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At least 19 recordsLinked to original sources
PubMed1985

[Total prostatocystectomy followed by enterocystoplasty in the treatment of bladder neoplasms].

Bladder replacement enterocystoplasty in the treatment of bladder tumors provides the patient with maximum mictional comfort, and better protection of the kidneys than in the case of cutaneous urinary diversion. The remote carcinological results are satisfactory at over 60% nowadays at three years, against only 20%, seventeen years ago. The functional impact on continence is very good during the day but not yet satisfactory at night, but a sometimes lengthy re-education can help. The result on the upper urinary tract is still the delicate point in this technique, with the hope of an attenuation of the renal insufficiency thanks to the setting up of an antireflux process. However, the indications for this brilliant technique may be limited by the extension of the tumor and the fragility of the diasthesis.

Acute Kidney Injury↗
PubMed1997

The bladder tumor antigen (BTA) test compared to voided urine cytology in the detection of bladder neoplasms.

PURPOSE: Tests to detect recurrent bladder neoplasms are limited and none is consistently accurate. Recent studies suggest that the bladder tumor antigen (BTA) test, an agglutination reaction for basement membrane complexes, is superior to voided urine cytology in clinical practice. We compared BTA and voided urine cytology to bladder washings and cystoscopy, emphasizing diagnostic yield among patients with causes of basement membrane complexes other than bladder cancer. MATERIALS AND METHODS: Random voided urine specimens from 67 patients with a history of bladder neoplasms were collected before cystoscopy and bladder washing. Urine also was obtained from 34 patients with inflammatory bladder conditions including 5 with a history of prostate cancer. Each urine was tested for BTA according to a commercial kit. Positive results were indicated by yellow on a test pad. Blinded to all other results, each urine and each bladder washing were examined microscopically, and a positive test had malignant/suspicious cells. Bladder biopsies were performed when endoscopic lesions were seen. Specimens were grouped into 4 categories: group 1--biopsy proved bladder neoplasm, group 2--history of bladder cancer but not biopsy proved, group 3--history of prostate cancer and group 4--no history of urological cancer. RESULTS: Voided urine cytology was positive in 54% of specimens from patients with biopsy proved bladder neoplasms compared to 29% for BTA. Relative yield for voided urine cytology versus BTA was not changed if all group 2 cases having a positive bladder washing and positive cystoscopy were assumed to have bladder cancer, nor was relative yield altered by subsequent short-term followup. Of voided urine specimens 14% from group 1 patients and 41% from group 2 patients had scant cells. Overall diagnostic yield was superior for bladder washing. False-positive BTA occurred in 7 of 34 patients with no history of urological or prostate cancer. There were no false-positive voided urine cytology interpretations in these groups. CONCLUSIONS: BTA is not superior to voided urine cytology in detecting bladder neoplasms and may be limited by false-positive reactions in patients with other causes of basement membrane complexes in urine. Voided urine samples may be limited by high frequency of hypocellularity. Of 34 patients with a hypocellular urine specimen 4 had biopsy proved bladder cancer. Bladder washing yields best results but requires instrumentation. No test, including cystoscopy, is accurate always.

Antigens, Neoplasm↗
PubMed1995

[Tissue polypeptide antigen and carcinoembryonic antigen in bladder neoplasms].

The study was designed to evaluate the effect of acetilation phenotype and smoking on the concentration of tissue polypeptide antigen (TPA) and carcinoembryonic antigen (CEA) in serum of patients with neoplasm of bladder. The study covered a group of 76 patients suffering from neoplasm of bladder and a control group composed of 46 persons. Acetylation phenotype as well as TPA and CEA concentrations in serum were determined. In addition, data on smoking habit were collected. The study indicated significant difference in TPA values in both group while there was no difference in regard to CEA values. It was found that in patients with neoplasm of bladder both acetylation phenotype and smoking affect significantly TPA concentration in serum.

Acetylation↗
PubMed1976

Immune evaluation with skin testing. A study of testicular, prostatic, and bladder neoplasms.

Fifty patients with testicular carcinoma, 45 with prostatic neoplasm, 84 with bladder carcinoma, and 13 with benign bladder papilloma were evaluated for skin reactivity to DNCB and other intradermal antigens. Correlation between pathologic staging and skin-test reactivity was sought. Reaction to DNCB among patients with testis tumors was more significantly depressed by chemotherapy than by the extent of retroperitoneal or distant metastatic disease indicating that skin testing as a means of following the course of disease or of predicting survival may be limited by alterations caused by chemotherapy. DNCB reactivity did not correlate with the prognosis for the different stages of disease, but follow-up studies of individual patient survival are needed for substantiation. Depression of DNCB reactivity exists among patients with prostatic carcinoma whether the disease is localized or widely metastatic. Only lengthy follow-up will determine if there is any correlation of reactivity with survival in individual patients. DNCB reactivity among patients with bladder tumors shows progressive reduction with increasing stage disease and lends support to the evidence suggesting immune deficiency in patients with bladder neoplasm.

