Abstract:
INTRODUCTION:Clinical T1 (cT1) bladder cancer is associated with high rates of recurrence, upstaging, and progression. Guidelines recommend that these patients be treated with adjuvant intravesical Bacillus Calmette-Guérin immunotherapy (BCG) or upfront radical cystectomy (RC). We analyzed the National Cancer Database (NCDB) to identify demographic and clinical determinants of guideline-based treatment (GBT) and RC. PATIENTS AND METHODS:We identified 47,694 patients in the NCDB with cT1 bladder cancer diagnosed in 2004-2013. Those who did not receive any treatment or underwent primary chemotherapy were excluded. Mixed effects logistic regression adjusted for facility-level variation was used to identify factors associated with receipt of GBT. RESULTS:The median age of the cohort was 72 years (interquartile range, 63-79). Of the patients, 22.4% were female, 5.1% were African American, and 2.7% had variant histology. Nearly one-third of patients received GBT: 11,453 (24%) were initially treated with BCG and 3320 (7%) were initially treated with RC. Recent year of diagnosis (odds ratio [OR], 1.67; 95% confidence interval [CI], 1.52-1.85; P < .001), treatment at an academic center (OR, 2.42; 95% CI, 2.27-2.59; P < .001), and private insurance status (OR, 1.41; 95% CI, 1.19-1.66; P < .001) were associated with increased odds of GBT. Of patients who received GBT, variant histology (OR, 5.89; 95% CI, 4.65-7.47; P < .001), and recent year of diagnosis (OR, 1.89; 95% CI, 1.50-2.39; P < .001) were associated with greater odds of RC. CONCLUSION:There is low treatment-guideline compliance for patients with cT1 disease. However, there appears to be a temporal trend toward increased use of GBT. Efforts should be made to understand why many cT1 bladder cancer patients do not receive GBT.
journal_name
Clin Genitourin Cancerjournal_title
Clinical genitourinary cancerauthors
Balakrishnan AS,Washington SL 3rd,Meng MV,Porten SPdoi
10.1016/j.clgc.2019.01.007subject
Has Abstractpub_date
2019-06-01 00:00:00pages
e461-e471issue
3eissn
1558-7673issn
1938-0682pii
S1558-7673(19)30018-7journal_volume
17pub_type
杂志文章abstract:INTRODUCTION:Oxidative stress has been found to be associated with the progression of prostate cancer (PCa); however, human studies which identify differential roles of each oxidation pathway in PCa progression are lacking. We aimed to identify which oxidative stress markers, specifically lipid and global oxidation and...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.09.014
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Piritrexim is reported to have a response rate of 38% in patients with chemotherapy-naive disease and 23% for second-line therapy after chemotherapy failure. We report the results of a multiinstitutional, open-label, 2-stage, phase II study that further evaluates oral piritrexim in patients with urothelial c...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.3816/CGC.2008.n.005
更新日期:2008-03-01 00:00:00
abstract::An interesting and reciprocal association between the metabolic syndrome and prostate cancer has been identified. Metabolic alterations, such as hyperinsulinemia, increased levels of insulin growth factor-1, and insulin resistance could be on the basis of development and progression of many tumors, including prostate ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clgc.2013.04.009
更新日期:2013-09-01 00:00:00
abstract::Patients receiving androgen deprivation therapy are associated with increasing loss of bone mineral density (BMD) and higher risk of skeletal-related events. We reviewed and analyzed the influence of diphosphonates on BMD change. A systemic literature research was conducted in PubMed and related bibliographies. The fo...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.clgc.2018.07.016
更新日期:2018-12-01 00:00:00
abstract:INTRODUCTION:Estimation of prognosis is patients undergoing radical cystectomy is often unreliable, as occult disease remains undetected by conventional diagnostic tools. The purpose of this study was to evaluate the feasibility and the clinical significance of a polymerase chain reaction assay to detect cytokeratin 7 ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.11.005
更新日期:2017-08-01 00:00:00
abstract:INTRODUCTION:The objective of this study was to examine the overall survival (OS) in patients diagnosed with high-grade T1 non-muscle-invasive bladder cancer treated with early radical cystectomy versus local treatment of the primary tumor, defined as endoscopic management with or without intravesical chemotherapy or i...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2020.03.013
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Among men with high-risk non-metastatic castrate-resistant prostate cancer (nmCRPC), we used network meta-analysis to compare non-steroidal anti-androgens (NSAAs) and stratified class-level meta-analysis to identify subgroups with particular benefit from NSAAs with androgen deprivation therapy versus androge...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clgc.2020.02.005
