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Association of Prehabilitation in the Precystectomy Pathway in Patients With Bladder Cancer on Postoperative Outcomes
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-12-30 DOI: 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.
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引用次数: 0
CIRCULATING miR-1-3p, miR-96-5p, miR-148a-3p, and miR-375-3p Support Differentiation Between Prostate Cancer and Benign Prostate Lesions
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-12-30 DOI: 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 ,&nbsp;Piotr Popławski ,&nbsp;Dorota Sys ,&nbsp;Joanna Bogusławska ,&nbsp;Alex Białas ,&nbsp;Marek Zawadzki ,&nbsp;Agnieszka Piekiełko-Witkowska ,&nbsp;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 &lt; 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}
引用次数: 0
Adrenal Metastasis Ablation in Oligometastatic Renal Cell Carcinoma: A Case Series
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-12-28 DOI: 10.1016/j.clgc.2024.102295
Anna Ochsner , Kamil Malshy , Borivoj Golijanin , Anthony Mega , Scott Collins , Aaron Maxwell , Sari Khaleel , Bryan Jay , Dragan Golijanin
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引用次数: 0
Does Bladder Outlet Obstruction Releated to Recurrence In Low Risk Ta Low Grade Non Muscle Invasive Bladder Cancer?
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-12-28 DOI: 10.1016/j.clgc.2024.102296
Serhat Yentur , Yunus Emre Dusunus , Ismail Ulus , Ismail Engin Kandirali , Sergen Sahin

Introduction

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 ,&nbsp;Yunus Emre Dusunus ,&nbsp;Ismail Ulus ,&nbsp;Ismail Engin Kandirali ,&nbsp;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}
引用次数: 0
Racial Differences in Survival and Healthcare Resource Utilization Among Medicaid-Insured Adults With Metastatic Prostate Cancer 有医疗补助的成年转移性前列腺癌患者的生存和医疗资源利用的种族差异
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-12-12 DOI: 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.
引言:前列腺癌(PC)的种族差异在黑人或非裔美国人(BAA)患者中得到了很好的研究,但在西班牙裔美国人(一个快速增长的美国少数民族)中却没有得到很好的研究。本研究比较了医疗保险患者转移性去势敏感PC (mCSPC)和转移性去势抵抗PC (mCRPC)的总生存期(OS)和医疗资源利用率(HRU)的种族差异。材料和方法:对医疗补助申请进行了回顾性纵向队列研究,以估计OS(多变量Cox比例风险模型)和HRU(多变量泊松模型)的种族差异,并对人口统计学和临床特征的混杂因素进行了调整。分别对mCSPC和mccrpc进行分析。结果:研究纳入1253例mCSPC患者(BAA: N = 467;白色:N = 446;西班牙裔:N = 219;其他种族:N = 121)和871例mCRPC患者(BAA: N = 278;白色:N = 320;西班牙裔:N = 190;其他种族:N = 83)。在mCSPC患者中,西班牙裔患者的调整生存期明显长于白人患者(风险比(HR);95%置信区间:0.63;0.42 - -0.94)。BAA和White患者的生存率相当(0.87;0.66 - -1.15)。与白人患者相比,BAA患者的调整后pc相关门诊(OP)就诊率较低(发病率比[IRR] 0.72;0.55 - -0.96)。在mCRPC患者中,西班牙裔患者比白人患者生存时间更长(HR: 0.63;0.43 - -0.93)。BAA和White患者的生存率相当(HR: 0.84;0.62 - -1.14)。与白人患者相比,BAA患者与pc相关的OP就诊次数显著减少(IRR: 0.71;0.55-0.92),与个人电脑相关的急诊室(ER)就诊次数显著增加(IRR: 5.41;1.94-15.09)和住院人数(IRR: 1.90;1.10 - -3.25)。结论:白人和BAA医疗保险患者的mCSPC和mCRPC具有相似的生存结果,而西班牙裔患者(一个未充分研究的少数群体)的生存时间明显长于白人患者。在mCSPC和mccrpc队列中,不同种族的HRU存在不同程度的差异。HRU和OS的种族差异之间的关系有待进一步研究。
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引用次数: 0
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 肌侵性膀胱癌经尿道膀胱肿瘤切除加全身化疗后膀胱保留策略实现无创降期的可行性及肿瘤预后。
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-12-10 DOI: 10.1016/j.clgc.2024.102290
Takehisa Onishi , Takuji Shibahara , Sho Sekito , Manabu Kato , Yusuke Sugino , Takahiro Inoue

Objective

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 ,&nbsp;Takuji Shibahara ,&nbsp;Sho Sekito ,&nbsp;Manabu Kato ,&nbsp;Yusuke Sugino ,&nbsp;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}
引用次数: 0
Comprehensive Genetic Profile of Chinese Muscle-Invasive Bladder Cancer Cohort 中国肌肉浸润性膀胱癌队列的综合遗传图谱。
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-12-03 DOI: 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.
