Pub Date : 2024-12-30DOI: 10.1016/j.clgc.2024.102297
Sasha E. Knowlton , Alexis C. Wardell , Angela Smith , Marc Bjurlin , Matthew Nielsen , Hung-Jui Tan
Purpose
Prehabilitation in patients with bladder cancer recommended for cystectomy has the potential to improve functional status and outcomes after cystectomy. Prior research has shown that increasing exercise preoperatively can improve strength and quality of life, but research has not yet investigated the impact on length of stay, readmissions, complications and mortality.
Methods
We compared historical controls (2021-2022) for patients with bladder cancer who underwent radical cystectomy at a major academic center to those referred for prehabilitation consultation (2023) on postoperative outcomes, namely hospital length of stay, 30 and 90 day readmission rates, postoperative complications and 90-day mortality.
Results
In total, 16 patients received prehabilitation consultation and were compared to 175 patients who did not receive consultation. There were no significant differences in hospital length of stay or 30 or 90 day readmission rates. There were differences in the incidences of some postoperative complications, although not statistically significant.
Conclusions
In this study, prehabilitation consultation did not improve length of stay, 30 or 90 day readmission rates or some postoperative complications, but was limited by low rate of referral. Further research is needed regarding the implementation of prehabilitation programs for bladder cancer.
{"title":"Association of Prehabilitation in the Precystectomy Pathway in Patients With Bladder Cancer on Postoperative Outcomes","authors":"Sasha E. Knowlton , Alexis C. Wardell , Angela Smith , Marc Bjurlin , Matthew Nielsen , Hung-Jui Tan","doi":"10.1016/j.clgc.2024.102297","DOIUrl":"10.1016/j.clgc.2024.102297","url":null,"abstract":"<div><h3>Purpose</h3><div>Prehabilitation in patients with bladder cancer recommended for cystectomy has the potential to improve functional status and outcomes after cystectomy. Prior research has shown that increasing exercise preoperatively can improve strength and quality of life, but research has not yet investigated the impact on length of stay, readmissions, complications and mortality.</div></div><div><h3>Methods</h3><div>We compared historical controls (2021-2022) for patients with bladder cancer who underwent radical cystectomy at a major academic center to those referred for prehabilitation consultation (2023) on postoperative outcomes, namely hospital length of stay, 30 and 90 day readmission rates, postoperative complications and 90-day mortality.</div></div><div><h3>Results</h3><div>In total, 16 patients received prehabilitation consultation and were compared to 175 patients who did not receive consultation. There were no significant differences in hospital length of stay or 30 or 90 day readmission rates. There were differences in the incidences of some postoperative complications, although not statistically significant.</div></div><div><h3>Conclusions</h3><div>In this study, prehabilitation consultation did not improve length of stay, 30 or 90 day readmission rates or some postoperative complications, but was limited by low rate of referral. Further research is needed regarding the implementation of prehabilitation programs for bladder cancer.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102297"},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-30DOI: 10.1016/j.clgc.2024.102294
Rafał Osiecki , Piotr Popławski , Dorota Sys , Joanna Bogusławska , Alex Białas , Marek Zawadzki , Agnieszka Piekiełko-Witkowska , Jakub Dobruch
Introduction
microRNAs (miRNAs) are small noncoding RNAs and promising cancer biomarkers. Prostate-specific antigen (PSA) testing revolutionized prostate cancer (PCa) diagnostics and monitoring. However, PSA testing also contributes to PCa overdiagnoses that are detrimental on patients’ health and may lead to overtreatment. Here, we searched for circulating miRNAs that could serve as biomarkers facilitating differentiation between PCa and benign prostate hyperplasia (BPH).
Patients
66 patients with PCa or BPH were investigated (33 patients in each cohort). Men with PCa underwent minimally invasive radical prostectomy (RP), whereas men with BPH underwent either holmium laser enucleation of the prostate (HOLEP), transurethral resection of the prostate (TURP) or simple prostatectomy.
Methods
We performed RNAseq of PCa and BPH serum samples, integrated our data with TCGA-PRAD cohort, followed by qPCR validation using independent cohort of PCa and BPH patients.