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:There are little data on the outcomes and tolerance, as well as the impact on the CD4 counts, of human immunodeficiency virus (HIV)-positive patients with prostate cancer who undergo high-dose external beam radiotherapy. MATERIALS AND METHODS:We identified 15 HIV-positive patients with prostate cancer who...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2013.07.008
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Neutrophil-to-lymphocyte ratio (NLR) might reflect an increased neutrophilic inflammatory response, and urothelial tumors with squamous-cell features (SqD) have been linked to inflammation. We hypothesized that NLR could be prognostic in these patients. PATIENTS AND METHODS:In patients with SqD muscle-invas...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2017.01.024
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Everolimus is an approved agent for use after disease progression with vascular endothelial growth factor receptor-tyrosine kinase inhibitors (VEGFR-TKIs) in patients with metastatic renal cell carcinoma. With recently published trials showing efficacy of nivolumab and cabozantinib in the second-line therapy...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2015.12.011
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:The objective of this study was to determine the outcomes of young adults with kidney cancer treated during the targeted therapy era and evaluate the impact of young age on survival. MATERIALS AND METHODS:We reviewed the records from 445 patients younger than 55 years with kidney cancer at a single institut...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.09.012
更新日期:2020-04-01 00:00:00
abstract:INTRODUCTION/BACKGROUND:Targeted therapy has become the mainstay of treatment for mRCC. The efficacy of this therapy in the older population is poorly understood. PATIENTS AND METHODS:Data from patients with mRCC treated with first-line anti-VEGF therapy were collected through the International mRCC Database Consortiu...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2014.02.009
更新日期:2014-10-01 00:00:00
abstract::Nephrectomy is the reference-standard treatment for renal-cell carcinoma (RCC). For patients with unresectable disease, tumor may be shrunk by using chemotherapy, thereby permitting surgical resection, which can be curative. We provided neoadjuvant cabozantinib, the preferred tyrosine kinase inhibitor for advanced RCC...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clgc.2020.04.003
更新日期:2020-12-01 00:00:00
abstract::Testicular germ cell tumors (TGCTs) represent the most common solid tumors among men aged 15 to 34 years. Fortunately, recent advances have made testicular cancer a highly curable disease. Despite the high cure rates, there are still several areas in testis cancer care where treatment decisions are controversial and g...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clgc.2018.10.007
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Preliminary studies suggested that selected drug-related toxicities of sunitinib may correlate with a better prognosis. PATIENTS AND METHODS:From January 2006 through December 2015, we retrospectively analyzed data of 145 patients with metastatic renal cell carcinoma treated with sunitinib as a first-line t...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2019.10.003
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Level 1 evidence has demonstrated increased overall survival with cisplatin-based neoadjuvant chemotherapy for patients with muscle-invasive urothelial cancer. Usage remains low, however, in part because neoadjuvant chemotherapy will not be effective for every patient. To identify the patients most likely to...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2016.03.006
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Therapeutic options for renal cell cancer are inadequate. Depsipeptide is a histone deacetylase inhibitor with promising preclinical and early clinical activity. PATIENTS AND METHODS:Patients with refractory renal cell cancer with normal organ function and no history of significant cardiovascular disease we...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.3816/CGC.2006.n.018
更新日期:2006-06-01 00:00:00
abstract::Effective options are lacking for progressive castration-refractory prostate cancer (CRPC) after conventional chemotherapy. Sunitinib is an orally administered multitargeted tyrosine kinase inhibitor that is approved multinationally for renal cell carcinoma and gastrointestinal stromal tumors. A phase II trial was con...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.3816/CGC.2008.n.023