目的:我们研究的目的是表征中国人群中肌肉浸润性膀胱癌(MIBC)的突变谱,识别突变特征并探索潜在的治疗靶点。方法:我们收集了62例中国MIBC患者的样本。对每位患者采集肿瘤组织或血液样本,采用全外显子组测序。结果:最常发生突变的基因包括TP53(41%)、TTN(41%)、HYDIN(34%)、FRG1(33%)、ZNF717(23%)、AHNAK2(21%)、MUC4(21%)、KMT2D(20%)、CDC27(18%)和IGSF3(18%)。最常发生突变的DNA损伤修复(DDR)基因为TP53(49%)、SMARCA4(10%)、ERCC2(8%)、BRAC2(6%)、HERC2(6%)、HLTF(6%)、PALB2(6%)和POLG(6%)。此外,我们的分析证实了DDR突变与高TMB之间的关联(P = 0.022)。吸烟与不吸烟、饮酒者与不饮酒者的MSI差异有统计学意义(P = 0.022)。通过分析来自TCGA数据库的323例白人MIBC样本数据,我们在我们的队列和TCGA白人队列中都发现了频繁突变的驱动基因,包括TP53、KMT2D、KMT2C和FGFR3。我们的研究还揭示了与TCGA白人队列相比具有不同突变频率的基因,包括FRG1, CDC27, IGSF3, MUC16和ARID1A。结论:我们的研究提供了对中国MIBC队列基因组改变的全面了解,为临床应用提供了潜在的线索。
{"title":"Comprehensive Genetic Profile of Chinese Muscle-Invasive Bladder Cancer Cohort","authors":"Sujun Han ,&nbsp;Yining Li ,&nbsp;Dong Chen ,&nbsp;Zhannan Si ,&nbsp;Tao Xu ,&nbsp;Yiqing Du ,&nbsp;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}
引用次数: 0
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-11-18 DOI: 10.1016/j.clgc.2024.102247
{"title":"","authors":"","doi":"10.1016/j.clgc.2024.102247","DOIUrl":"10.1016/j.clgc.2024.102247","url":null,"abstract":"","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102247"},"PeriodicalIF":2.3,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678038","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}
引用次数: 0
ALK-Rearranged Renal Cell Carcinoma: A Study of Three Cases With Clinicopathologic Features and Effect of Postoperative Adjuvant Immunotherapy alk重排肾细胞癌3例临床病理特征及术后辅助免疫治疗效果分析
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-11-14 DOI: 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.
