-specific survival (CSS) were performed.
Background: Evidence-based medicine (EBM) was introduced as a concept in the early 1990s as an integration of the best available evidence with clinical expertise and patient values.
Objective: To evaluate the current status of EBM training and EBM perception, attitudes, and self-perceived skills among European urology residents.
Design Setting And Participants: Our online open survey comprised 28 multiple-choice items, including ten questions with responses on a five-point Likert scale ranging from 1 = strongly disagree to 5 = strongly agree.
Long-term Recurrence and Progression Patterns in a Contemporary Series of Patients with Carcinoma In Situ of the Bladder With or Without Associated Ta/T1 Disease Treated with Bacillus Calmette-Guérin: Implications for Risk-adapted Follow-up.
Eur Urol Focus
March 2023
Background: Limited data are available on patients with carcinoma in situ (CIS) of the bladder managed according to current clinical practice guidelines.
Objective: To assess the patterns of recurrence, progression to muscle-invasive bladder cancer (MIBC), and upper tract urothelial carcinoma (UTUC) in patients with CIS, and to compare the effectiveness of adequate versus inadequate bacillus Calmette-Guérin (BCG) immunotherapy.
Design, Setting, And Participants: A retrospective analysis of 386 patients with CIS of the bladder with or without associated pTa/pT1 disease treated with BCG between 2008 and 2015.
Corrigendum to <'Mitomycin C allergy after passive and device-assisted hyperthermia for non-muscle invasive bladder cancer treatment: A retrospective cohort from a high-volume center'> <[Volume 40, Issue 7, July 2022, Pages 345.e19-345.e23]>.
Urol Oncol
October 2022
Purpose: Non-muscle-invasive bladder cancers (NMIBC) constitute 3-quarters of all primary diagnosed bladder tumors. For risk-adapted management of patients with NMIBC, different risk group systems and predictive models have been developed. This study aimed to externally validate EORTC2016, CUETO and novel EAU2021 risk scoring models in a multi-institutional retrospective cohort of patients with high-grade NMIBC who were treated with an adequate BCG immunotherapy.
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