Decreasing Non-bladder-cancer Mortality After Radical Cystectomy.

Unlabelled: Life expectancy is increasing in many parts of the world. Using proportional hazard models for competing risks, we investigated whether this increase has changed outcomes after radical cystectomy in a sample of 1419 consecutive patients treated between 1993 and 2018. During the observation period, the mean age and the proportion of patients with American Society of Anesthesiologists physical status class 3 or 4 increased, whereas the proportion of patients with heart disease decreased.

Validation of a Questionnaire-Suitable Comorbidity Index in Patients Undergoing Radical Cystectomy.

Objective: To investigate the capability of a modified self-administrable comorbidity index recommended in the standard sets for neoplastic diseases published by the International Consortium for Health Outcomes Measurement (ICHOM) to predict 90-day and long-term mortality after radical cystectomy.

Methods: A single-center series of 1,337 consecutive patients who underwent radical cystectomy for muscle-invasive or high-risk non-muscle-invasive urothelial or undifferentiated bladder cancer were stratified by the modified self-administrable comorbidity index and Charlson score, respectively. Multivariate logit models (for 90-day mortality) and proportional-hazards models (for overall and non-bladder cancer mortality) were used for statistical workup.

Urinary MicroRNAs as Potential Markers for Non-Invasive Diagnosis of Bladder Cancer.

Currently, voided urine cytology (VUC) serves as the gold standard for the detection of bladder cancer (BCa) in urine. Despite its high specificity, VUC has shortcomings in terms of sensitivity. Therefore, alternative biomarkers are being searched, which might overcome these disadvantages as a useful adjunct to VUC.

Long-Term Mortality in Patients with Positive Lymph Nodes at the Time of Radical Prostatectomy.

Background: The aim of this study was to determine prognostic factors and to provide long-term mortality data in patients with positive lymph nodes at the time of radical prostatectomy in a sample with long-term follow-up.

Methods: A total of 527 patients with complete data sets treated in the years 1992-2014 were studied. The median follow-up was 7.

Socioeconomic Status-Related Parameters as Predictors of Competing (Non-Bladder Cancer) Mortality after Radical Cystectomy.

Objective: To investigate the impact of socioeconomic status-related parameters on competing (non-bladder cancer) mortality after radical cystectomy.

Patients And Methods: A total of 1,268 consecutive patients who underwent radical cystectomy for urothelial or undifferentiated bladder cancer at our institution between 1993 and 2016 with a mean age of 69 years (median 70 years) were studied. The mean -follow-up of the censored patients was 7.

Which comorbidity classification is best suited to identify patients at risk for 90-day and long-term non-bladder cancer mortality after radical cystectomy?

Purpose: There is no consensus on the best comorbidity measure in candidates for radical cystectomy. The aim of this study was to identify tool best suited to identify patients at risk for 90-day or premature long-term non-bladder cancer mortality.

Methods: We studied 1268 patients who underwent radical cystectomy to identify patients at risk for 90-day and later-than-90-day mortality, respectively.

Evaluation of TERT promoter mutations in urinary cell-free DNA and sediment DNA for detection of bladder cancer.

Background: Cell-free DNA (cfDNA) is proposed to be a valuable source of biomarkers in liquid biopsies for various diseases as it is supposed to partially originate from tumor cells. However, data about the diagnostic implications of cfDNA in urine for the detection of bladder cancer (BCa) is sparse.

Methods: We evaluated the usability of urinary cfDNA for diagnostic purposes compared to urine sediment DNA (sDNA) in 53 BCa patients and 36 control subjects by analyzing two abundant point-mutations (C228T/C250T) in the TERT promoter using Next-Generation Sequencing.

Predicting 90-day and long-term mortality in octogenarians undergoing radical cystectomy.

Background: Radical cystectomy bears a considerable perioperative mortality risk particularly in elderly patients. In this study, we searched for predictors of perioperative and long-term competing (non-bladder cancer) mortality in elderly patients selected for radical cystectomy.

Methods: We stratified 1184 consecutive patients who underwent radical cystectomy for high risk superficial or muscle-invasive urothelial or undifferentiated carcinoma of bladder into two groups (age < 80 years versus 80 years or older).

Gender and Mortality after Radical Cystectomy: Competing Risk Analysis.

Background: Data on the impact of gender on mortality after radical cystectomy is conflicting. We investigated a large single center sample with long-term follow-up in order to determine the relationship between gender and outcome.

Patients And Methods: A total of 1,184 consecutive patients who underwent radical cystectomy for high risk superficial or muscle-invasive urothelial or undifferentiated bladder cancer between 1993 and 2015 were stratified by gender.

Validation of the Preoperative Score to Predict Postoperative Mortality in Patients Undergoing Radical Cystectomy.

Standardized prediction of perioperative mortality risk is of major clinical concern in the radical cystectomy setting. We validated the recently developed Preoperative Score to Predict Postoperative Mortality (POSPOM) in a sample of 1083 consecutive cystectomy patients treated between 1993 and 2014. POSPOM was calculated as originally described based on age and 13 further parameters; three parameters which were not available in our database were ignored.