dalk -重排肾细胞癌(ALK-RCC)是一种罕见的肾脏恶性上皮肿瘤。ALK-RCC最近被世界卫生组织(WHO)肿瘤分类第5版列为分子定义的RCC亚型。患者和方法我们从临床病理、免疫组织化学(IHC)和分子遗传学方面,以及术后辅助治疗方案和预后相关信息,回顾性地描述了3例alk - rcc。结果女性2例,男性1例。患者年龄38 ~ 64岁,平均51.3岁。肿瘤大小从32mm到89mm不等(平均55.3 mm,中位45mm)。3例肿瘤均呈弥漫性ALK蛋白阳性。通过下一代测序确定ALK融合伙伴(病例1为TPM3,病例2为VCL,病例3为EML4)。在组织形态学上,肿瘤是异质性的,表现为管状、乳头状、小梁状和实体生长模式,以及多边形到横纹肌样的肿瘤细胞。病例1和病例3为粘液性背景。通过免疫组化(IHC)对肿瘤相关CD8+ T细胞进行定量分析,将病例1的肿瘤免疫表型(IPs)定义为免疫荒漠型,病例2为免疫炎症型,病例3为免疫排斥型。3例患者随访18 ~ 129个月,平均59.3个月。病例1拒绝术后辅助治疗,随访129个月无疾病存活。病例2术后接受pd -1靶向单克隆抗体治疗,随访18个月无疾病存活。病例3初诊时表现为腹膜后淋巴结及肺转移。她术后接受pd -1靶向单克隆抗体治疗,随访时计算机断层扫描没有显示任何益处。结论alk - rcc是一种独特的实体,具有临床病理、遗传和免疫表型异质性。初筛时的ALK IHC分析有助于疑难病例的诊断。对于进展性alk - rcc,可根据IP特征选择术后辅助免疫治疗。具有免疫排斥表型的患者可能无法从免疫治疗中获益。
{"title":"ALK-Rearranged Renal Cell Carcinoma: A Study of Three Cases With Clinicopathologic Features and Effect of Postoperative Adjuvant Immunotherapy","authors":"Xinting Zhang ,&nbsp;Chaoran Ban ,&nbsp;Yupeng Chen ,&nbsp;Sheng Zhang ,&nbsp;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}
引用次数: 0
Prospective Study of Patient, Nursing, and Oncology Provider Perspectives on Telemedicine Visits for Renal Cell Carcinoma Clinical Trials 肾细胞癌临床试验中远程医疗访问的患者、护理和肿瘤提供者观点的前瞻性研究
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-11-13 DOI: 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.
临床试验使肾细胞癌(RCC)患者能够接受有希望的研究药物,但准入可能受到限制。远程医疗(TM)是一个越来越多的利用平台,可以扩大访问,但其在临床试验护理中的应用前景尚不清楚。患者和方法一项前瞻性研究于2023年1月至2023年10月在纪念斯隆凯特琳癌症中心进行。参加治疗性临床试验的RCC患者均有TM就诊史。英文调查问卷分发给患者、临床试验护理护士(ctn)和从事临床试验的肿瘤学提供者。结果39名患者、7名ctn和15名肿瘤提供者被纳入我们的分析。在临床试验护理方面,26例(67%)患者倾向于面对面护理,4例(11%)患者倾向于TM, 9例(22%)患者无偏好。然而,25名患者(64%)报告TM提供了相同的护理质量,38名患者(97%)报告了积极或中性的体验。相反,7名ctn(100%)和11名提供者(73%)倾向于亲自护理,而4名(27%)表示没有偏好。大多数,包括6名ctn(86%)和13名提供者(87%),报告TM护理质量较差。然而,大多数人,包括7名ctn(100%)和14名提供者(93%),报告了对TM的积极体验。结论在本研究中,三分之一的RCC参与者倾向于TM或没有偏好,大多数人认为TM提供了同等质量的护理。然而,提供者更倾向于亲自就诊,并报告TM的护理质量较差。这些发现为进一步评估将TM整合到临床试验中的安全性和可行性提供了依据。
{"title":"Prospective Study of Patient, Nursing, and Oncology Provider Perspectives on Telemedicine Visits for Renal Cell Carcinoma Clinical Trials","authors":"Sahil D. Doshi ,&nbsp;Andrea Knezevic ,&nbsp;Carlene Gonzalez ,&nbsp;Patricia Fischer ,&nbsp;Robert Goodman ,&nbsp;Suzanne Gornell ,&nbsp;Sweta Patel ,&nbsp;Cindy Puzio ,&nbsp;Alisa Ritea ,&nbsp;Chung-Han Lee ,&nbsp;Lauren Evans ,&nbsp;Martin H. Voss ,&nbsp;Robert J. Motzer ,&nbsp;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}
引用次数: 0
期刊
Clinical genitourinary cancer
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