Results
RNAseq detected 295 miRNAs in serum samples, including 283 miRNAs that were both expressed by PCa tissues and present in PCa sera. 10 miRNAs were selected for qPCR validation. Expression of serum miR-1-3p, miR-96-5p, miR-148a-3p, and miR-375-3p was decreased in PCa patients when compared to BPH samples. Diagnostic accuracy of combinations of PSA with geometric means of [miR-1-3p, miR-148a-3p], [miR-148a-3p, miR-375-3p], and [miR-375-3p, miR-96-5p] exceed diagnostic value of PSA alone, with the top AUC 0.97 for [miR-1-3p, miR-148a-3p]/PSA (cut-off < 0.002893, sensitivity 95.83 %, specificity 91.30 %).
Conclusions
In conclusion, we found a miRNAs that can support PCa diagnosis.
{"title":"CIRCULATING miR-1-3p, miR-96-5p, miR-148a-3p, and miR-375-3p Support Differentiation Between Prostate Cancer and Benign Prostate Lesions","authors":"Rafał Osiecki , Piotr Popławski , Dorota Sys , Joanna Bogusławska , Alex Białas , Marek Zawadzki , Agnieszka Piekiełko-Witkowska , Jakub Dobruch","doi":"10.1016/j.clgc.2024.102294","DOIUrl":"10.1016/j.clgc.2024.102294","url":null,"abstract":"<div><h3>Introduction</h3><div>microRNAs <strong>(</strong>miRNAs) are small noncoding RNAs and promising cancer biomarkers. Prostate-specific antigen (PSA) testing revolutionized prostate cancer (PCa) diagnostics and monitoring. However, PSA testing also contributes to PCa overdiagnoses that are detrimental on patients’ health and may lead to overtreatment. Here, we searched for circulating miRNAs that could serve as biomarkers facilitating differentiation between PCa and benign prostate hyperplasia (BPH).</div></div><div><h3>Patients</h3><div>66 patients with PCa or BPH were investigated (33 patients in each cohort). Men with PCa underwent minimally invasive radical prostectomy (RP), whereas men with BPH underwent either holmium laser enucleation of the prostate (HOLEP), transurethral resection of the prostate (TURP) or simple prostatectomy.</div></div><div><h3>Methods</h3><div>We performed RNAseq of PCa and BPH serum samples, integrated our data with TCGA-PRAD cohort, followed by qPCR validation using independent cohort of PCa and BPH patients.</div></div><div><h3>Results</h3><div>RNAseq detected 295 miRNAs in serum samples, including 283 miRNAs that were both expressed by PCa tissues and present in PCa sera. 10 miRNAs were selected for qPCR validation. Expression of serum miR-1-3p, miR-96-5p, miR-148a-3p, and miR-375-3p was decreased in PCa patients when compared to BPH samples. Diagnostic accuracy of combinations of PSA with geometric means of [miR-1-3p, miR-148a-3p], [miR-148a-3p, miR-375-3p], and [miR-375-3p, miR-96-5p] exceed diagnostic value of PSA alone, with the top AUC 0.97 for [miR-1-3p, miR-148a-3p]/PSA (cut-off < 0.002893, sensitivity 95.83 %, specificity 91.30 %).</div></div><div><h3>Conclusions</h3><div>In conclusion, we found a miRNAs that can support PCa diagnosis.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102294"},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bladder cancer is common in men. The number of recurrences is one of the risk factors for progression and poor prognosis in nonmuscle invasive bladder cancer (NMIBC). We aimed to investigate whether bladder outlet obstruction (BOO) has an effect on bladder cancer recurrence in patients with nonmuscle invasive bladder cancer.
Materials and methods
Data from 207 male patients with nonmuscle invasive bladder cancer (NMIBC) diagnosed between November 2008 and March 2023, with low risk Ta Low-Grade tumors were retrospectively reviewed. Patients were divided into 2 groups as bladder outlet obstruction (n:133) and nonobstruction (n:74). We analyzed the results of the effect of obstruction on bladder cancer recurrence.
Results
Recurrence rates of patients with bladder outlet obstruction were found to be higher in Kaplan-Meier analysis. The log-rank test result of P = .034 was statistically significant at 5% significance level. Cox regression analysis revealed that bladder outlet obstruction had an increasing effect on recurrence (P = .049), while other variables (smoking, age, postmicturition residual [PMR]) did not create a significant difference in the risk of recurrence.
Conclusion
The presence of bladder outlet obstruction is a factor that increases the risk of recurrence. In bladder cancer patients, early treatment of bladder outlet obstruction will not only reduce the tumor recurrence rate but also have a positive impact on the patient's quality of life.