Adolescent↗
PubMed1992

[Transurethral microwave radiation for bladder neoplasm].

42 patients with bladder neoplasm were treated effectively by transurethral microwave radiation in our hospital from March, 1990 to October 1991. No serious complication was found after this treatment and its long-term result was better than others. The principle of this method is to use the biological availability of microwave to heat the neoplasm and to evoke the cellular immunity system to kill tumor cells, because tumor cells is more likely to be killed than normal tissue cell by heat. Generally, tumor cells would be killed when the temperature is higher than 42 degrees C. The protection against microwave during the treatment was also discussed.

Adult↗
PubMed1999

Chromosomal imbalances in noninvasive papillary bladder neoplasms (pTa).

Almost 70% of urinary bladder neoplasms present as low-grade papillary noninvasive tumors (stage pTa). To determine which genomic alterations can occur in pTa tumors of different grades and to evaluate the prognostic significance of chromosomal imbalances, we analyzed 113 pTa tumors (40 grade 1, 55 grade 2, 18 grade 3) by comparative genomic hybridization. pTaG1 (1.9 +/- 2.0) and pTaG2 (3.1 +/- 2.9) tumors had only few genomic alterations with 9q- (44%), 9p- (36%), and -Y (21%) being most prevalent. Neither the total number of aberrations nor any individual alteration was linked to the risk of recurrence in 95 pTaG1/G2 tumors with clinical follow-up information. pTaG3 tumors were characterized by a high number of alterations (7.7 +/- 4.5; P < 0.0001 for G3 versus G2). Several chromosomal imbalances that have previously been reported to be typical for invasive bladder neoplasms were significantly more frequent in pTaG3 than in pTaG2 tumors, including 2q-, 5p+, 5q-, 6q-, 8p-, 10q-, 18q-, and 20q+. A malfunction of genes at these loci may contribute to the development of high-grade urothelial neoplasias. However, there is no evidence for a direct role of these alterations for development of invasive tumor growth.

Carcinoma in Situ↗
PubMed1998

Office evaluation and management of bladder neoplasms.

Transitional cell carcinoma is the predominant bladder neoplasm. These tumors are heterogeneous, and the risk of recurrence and progression should guide further management. When this approach is used, patients at lower risk avoid the morbidity and expense of unnecessary interventions and tests, whereas higher-risk patients are treated more aggressively. Cystoscopy and IVP remain the standard initial evaluation for patients suspected of having a bladder neoplasm. Intravesical chemotherapy and immunotherapy can be administered safely in the office to reduce disease recurrence when appropriate. The advent of lasers has permitted fulgaration of low-grade neoplasms in the office with local anesthesia. Surveillance of patients with superficial disease is still largely dependent on office-based cystoscopy. Tumor markers for the identification of recurrent disease are being investigated and may prove useful to reduce the number of negative cystoscopic evaluations performed for surveillance. Patients postcystectomy are followed up with attention to detection of recurrent disease in remnant urothelium, metastatic disease, and metabolic and nutritional disturbances, which may result from urinary diversion.

Disease Progression↗
PubMed1993

Why do most primary bladder neoplasms first appear around the ureteric orifices?

The majority of primary bladder neoplasms are known to arise within the mucosa around the ureteric orifices and bladder base. This may be due to the mucosa in this area being more susceptible to carcinogens than other areas of the bladder. Deficiency in the nucleotide salvage pathway enzyme thymidine kinase (TK), and especially its TK1 isozyme, has been shown to predispose cell lines to increased mutagenesis. Total TK and TK1 activities were measured in mucosal samples taken adjacent to the ureteric orifices and dome in 32 normal bladders and both total TK and TK1 were shown to be significantly decreased in the mucosa adjacent to the ureteric orifices. This may explain why primary bladder neoplasms occur more commonly in this site.

Adult↗
PubMedDate not supplied

Staging of urinary bladder neoplasms with MR imaging: is Gd-DTPA helpful?

