Radical cystectomy with bilateral pelvic lymph node dissection is the standard of care for patients with clinically localized muscle-invasive bladder cancer. Survival after radical cystectomy is associated with final pathologic staging. Survival decreases with increasing pT stage because of the presence of occult micrometastases, indicating the need for systemic chemotherapy. Systemic chemotherapy is delivered as either neoadjuvant therapy preoperatively, or as adjuvant therapy postoperatively. This article reviews the evidence for neoadjuvant and adjuvant chemotherapy for the treatment of muscle-invasive bladder and upper tract urothelial cancer and offers recommendations based on these data and recently updated clinical guidelines.
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PD-L1 expression in high-risk non-muscle invasive bladder cancer is not a biomarker of response to BCG.
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Department of Urology, Erasmus University Medical Center, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, Room Be-304, 3015 GD, Rotterdam, The Netherlands.
Purpose: Up to 50% of high-risk non-muscle invasive bladder cancer (HR-NMIBC) patients fail Bacillus Calmette-Guérin (BCG) treatment, resulting in a high risk of progression and poor clinical outcomes. Biomarkers that predict outcomes after BCG are lacking. The antitumor effects of BCG are driven by a cytotoxic T cell response, which may be controlled by immune checkpoint proteins like Programmed Death Ligand 1 (PD-L1).
View Article and Find Full Text PDFIntroduction: Laser ablation using a 980-nm wavelength diode laser, which is a new-generation laser, for recurrent bladder cancer is known to have a lower incidence of complications and recurrence than conventional transurethral resection of bladder tumor surgery. This is the first study to report the use of 980-nm diode laser ablation for recurrent non-muscle-invasive bladder cancer in Japan.
Case Presentation: A 73-year-old man underwent transurethral laser ablation for the treatment of recurrent non-muscle-invasive bladder cancer.
Introduction: Intravesical Bacillus Calmette-Guérin immunotherapy is generally a safe treatment for non-muscle-invasive bladder cancer but sometimes causes complications.
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Real-world data on utilization of neoadjuvant chemotherapy for muscle invasive bladder cancer: impact on surgical complications and oncological efficacy.
Acta Oncol
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Institute of Clinical Medicine, UIT- The Arctic University, Tromsø, Norway; Department of Urology, University Hospital of North Norway, Tromsø, Norway.
Background And Purpose: Recommended treatment of urothelial muscle-invasive bladder cancer (MIBC) is cisplatin-based neoadjuvant chemotherapy (NAC) followed by cystectomy, but there are challenges with low utilization of NAC. We aimed to evaluate the utilization of NAC, perioperative complications and oncological efficacy in a real-world setting.
Patients And Methods: All patients operated with radical cystectomy at the University Hospital of North Norway during 2011-2021 for MIBC were included.
Diffusion-weighted MRI-Derived ADC and tumor volume as predictive imaging markers for neoadjuvant chemotherapy response in muscle-invasive bladder cancer.
BMC Med Imaging
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Urology and Nephrology Research Center, Research Institute for Urology and Nephrology, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, No.103, Shahid Jafari St., Pasdaran Ave., Tehran, 1666677951, Iran.
Background: This prospective study tested the hypothesis that the apparent diffusion coefficient (ADC) value and tumor volume (TV) measured in diffusion-weighted magnetic resonance imaging (DW-MRI) before, during, and after the treatment are quantitative imaging markers to assess tumor response in muscle-invasive bladder cancer (MIBC) patients undergoing neoadjuvant chemotherapy (NAC).
Methods: Multi-parametric MRI was prospectively done for MIBC patients at 3 time points. Pre-treatment ADC value, pre-treatment TV, as well as, percent of changes (ΔADC%, and ΔTV%) in these parameters at mid- and post-treatment relative to baseline were calculated and compared between the patients with and without clinical complete response (CR).
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