{"title":"Does Bladder Outlet Obstruction Releated to Recurrence In Low Risk Ta Low Grade Non Muscle Invasive Bladder Cancer?","authors":"Serhat Yentur , Yunus Emre Dusunus , Ismail Ulus , Ismail Engin Kandirali , Sergen Sahin","doi":"10.1016/j.clgc.2024.102296","DOIUrl":"10.1016/j.clgc.2024.102296","url":null,"abstract":"<div><h3>Introduction</h3><div>Bladder cancer is common in men. The number of recurrences is one of the risk factors for progression and poor prognosis in nonmuscle invasive bladder cancer (NMIBC). We aimed to investigate whether bladder outlet obstruction (BOO) has an effect on bladder cancer recurrence in patients with nonmuscle invasive bladder cancer.</div></div><div><h3>Materials and methods</h3><div>Data from 207 male patients with nonmuscle invasive bladder cancer (NMIBC) diagnosed between November 2008 and March 2023, with low risk Ta Low-Grade tumors were retrospectively reviewed. Patients were divided into 2 groups as bladder outlet obstruction (n:133) and nonobstruction (n:74). We analyzed the results of the effect of obstruction on bladder cancer recurrence.</div></div><div><h3>Results</h3><div>Recurrence rates of patients with bladder outlet obstruction were found to be higher in Kaplan-Meier analysis. The log-rank test result of <em>P</em> = .034 was statistically significant at 5% significance level. Cox regression analysis revealed that bladder outlet obstruction had an increasing effect on recurrence (<em>P</em> = .049), while other variables (smoking, age, postmicturition residual [PMR]) did not create a significant difference in the risk of recurrence.</div></div><div><h3>Conclusion</h3><div>The presence of bladder outlet obstruction is a factor that increases the risk of recurrence. In bladder cancer patients, early treatment of bladder outlet obstruction will not only reduce the tumor recurrence rate but also have a positive impact on the patient's quality of life.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102296"},"PeriodicalIF":2.3,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-12DOI: 10.1016/j.clgc.2024.102291
Maral DerSarkissian , Bhakti Arondekar , Deepshekhar Gupta , Jasmina Ivanova , Alexander Niyazov , Enrico Zanardo , Tracy Guo , Jingru Wang , Mei Sheng Duh , Stephen J. Freedland
Introduction
Racial disparities in prostate cancer (PC) are well studied among Black or African American (BAA) patients but not among Hispanics, a quickly growing US minority group. This study compared overall survival (OS) and healthcare resource utilization (HRU) by race in Medicaid-insured patients with metastatic castration-sensitive PC (mCSPC) and metastatic castration-resistant PC (mCRPC).
Materials and methods
A retrospective longitudinal cohort study of Medicaid claims was conducted to estimate racial disparities in OS (with a multivariable Cox proportional hazards model) and in HRU (with a multivariable Poisson model), adjusting for confounding by demographic and clinical characteristics. Analyses were conducted separately for mCSPC and mCRPC.
Results
The study included 1,253 mCSPC patients (BAA: N = 467; White: N = 446; Hispanic: N = 219; Other races: N = 121) and 871 mCRPC patients (BAA: N = 278; White: N = 320; Hispanic: N = 190; Other races: N = 83). Among mCSPC patients, Hispanic patients had significantly longer adjusted survival vs. White patients (hazard ratio (HR); 95% confidence interval: 0.63; 0.42-0.94). BAA and White patients had comparable survival (0.87; 0.66-1.15). BAA patients had lower rates of adjusted PC-related outpatient (OP) visits vs. White patients (incidence rate ratios [IRR] 0.72; 0.55-0.96). Among mCRPC patients, Hispanic patients had longer survival vs. White patients (HR: 0.63; 0.43-0.93). BAA and White patients had comparable survival (HR: 0.84; 0.62-1.14). BAA patients had significantly fewer PC-related OP visits vs. White patients (IRR: 0.71; 0.55-0.92) and significantly more PC-related emergency room (ER) visits (IRR: 5.41; 1.94-15.09) and inpatient admissions (IRR: 1.90; 1.10-3.25).
Conclusion
White and BAA Medicaid-insured patients with mCSPC and mCRPC had similar survival outcomes, whereas Hispanic patients, an under-studied minority group, had significantly longer survival compared to White patients. Differential HRU was observed among racial groups to different extents in the mCSPC and mCRPC cohorts. Further studies are needed to understand the relation between racial disparities in HRU and OS.
