Management of bladder cancer in older patients: Position paper of a SIOG Task Force

Publication date: Available online 10 February 2020Source: Journal of Geriatric OncologyAuthor(s): Nicolas Mottet, Maria J. Ribal, Helen Boyle, Maria De Santis, Philippe Caillet, Ananya Choudhury, Tullika Garg, Matthew Nielsen, Patrick Wüthrich, Kilian M. Gust, Shahrokh F. Shariat, Georgios GakisAbstractMedian age at bladder cancer (BC) diagnosis is older than for other major tumours. Age should not determine treatment, and patients should be fully involved in decisions. Patients should be screened with Mini-Cog™ for cognitive impairment and the G8 to ascertain need for comprehensive geriatric assessment. In non-muscle invasive disease, older adult patients should have standard therapy. Age does not contraindicate intravesical therapy. Independent of age and fitness, patients with muscle-invasive BC should have at least cross-sectional imaging. Data suggest extensive undertreatment in older adult patients, leading to poor outcomes. Standard treatment for a fit patient differs between countries. Radical cystectomy and trimodality therapy are first-line options. Radical cystectomy patients should be referred to an experienced centre and prehabilitation is mandatory. Older adult patients should be considered for neoadjuvant and adjuvant therapy, according to guidelines. In urinary diversion, avoiding bowel surgery for reconstruction of the lower urinary tract significantly reduces complications. If a patient is unfit for or refuses standard treatment, RT alone, or TUR...
Source: Journal of Geriatric Oncology - Category: Cancer & Oncology Source Type: research

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Conclusion: We report the efficacy and safety of IFX maintained for up to 12 years in psoriasis patients. The long-term use of IFX was associated with a high BMI confirming the critical role of weight-based dosing for this drug. PMID: 32231699 [PubMed]
Source: Dermatology Research and Practice - Category: Dermatology Tags: Dermatol Res Pract Source Type: research
reda Roberta Ottria Due to the involvement of the endocannabinoid system (ECS) in cancer onset and progression and the less studied connection between ECS and bladder cancer, here an evaluation of the ECS modifications associated with bladder cancer is reported. Urine samples were collected from healthy volunteers and patients with bladder cancer at different grades. Endocannabinoids (ECs) and N-acylethanolamides (NAEs) were quantified by HPLC-MS/MS and results normalized for creatinine content. An increase in the urine concentrations of four ECs and NAEs analyzed was observed with a statistically significant increas...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
Bladder neoplasms and NF-κB: an unfathomed association. Expert Rev Mol Diagn. 2020 Mar 31;: Authors: Jebaraj Walter CE, Durairajan S, Periyandavan K, Priya Doss C G, Davis G DJ, Vasanthi A HR, Johnson T, Zayed H Abstract Introduction: Bladder cancer is the second most common genitourinary tract cancer and is often recurrent and/or chemoresistant after tumor resection. Cigarette smoking, exposure to aromatic amines, and chronic infection/inflammation are bladder cancer risk factors. NF-κB is a transcription factor that plays a critical role in normal physiology and bladder cancer. Bladder ca...
Source: Expert Review of Molecular Diagnostics - Category: Laboratory Medicine Tags: Expert Rev Mol Diagn Source Type: research
Researchers reported updated findings of infigratinib in upper tract urothelial carcinoma and urothelial carcinoma of the bladder, supporting the development of phase III studies in this setting.
Source: CancerNetwork - Category: Cancer & Oncology Authors: Source Type: news
AbstractPurposeTo report the incidence of urinary tract malignancies (UTM) and to compare the diagnostic accuracy of cytology with cystoscopy, renal ultrasound (US) and computed tomography (CT) in patients with hematuria.MethodsA retrospective analysis was conducted of patients who underwent cystoscopy, cytology, US and CT for hematuria between 2011 and 2017. Age, gender, BMI, smoking status, and results of further diagnostic interventions including transurethral resection of the bladder (TURB), ureterorenoscopy (URS), renal biopsy and imaging were extracted from medical charts. Logistic regression to identify risk factors...
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
ConclusionsThe VI-RADS score can provide a good predictive ability for detecting the muscle invasiveness of primary bladder cancer with VI-RADS 3 or VI-RADS 4 as the cutoff value.Key Points• VI-RADS score has high sensitivity and specificity for predicting muscle invasion.• The diagnostic efficiencies of VI-RADS 3 and VI-RADS 4 as the cutoff value are similar.• VI-RADS score could be used for detecting muscle invasion of bladder cancer in clinical practice.
Source: European Radiology - Category: Radiology Source Type: research
This study aims to evaluate which urine fraction is preferred for BC diagnosis using methylation markers: full void urine, urine pellet or supernatant. Methylation levels of nine markers were determined in the three urine fractions and correlated with their respective tumor tissues in BC patients and compared to controls. For all markers and marker panel GHSR/MAL, diagnostic performance was determined by calculating the area under the curve (AUC) of the respective receiver operating characteristic curves. For most of the markers, there was a significant correlation between the methylation levels in each of the urine fracti...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
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Source: Current Opinion in Urology - Category: Urology & Nephrology Tags: BLADDER CANCER: Edited by Juan Palou and Óscar Rodríguez Faba Source Type: research
Purpose of review Given the worldwide shortage of Bacillus Calmette–Guérin (BCG), we review the efficacy of alternative BCG application schedules, doses or strains and intravesical chemotherapy in patients with nonmuscle-invasive bladder cancer (NMIBC). Recent findings Modifying BCG schedules by reducing the dose is preferable to reducing the frequency of BCG that increases recurrence rates and should be avoided if possible. Changing the BCG substrain represents a reasonable option, as current evidence does not suggest different oncological outcomes with specific BCG substrains. Mitomycin C (MMC) alone is...
Source: Current Opinion in Urology - Category: Urology & Nephrology Tags: BLADDER CANCER: Edited by Juan Palou and Óscar Rodríguez Faba Source Type: research
Purpose of review To summarize the current knowledge on the role of repeated transurethral resection of the bladder (re-TURBT) at the light of recently published trials that indicate the possibility to safely avoid it in well selected patients. Recent findings Recently published trials tried to predict the histology of re-TURBT with the aim of improving patients’ selection for this procedure. The en bloc resection technique seems to improve the quality of the resection, thereby diminishing and even eliminating the risk of upstaging and the residual disease rate after TURBT. Moreover, the introduction of multipar...
Source: Current Opinion in Urology - Category: Urology & Nephrology Tags: BLADDER CANCER: Edited by Juan Palou and Óscar Rodríguez Faba Source Type: research
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