Predictive factors for recurrence progression and cancer specific survival in high-risk bladder cancer.

Abstract:

PURPOSE OF REVIEW:Despite standard treatment with transurethral resection (TUR) and adjuvant Bacillus Calmette-Guérin (BCG), a large percentage of high-risk bladder cancer (HRBC) recur, and some progress. On the basis of review of the current guidelines and literature, we have developed actualized clinical and molecular prognostic factors of recurrence, progression and cancer specific survival (CSS) in patients with HRBC. RECENT FINDINGS:A Medline search was conducted to identify the current literature updating the most important clinic and pathological predictive factors published in the last years. Also, there have been reviewed the new molecular markers that can assess prognosis and BCG response. SUMMARY:Despite different methodological bias, as short follow-up, a small number of patients and a different definition of prognostic factors, increased evidence supports sex, age, grade, stage, multifocality, history of previous recurrences, carcinoma in situ in the prostatic urethra and early recurrence as prognostic factors for recurrence, progression and CSS in nonmuscle invasive bladder cancer. Also lymphovascular invasion in TUR and new molecular markers (galectin-3, profilin-1, and combination of markers) are increasingly useful in predicting prognosis and BCG response. Moreover, there is enough evidence to consider the implementation of new specific risk tables for patients treated with BCG. In cases with poor prognostic factors after TUR in HRBC early cystectomy should be considered.

journal_name

Curr Opin Urol

authors

Rodríguez Faba O,Palou J

doi

10.1097/MOU.0b013e328356ac20

subject

Has Abstract

pub_date

2012-09-01 00:00:00

pages

415-20

issue

5

eissn

0963-0643

issn

1473-6586

journal_volume

22

pub_type

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