{"title":"Racial Differences in Survival and Healthcare Resource Utilization Among Medicaid-Insured Adults With Metastatic Prostate Cancer","authors":"Maral DerSarkissian , Bhakti Arondekar , Deepshekhar Gupta , Jasmina Ivanova , Alexander Niyazov , Enrico Zanardo , Tracy Guo , Jingru Wang , Mei Sheng Duh , Stephen J. Freedland","doi":"10.1016/j.clgc.2024.102291","DOIUrl":"10.1016/j.clgc.2024.102291","url":null,"abstract":"<div><h3>Introduction</h3><div>Racial disparities in prostate cancer (PC) are well studied among Black or African American (BAA) patients but not among Hispanics, a quickly growing US minority group. This study compared overall survival (OS) and healthcare resource utilization (HRU) by race in Medicaid-insured patients with metastatic castration-sensitive PC (mCSPC) and metastatic castration-resistant PC (mCRPC).</div></div><div><h3>Materials and methods</h3><div>A retrospective longitudinal cohort study of Medicaid claims was conducted to estimate racial disparities in OS (with a multivariable Cox proportional hazards model) and in HRU (with a multivariable Poisson model), adjusting for confounding by demographic and clinical characteristics. Analyses were conducted separately for mCSPC and mCRPC.</div></div><div><h3>Results</h3><div>The study included 1,253 mCSPC patients (BAA: N = 467; White: N = 446; Hispanic: N = 219; Other races: N = 121) and 871 mCRPC patients (BAA: N = 278; White: N = 320; Hispanic: N = 190; Other races: N = 83). Among mCSPC patients, Hispanic patients had significantly longer adjusted survival vs. White patients (hazard ratio (HR); 95% confidence interval: 0.63; 0.42-0.94). BAA and White patients had comparable survival (0.87; 0.66-1.15). BAA patients had lower rates of adjusted PC-related outpatient (OP) visits vs. White patients (incidence rate ratios [IRR] 0.72; 0.55-0.96). Among mCRPC patients, Hispanic patients had longer survival vs. White patients (HR: 0.63; 0.43-0.93). BAA and White patients had comparable survival (HR: 0.84; 0.62-1.14). BAA patients had significantly fewer PC-related OP visits vs. White patients (IRR: 0.71; 0.55-0.92) and significantly more PC-related emergency room (ER) visits (IRR: 5.41; 1.94-15.09) and inpatient admissions (IRR: 1.90; 1.10-3.25).</div></div><div><h3>Conclusion</h3><div>White and BAA Medicaid-insured patients with mCSPC and mCRPC had similar survival outcomes, whereas Hispanic patients, an under-studied minority group, had significantly longer survival compared to White patients. Differential HRU was observed among racial groups to different extents in the mCSPC and mCRPC cohorts. Further studies are needed to understand the relation between racial disparities in HRU and OS.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102291"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate the oncological outcomes of selective bladder preservation therapy, comprising maximal TURBT plus neoadjuvant chemotherapy (NAC) followed by 2nd-TURBT.
Methods
From 2012 to 2022, 110 localized muscle-invasive bladder cancer patients who desired bladder preservation (BP) received maximal TURBT plus NAC followed by restaging (CT scan+ 1st-TURBT) and 2nd-TURBT. Sixty-one patients with pure urothelial carcinoma of the urinary bladder (PUCUB) who achieved noninvasive downstaging (NID) after NAC and had no residual tumor at 2nd-TURBT underwent conservative treatment (BP group). Overall survival (OS), cancer-specific survival (CSS), distant metastasis-free survival (DMFS), and cystectomy and distant metastasis-free survival (CDMFS) were estimated using the Kaplan-Meyer method. Propensity score matching was performed to compare the survival outcomes of patients in the BP group with those who underwent NAC + radical cystectomy (RC) and were diagnosed with ypT1 or less (RC group, n = 42). Multivariable Cox regression (MCR) models addressed survivals according to each treatment method.
Results
In the BP group, 5-year OS, CSS, DMFS, and CDMFS were 87.4%, 93.8%, 83.1%, and 76.8%, respectively. MCR models for survival showed no differences in OS (BP: hazard ratio [HR] 1.24, P = .83), CSS (BP: HR 1.15, P = .74), and DMFS (BP: HR 1.09, P = .91) between the matched cohort.