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:To prospectively assess the ideal dosing and the value of fluorescent sentinel lymph node (LN) detection with indocyanine green (ICG) for the detection of LN metastases in intermediate- and high-risk patients undergoing robot-assisted prostatectomy and extended pelvic LN dissection (ePLND). PATIENTS AND METH...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.10.014
更新日期:2017-08-01 00:00:00
abstract:INTRODUCTION:The aims of the present study were to compare the clinicopathologic characteristics between type 1 and type 2 papillary renal cell carcinoma (pRCC) and to evaluate the effect of the subclassification of pRCC on the oncologic outcomes after surgery. MATERIALS AND METHODS:The records of 274 patients with pR...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.07.020
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:Second-line systemic therapy for advanced urothelial carcinoma (UC) has substantial unmet needs, and current agents show dismal activity. Second-line trials of metastatic UC have used response rate (RR) and median progression-free survival (PFS) as primary endpoints, which may not reflect durable benefits. A ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,meta分析
doi:10.1016/j.clgc.2013.09.002
更新日期:2014-04-01 00:00:00
abstract::Epigenetic alterations, including methylation of key tumor suppressor genes, may play a role in the progression of prostate cancer to a castration-refractory state. Azacitidine, an agent approved for the treatment of myelodysplastic syndromes, appears to exert its antineoplastic effects partly by hypomethylating DNA t...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.3816/CGC.2007.n.036
更新日期:2007-12-01 00:00:00
abstract:INTRODUCTION/BACKGROUND:The increase of prostate cancer diagnosis after the introduction of prostate-specific antigen (PSA) screening resulted in overtreatment of patients with low risk tumors. The histological Gleason score (GS) revised in 2005 by the International Society of Urological Pathology (ISUP) is currently t...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2014.01.009
更新日期:2014-10-01 00:00:00
abstract:PURPOSE:To determine the therapeutic value of lymph node dissection (LND) during cytoreductive nephrectomy (CN) and assess predictors of cancer-specific survival (CSS) in metastatic renal-cell carcinoma. PATIENTS AND METHODS:We identified 293 consecutive patients treated with CN at 4 academic institutions from March 2...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2017.10.004
更新日期:2018-04-01 00:00:00
abstract::Active surveillance (AS) has been claimed to avoid overtreatment of prostate cancer (PCa). It remains unclear which patients may benefit from AS. One way to clarify this is to improve the definition of insignificant PCa. PSA and Gleason score--the basic instruments used to select patients for AS--suffer from systemati...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clgc.2015.06.001
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Partial nephrectomy (PN) is the standard treatment for localized renal tumors. Laparoscopic PN (LPN) after selective embolization of tumor (LPNE) in a hybrid operating room has been developed to make LPN easier and safer. The aim of this study was to compare outcomes of LPNE and robot-assisted PN (RAPN). PA...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2018.07.005
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Tumor location in bladder neck has reported to be a prognostic factor for non-muscle-invasive bladder cancer (NMIBC). We investigated the impact of bladder neck involvement (BNI) on recurrence in NMIBC using time-dependent covariate analysis. PATIENTS AND METHODS:We enrolled 585 Japanese patients who underw...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.10.005
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:The prognostic value of molecular markers in renal cell carcinoma has been investigated in several studies. Although their value is still not confirmed, various proteins are important. We describe the effect on long-term survival of the status of the von Hippel-Lindau (VHL) hypoxia-inducible factor 1-α (HIF1...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2017.05.016
更新日期:2017-12-01 00:00:00
abstract::Targeted therapy has changed the treatment of metastatic renal cell carcinoma (mRCC). However, it is unclear if patients need to start systemic therapy immediately or if treatment can be deferred. Identification of the appropriate time to discontinue therapy is also uncertain. We reviewed treatment guidelines and tria...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clgc.2012.06.002
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to analyze trends of bladder cancer (BC) stages and incidence in Europe and the United States (US). MATERIALS AND METHODS:Tumor stages after radical cystectomy were assessed in a monocentric cohort from 2006 to 2016. BC incidence was assessed between 2004 and 2014 based on the ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.10.008
更新日期:2020-06-01 00:00:00