Selection Effects May Explain Smoking-related Outcome Differences After Radical Cystectomy.

The impact of smoking on mortality among patients with bladder cancer is subject to controversy. We investigated 1000 patients who consecutively underwent radical cystectomy between 1993 and 2013. Proportional hazards models for competing risks were used to study the combined effects of variables on mortality.

Urinary transcript quantitation of CK20 and IGF2 for the non-invasive bladder cancer detection.

Purpose: Cytokeratin 20 (CK20) and insulin-like growth factor 2 (IGF2) were previously proposed to be elevated in clinical samples from patients with bladder cancer (BCa). A two cohort design validation study was used to assess the relevance for BCa detection by transcript quantitation of both markers in urine samples. Their diagnostic value was assessed in comparison with voided urine cytology (VUC).

Prostate-specific Membrane Antigen-targeted Ligand Positron Emission Tomography/Computed Tomography and Immunohistochemical Findings in a Patient With Synchronous Metastatic Penile and Prostate Cancer.

A 68-year-old man presented with synchronous metastatic penile and prostate cancer. 68Ga-labeled prostate-specific membrane antigen-targeted ligand positron emission tomography/computed tomography (PSMA-PET/CT) revealed tracer uptake in inguinal, pelvic, and retroperitoneal metastases. Lymph node biopsies and immunohistochemical staining revealed that both cancers involved the lymph nodes and expressed PSMA.

Validation of the diagnostic utility of urinary midkine for the detection of bladder cancer.

As it has been demonstrated previously that midkine (also known as neurite growth-promoting factor 2) protein levels in urine of bladder cancer (BCa) patients are increased compared to healthy controls, the present study validated the diagnostic utility of midkine in an independent patient cohort and compared the observed values with voided urine cytology (VUC), which is the current reference standard for non-invasive diagnosis of BCa. Voided urine samples were prospectively collected from 92 BCa patients and 70 control subjects. Protein levels of midkine were assessed using a commercially available enzyme-linked immunosorbent assay and normalized to urinary creatinine.

An easily applicable single condition-based mortality index for patients undergoing radical prostatectomy or radical cystectomy.

Purpose: There is no generally accepted instrument to measure comorbidity in patients with cancer. We determined which single comorbid conditions are independently associated with competing mortality after radical prostatectomy or radical cystectomy in order to develop a mortality index.

Methods: The study samples consisted of 2,961 consecutive patients who underwent radical prostatectomy between 1992 and 2007 for clinically localized prostate cancer and 932 consecutive patients who underwent radical cystectomy between 1993 and 2012 for high-risk non-muscle-invasive or muscle-invasive urothelial or undifferentiated bladder cancer.

Growth of a Level III Vena Cava Tumor Thrombus Within 1 Month.

We describe a patient with rapid growth of a vena cava tumor thrombus from level I-II to level III within 1 month. This case illustrates that once the diagnosis of vena cava involvement is established in renal cell carcinoma, surgery should not be delayed without urgent reasons.

Age, American Society of Anesthesiologists physical status classification and Charlson score are independent predictors of 90-day mortality after radical cystectomy.

Purpose: Radical cystectomy (RC) is a major surgical procedure accompanied with meaningful complications and countable perioperative mortality. To identify the risk factors predicting the perioperative morbidity and mortality is essential. The study aimed to identify relevant, patient-specific factors associated with 90-day mortality following RC, which may serve as a foundation for improving healthcare delivery to patients with bladder cancer.

Decreased Overall and Bladder Cancer-Specific Mortality with Adjuvant Chemotherapy After Radical Cystectomy: Multivariable Competing Risk Analysis.

Unlabelled: Adding chemotherapy to radical cystectomy (RC) may improve outcome. Neoadjuvant treatment is advocated by guidelines based on meta-analysis data but is severely underused in clinical practice. Adjuvant treatment of patients at risk could be an alternative.

Lee mortality index as comorbidity measure in patients undergoing radical cystectomy.

To investigate the recently described Lee mortality index as predictor of mortality after radical cystectomy. A total of 735 patients who underwent radical cystectomy for bladder cancer between 1993 and 2010 were studied. Median patient age was 67 years and the median follow-up was 7.

Relationship of the number of removed lymph nodes to bladder cancer and competing mortality after radical cystectomy.

Unlabelled: The extent of lymph node dissection in radical cystectomy is a subject of controversy. A more extended dissection has been reported to be associated with superior survival. We analyzed the relationship between the lymph node count and different causes of death in a sample of 735 patients who underwent radical cystectomy for recurrent or muscle-invasive urothelial or undifferentiated carcinoma of the bladder.

Superglue in the Urethra: Surgical Treatment.

We describe a case of superglue application into the male urethra with successful surgical treatment of the glue particles by external urethrotomy.

Perioperative complications of radical cystectomy in a contemporary series.

Objectives: Radical cystectomy is the preferred standard treatment for patients with muscle-invasive bladder cancer. With improvements in intra- and perioperative care lower complication rates have been reported. We retrospectively evaluated our series of patients who underwent radical cystectomy for advanced bladder cancer for perioperative complications as well as operative time, postoperative hospital stay and transfusion rates.