Conclusions
BP therapy incorporating maximal TURBT plus NAC followed by 2nd-TURBT may be used as an alternative therapy to RC for selected muscle-invasive PUCUB patients. As this was a retrospective study, further randomized trials with longer follow-up are needed.
目的:评价选择性膀胱保留治疗的肿瘤预后,包括最大TURBT +新辅助化疗(NAC),再进行第二次TURBT。方法:2012 - 2022年,110例有膀胱保留(BP)需求的局限性肌浸润性膀胱癌患者行最大TURBT + NAC,再行CT扫描+第1次TURBT和第2次TURBT。61例单纯尿路上皮癌(PUCUB)患者在NAC后达到无创降期(NID),第2次turbt无肿瘤残留,接受保守治疗(BP组)。总生存期(OS)、癌症特异性生存期(CSS)、远端无转移生存期(DMFS)、膀胱切除术和远端无转移生存期(CDMFS)采用Kaplan-Meyer方法进行估计。采用倾向评分匹配来比较BP组患者与接受NAC +根治性膀胱切除术(RC)且诊断为ypT1或更少患者的生存结果(RC组,n = 42)。多变量Cox回归(MCR)模型根据每种治疗方法计算生存率。结果:BP组5年OS、CSS、DMFS、CDMFS分别为87.4%、93.8%、83.1%、76.8%。MCR生存模型显示,在匹配队列中,OS (BP:风险比[HR] 1.24, P = 0.83)、CSS (BP: HR 1.15, P = 0.74)和DMFS (BP: HR 1.09, P = 0.91)无差异。结论:对于部分肌肉侵袭性PUCUB患者,采用最大TURBT + NAC再进行第二次TURBT的BP治疗可作为RC的替代疗法。由于这是一项回顾性研究,需要进一步的随机试验和更长时间的随访。
{"title":"Feasibility and Oncological Outcome of Patients Achieving Noninvasive Downstaging After Transurethral Resection of Bladder Tumor Plus Systemic Chemotherapy for Bladder Preservation Strategy in Muscle-Invasive Bladder Cancer","authors":"Takehisa Onishi , Takuji Shibahara , Sho Sekito , Manabu Kato , Yusuke Sugino , Takahiro Inoue","doi":"10.1016/j.clgc.2024.102290","DOIUrl":"10.1016/j.clgc.2024.102290","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the oncological outcomes of selective bladder preservation therapy, comprising maximal TURBT plus neoadjuvant chemotherapy (NAC) followed by 2nd-TURBT.</div></div><div><h3>Methods</h3><div>From 2012 to 2022, 110 localized muscle-invasive bladder cancer patients who desired bladder preservation (BP) received maximal TURBT plus NAC followed by restaging (CT scan+ 1st-TURBT) and 2nd-TURBT. Sixty-one patients with pure urothelial carcinoma of the urinary bladder (PUCUB) who achieved noninvasive downstaging (NID) after NAC and had no residual tumor at 2nd-TURBT underwent conservative treatment (BP group). Overall survival (OS), cancer-specific survival (CSS), distant metastasis-free survival (DMFS), and cystectomy and distant metastasis-free survival (CDMFS) were estimated using the Kaplan-Meyer method. Propensity score matching was performed to compare the survival outcomes of patients in the BP group with those who underwent NAC + radical cystectomy (RC) and were diagnosed with ypT1 or less (RC group, n = 42). Multivariable Cox regression (MCR) models addressed survivals according to each treatment method.</div></div><div><h3>Results</h3><div>In the BP group, 5-year OS, CSS, DMFS, and CDMFS were 87.4%, 93.8%, 83.1%, and 76.8%, respectively. MCR models for survival showed no differences in OS (BP: hazard ratio [HR] 1.24, <em>P</em> = .83), CSS (BP: HR 1.15, <em>P</em> = .74), and DMFS (BP: HR 1.09, <em>P</em> = .91) between the matched cohort.</div></div><div><h3>Conclusions</h3><div>BP therapy incorporating maximal TURBT plus NAC followed by 2nd-TURBT may be used as an alternative therapy to RC for selected muscle-invasive PUCUB patients. As this was a retrospective study, further randomized trials with longer follow-up are needed.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102290"},"PeriodicalIF":2.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-03DOI: 10.1016/j.clgc.2024.102280
Sujun Han , Yining Li , Dong Chen , Zhannan Si , Tao Xu , Yiqing Du , Nianzeng Xing
Objective
The aim of our study was to characterize the spectrum of mutations in muscle-invasive bladder cancer (MIBC) in the Chinese population, identifying mutational features and exploring potential therapeutic targets.