This study was performed to investigate whether intravenous administration of Gd-DTPA can improve the accuracy of MR imaging in the detection and staging of bladder neoplasms. In 68 patients with suspected urinary bladder neoplasms, MR examinations were performed with T1-weighted SE sequences before and after intravenous administration of Gd-DTPA. The findings were compared with surgical staging using the TNM classification. Overall staging accuracy of contrast enhanced MR was 46%; if stages Ta-T3a were combined into one group, the accuracy was 69%. Accuracy was low (19%) in tumors without muscular bladder wall invasion (Ta). In cases with extravesical spread (greater than or equal to T3b), the accuracy of staging was 87%. Contrast enhanced MR detected extravesical extension of tumor with a sensitivity of 93% and a specificity of 95%. Contrast enhancement increased the sensitivity for detection of urinary bladder neoplasms from 70% on precontrast T1-weighted scans to 79% on postcontrast scans. In comparison with T2-weighted scans, the Gd-DTPA enhanced T1-weighted scans had better image quality and lower acquisition times.

Adult↗
PubMed2003

A population-based study of 538 patients with newly detected urinary bladder neoplasms followed during 5 years.

OBJECTIVE: To describe in detail the diagnosis and clinical course of an unselected population-based cohort of patients with newly diagnosed bladder neoplasms. MATERIAL AND METHODS: A total of 538 patients registered in the Stockholm region with newly diagnosed primary bladder neoplasms (transitional cell carcinomas) in 1995 and 1996 were followed for at least 5 years. All hospitals and urology units in the region participated in the study. Treatment and follow-up were performed according to a standard-of-care programme. Routine pathological reports were used. Original case records were scrutinized on location in 2001. In addition, a tumour bank of freshly frozen tumour tissue was established. RESULTS: The calculated 5-year cancer-specific survival rate for the 538 patients in the cohort was 78%. No patient (0/29) with TaG1 tumours showed progression or died of bladder cancer. Only 2/187 patients (1%) with stage Ta and grade 2A or 2B tumours died of bladder cancer. In contrast, after 5 years of follow-up, patients with TaG3 and T1G2B tumours had disease-specific death rates of 20% and 27%, respectively. The result of the first cystoscopy examination after the initial resection of non-invasive tumours was of prognostic value. Recurrent disease was present in 62% (248/402) of all patients with Ta and T1 tumours at diagnosis and patients with T1 tumours had recurrences earlier than those with Ta tumours. Moreover, 32% (35/110) of the patients who presented with T1 tumours at diagnosis progressed to muscle-invasive disease during the follow-up period. The overall prognosis for patients presenting with muscle-invasive tumours (T2+) was dismal, with 69% (80/116) of the patients dying of the disease. CONCLUSIONS: We analysed a population-based cohort of patients with urinary bladder neoplasms in order to establish a clearly defined and unselected clinical series, with the main aims of comparing and evaluating the clinical utility of new molecular biology techniques. In the present series, TaG1 tumours behaved benignly. The disease-specific mortality rate was low for initial TaG2 tumours, intermediate for initial TaG3 and T1 tumours and high for initial T2+ tumours.

Adult↗
PubMed1990

Gadolinium-enhanced magnetic resonance imaging in the staging of urinary bladder neoplasms.

Magnetic resonance imaging (MRI) proved to be an important diagnostic tool in the correct staging of bladder neoplasms. The advantage of multiplane imaging and high soft-tissue contrast may be extended by the use of MRI contrast media such as the gadoliniumdiethylene-triaminepentaacetic acid complex. In 60 patients with suspected or proved bladder tumors, the results of preoperative gadolinium-enhanced MRI were correlated with the histopathologic findings. The staging accuracy of infiltrating tumors was 83% and sensitivity and specificity 86% and 83%, respectively. Three tumors could only be localized after administration of gadolinium. All active tumors demonstrated significant contrast enhancement after intravenously injected gadolinium. Small papillary tumors or carcinoma in situ remain problematic to preoperative staging procedures. The advantages of gadolinium-enhanced MRI will best be employed in the exact pretherapeutic staging of infiltrative bladder neoplasms or in restaging procedures after chemotherapy and radiotherapy.

Adenocarcinoma↗
PubMed1978

Accuracy of CT staging of bladder neoplasms using the gas-filled method: report of 21 patients with surgical confirmation.

CT staging of bladder neoplasms is a highly accurate procedure with a proven accuracy rate of 81% and a potential accuracy rate probably above 90%. At this institution, CT staging has become a routine procedure for all patients with bladder neoplasms prior to surgery or radiotherapy as well as to follow the progress of therapy. Staging of bladder carcinoma is performed by cystoscopy with biopsy, intravenous urography, and CT of the gas-filled bladder. Of 21 patients with surgical confirmation, 17 were correctly staged solely from the CT image. Overstaging in the four errors resulted from confusion produced by normal contiguous extravesical structures and by tangential viewing of the normal bladder wall. Negative contrast allowed precise demonstration of the morphology of the intravesical portion of the tumor.

Aged↗