Methods
We collected samples from 62 Chinese patients with MIBC. For each patient, tumor tissues or blood samples were collected and sequenced by whole exome sequencing.
Results
Our findings revealed the most frequently mutated genes included TP53 (41%), TTN (41%), HYDIN (34%), FRG1 (33%), ZNF717 (23%), AHNAK2 (21%), MUC4 (21%), KMT2D (20%), CDC27 (18%) and IGSF3 (18%). The most frequently mutated DNA damage repair (DDR) genes were TP53 (49%), SMARCA4 (10%), ERCC2 (8%), BRAC2 (6%), HERC2 (6%), HLTF (6%), PALB2 (6%) and POLG (6%). Additionally, our analysis confirmed an association between DDR mutations and high TMB (P = .022). Significant differences in MSI were observed between smokers and nonsmokers (P = .022), drinkers and nondrinkers (P = .018). By analyzing the data of 323 white MIBC samples from TCGA database, we identified frequently mutated driver genes in both our cohort and TCGA white cohort, including TP53, KMT2D, KMT2C, and FGFR3. Our study also revealed genes with distinct mutation frequencies compared to the TCGA white cohort, including FRG1, CDC27, IGSF3, MUC16, and ARID1A.
Conclusions
Our study provided comprehensive insights into genomic alterations in a cohort of Chinese MIBC, which could provide potential clues for clinical applications.
{"title":"Comprehensive Genetic Profile of Chinese Muscle-Invasive Bladder Cancer Cohort","authors":"Sujun Han , Yining Li , Dong Chen , Zhannan Si , Tao Xu , Yiqing Du , Nianzeng Xing","doi":"10.1016/j.clgc.2024.102280","DOIUrl":"10.1016/j.clgc.2024.102280","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of our study was to characterize the spectrum of mutations in muscle-invasive bladder cancer (MIBC) in the Chinese population, identifying mutational features and exploring potential therapeutic targets.</div></div><div><h3>Methods</h3><div>We collected samples from 62 Chinese patients with MIBC. For each patient, tumor tissues or blood samples were collected and sequenced by whole exome sequencing.</div></div><div><h3>Results</h3><div>Our findings revealed the most frequently mutated genes included <em>TP53</em> (41%), <em>TTN</em> (41%), <em>HYDIN</em> (34%), <em>FRG1</em> (33%), <em>ZNF717</em> (23%), <em>AHNAK2</em> (21%), <em>MUC4</em> (21%), <em>KMT2D</em> (20%), <em>CDC27</em> (18%) and <em>IGSF3</em> (18%). The most frequently mutated DNA damage repair (DDR) genes were <em>TP53</em> (49%), <em>SMARCA4</em> (10%), <em>ERCC2</em> (8%), <em>BRAC2</em> (6%), <em>HERC2</em> (6%), <em>HLTF</em> (6%), <em>PALB2</em> (6%) and <em>POLG</em> (6%). Additionally, our analysis confirmed an association between DDR mutations and high TMB (<em>P</em> = .022). Significant differences in MSI were observed between smokers and nonsmokers (<em>P</em> = .022), drinkers and nondrinkers (<em>P</em> = .018). By analyzing the data of 323 white MIBC samples from TCGA database, we identified frequently mutated driver genes in both our cohort and TCGA white cohort, including <em>TP53, KMT2D, KMT2C</em>, and <em>FGFR3</em>. Our study also revealed genes with distinct mutation frequencies compared to the TCGA white cohort, including <em>FRG1, CDC27, IGSF3, MUC16</em>, and <em>ARID1A</em>.</div></div><div><h3>Conclusions</h3><div>Our study provided comprehensive insights into genomic alterations in a cohort of Chinese MIBC, which could provide potential clues for clinical applications.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102280"},"PeriodicalIF":2.3,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-14DOI: 10.1016/j.clgc.2024.102266
Xinting Zhang , Chaoran Ban , Yupeng Chen , Sheng Zhang , Hong Chen
Background
ALK-rearranged renal cell carcinoma (ALK-RCC) is a rare malignant epithelial tumor of the kidney. ALK-RCC has recently been listed in the 5th edition of the World Health Organization (WHO) Classification of Tumors as a molecularly defined RCC subtype.
Patients and Methods
We describe retrospectively 3 ALK-RCCs from clinicopathologic, immunohistochemical (IHC), and molecular genetic aspects, along with postoperative adjuvant therapeutic regime and prognosis-related information.
Results
Two patients were female and one patient was male. Patients’ age ranged from 38 to 64 years (mean 51.3 years). Tumor size ranged from 32 mm to 89 mm (mean 55.3 mm, median 45 mm). All 3 tumors were diffusely positive for ALK protein. ALK fusion partners (TPM3 for case 1, VCL for case 2, and EML4 for case 3) were identified by next-generation sequencing. Histomorphologically, the tumors were heterogeneous, showing tubulocystic, papillary, trabecular, and solid growth patterns and polygonal to rhabdoid neoplastic cells. Cases 1 and 3 set in a mucinous background. Upon quantification of tumor-associated CD8+ T cells by IHC, tumor immune phenotypes (IPs) were defined as immune-desert in case 1, immune-inflamed in case 2, and immune-excluded in case 3. Follow-up for the 3 patients ranged from 18 to 129 months (mean, 59.3 months). Case 1 refused postoperative adjuvant therapy and was alive without disease at 129-month follow-up. Case 2 was postoperatively treated with a PD-1-targeted monoclonal antibody, being alive without disease at 18-month follow-up. Case 3 showed retroperitoneal lymph nodes and lung metastases at initial diagnosis. She was postoperatively treated with a PD-1-targeted monoclonal antibody, with no benefit suggested by computed tomography on follow-up.
Conclusion
ALK-RCC represents a distinct entity with clinicopathological, genetic, and immunophenotypic heterogeneity. ALK IHC analysis during primary screening may aid diagnosis in difficult cases. For progressive ALK-RCCs, postoperative adjuvant immunotherapy may be best selected according to IP features. Patients with immune-excluded phenotypes may not benefit from immunotherapy.
{"title":"ALK-Rearranged Renal Cell Carcinoma: A Study of Three Cases With Clinicopathologic Features and Effect of Postoperative Adjuvant Immunotherapy","authors":"Xinting Zhang , Chaoran Ban , Yupeng Chen , Sheng Zhang , Hong Chen","doi":"10.1016/j.clgc.2024.102266","DOIUrl":"10.1016/j.clgc.2024.102266","url":null,"abstract":"<div><h3>Background</h3><div>ALK-rearranged renal cell carcinoma (ALK-RCC) is a rare malignant epithelial tumor of the kidney. ALK-RCC has recently been listed in the 5<sup>th</sup> edition of the World Health Organization (WHO) Classification of Tumors as a molecularly defined RCC subtype.</div></div><div><h3>Patients and Methods</h3><div>We describe retrospectively 3 ALK-RCCs from clinicopathologic, immunohistochemical (IHC), and molecular genetic aspects, along with postoperative adjuvant therapeutic regime and prognosis-related information.</div></div><div><h3>Results</h3><div>Two patients were female and one patient was male. Patients’ age ranged from 38 to 64 years (mean 51.3 years). Tumor size ranged from 32 mm to 89 mm (mean 55.3 mm, median 45 mm). All 3 tumors were diffusely positive for ALK protein. ALK fusion partners (TPM3 for case 1, VCL for case 2, and EML4 for case 3) were identified by next-generation sequencing. Histomorphologically, the tumors were heterogeneous, showing tubulocystic, papillary, trabecular, and solid growth patterns and polygonal to rhabdoid neoplastic cells. Cases 1 and 3 set in a mucinous background. Upon quantification of tumor-associated CD8<sup>+</sup> T cells by IHC, tumor immune phenotypes (IPs) were defined as immune-desert in case 1, immune-inflamed in case 2, and immune-excluded in case 3. Follow-up for the 3 patients ranged from 18 to 129 months (mean, 59.3 months). Case 1 refused postoperative adjuvant therapy and was alive without disease at 129-month follow-up. Case 2 was postoperatively treated with a PD-1-targeted monoclonal antibody, being alive without disease at 18-month follow-up. Case 3 showed retroperitoneal lymph nodes and lung metastases at initial diagnosis. She was postoperatively treated with a PD-1-targeted monoclonal antibody, with no benefit suggested by computed tomography on follow-up.</div></div><div><h3>Conclusion</h3><div>ALK-RCC represents a distinct entity with clinicopathological, genetic, and immunophenotypic heterogeneity. ALK IHC analysis during primary screening may aid diagnosis in difficult cases. For progressive ALK-RCCs, postoperative adjuvant immunotherapy may be best selected according to IP features. Patients with immune-excluded phenotypes may not benefit from immunotherapy.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102266"},"PeriodicalIF":2.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-13DOI: 10.1016/j.clgc.2024.102268
Sahil D. Doshi , Andrea Knezevic , Carlene Gonzalez , Patricia Fischer , Robert Goodman , Suzanne Gornell , Sweta Patel , Cindy Puzio , Alisa Ritea , Chung-Han Lee , Lauren Evans , Martin H. Voss , Robert J. Motzer , Ritesh R. Kotecha
Purpose
Clinical trials enable renal cell carcinoma (RCC) patients to receive promising investigational agents, yet access may be limited. Telemedicine (TM) is an increasingly utilized platform that can expand access, but perspectives on its use in clinical trial care are unknown.
Patients and Methods
A prospective study was conducted between Jan 2023 – Oct 2023 at Memorial Sloan Kettering Cancer Center. RCC patients enrolled on therapeutic clinical trials who had prior TM visits were eligible. Surveys in English were distributed to patients, treating clinical trial nurses (CTNs), and oncology providers engaged in clinical trials.
Results
39 patients, 7 CTNs, and 15 oncology providers were included in our analysis. Regarding clinical trial care, 26 patients (67%) preferred in-person, 4 (11%) preferred TM, and 9 (22%) had no preference. However, 25 patients (64%) reported TM provided an equal quality of care, and 38 (97%) reported a positive or neutral experience. Conversely, 7 CTNs (100%) and 11 providers (73%) preferred in-person care while 4 (27%) indicated no preference. Most, including 6 CTNs (86%) and 13 providers (87%), reported that TM quality of care was inferior. However, most, including 7 CTNs (100%) and 14 providers (93%), reported a positive experience with TM.
Conclusions
In this study, one third of RCC participants preferred TM or had no preference, and a majority felt TM delivered equal quality of care. Providers, however, preferred in-person visits and reported inferior quality of care with TM. These findings warrant further evaluation of safety and feasibility to optimize TM integration for clinical trial care delivery.
{"title":"Prospective Study of Patient, Nursing, and Oncology Provider Perspectives on Telemedicine Visits for Renal Cell Carcinoma Clinical Trials","authors":"Sahil D. Doshi , Andrea Knezevic , Carlene Gonzalez , Patricia Fischer , Robert Goodman , Suzanne Gornell , Sweta Patel , Cindy Puzio , Alisa Ritea , Chung-Han Lee , Lauren Evans , Martin H. Voss , Robert J. Motzer , Ritesh R. Kotecha","doi":"10.1016/j.clgc.2024.102268","DOIUrl":"10.1016/j.clgc.2024.102268","url":null,"abstract":"<div><h3>Purpose</h3><div>Clinical trials enable renal cell carcinoma (RCC) patients to receive promising investigational agents, yet access may be limited. Telemedicine (TM) is an increasingly utilized platform that can expand access, but perspectives on its use in clinical trial care are unknown.</div></div><div><h3>Patients and Methods</h3><div>A prospective study was conducted between Jan 2023 – Oct 2023 at Memorial Sloan Kettering Cancer Center. RCC patients enrolled on therapeutic clinical trials who had prior TM visits were eligible. Surveys in English were distributed to patients, treating clinical trial nurses (CTNs), and oncology providers engaged in clinical trials.</div></div><div><h3>Results</h3><div>39 patients, 7 CTNs, and 15 oncology providers were included in our analysis. Regarding clinical trial care, 26 patients (67%) preferred in-person, 4 (11%) preferred TM, and 9 (22%) had no preference. However, 25 patients (64%) reported TM provided an equal quality of care, and 38 (97%) reported a positive or neutral experience. Conversely, 7 CTNs (100%) and 11 providers (73%) preferred in-person care while 4 (27%) indicated no preference. Most, including 6 CTNs (86%) and 13 providers (87%), reported that TM quality of care was inferior. However, most, including 7 CTNs (100%) and 14 providers (93%), reported a positive experience with TM.</div></div><div><h3>Conclusions</h3><div>In this study, one third of RCC participants preferred TM or had no preference, and a majority felt TM delivered equal quality of care. Providers, however, preferred in-person visits and reported inferior quality of care with TM. These findings warrant further evaluation of safety and feasibility to optimize TM integration for clinical trial care delivery.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102268"},"PeriodicalIF":2.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}