Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0178874 (tumor progression)
 40,807 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

After reviewing the data on intravesical therapy for treatment or prophylaxis of urothelial tumors of the bladder, several statements seem appropriate. Bladder tumors confined to the mucosa and lamina propria represent a heterogeneous group. Papillary, grade I, noninvasive tumors (Ta) may recur frequently, subjecting the patient to numerous endoscopic procedures but these patients very infrequently have tumor progression. Treatment should not be overly aggressive and result in significant morbidity. These patients should be informed that they have a choice and may decide that they would rather take the risk of subsequent endoscopic procedures and avoid the regular visits to the office for intravesical drug instillation. High grade tumors, be they confined to the mucosa or invade the lamina propria, place the patient at significant risk of recurrence and local progression and thus require careful monitoring (Jordan et al, 1987; Torti et al, 1987). Intravesical therapy should be seriously considered, either to eradicate residual malignant cells or prevent a subsequent tumor. Thiotepa is moderately effective in delaying the development of subsequent low grade tumors when used for prophylaxis. Toxicity with Thiotepa is low and the drug is not expensive. Mitomycin C is effective for the treatment of residual tumor as well as when instilled regularly following complete transurethral resection. Side effects are primarily confined to chemical cystitis with an occasional patient having a rash. BCG may be the most effective intravesical agent in the treatment of carcinoma in situ. Randomized trials comparing BCG and chemotherapy are in progress and are eagerly awaited. The frequency and severity of local and systemic side effects are somewhat greater than with chemotherapeutic agents.
 ...
PMID:Should all superficial bladder tumors be treated with intravesical therapy? 267 6

Cancer of the urinary bladder is the fifth most common cancer in men and the second most urological malignancy in Western society [17], with an incidence rate per year of 29.8/100,000 males. Bladder tumors are distinguished as either invasive or superficial: invasive tumors are generally associated with poor prognosis, while 20-30% of superficial carcinomas recur and progress to become invasive and metastic [26, 27]. The most common prognostic factors for classification of urothelial cancer are staging and grading, which are based on morphological criteria. In the past decade, however, other criteria have been developed as a possible prognostic aid to better disease management, such as expression of specific cell surface antigens, DNA content, chromosomal aberrations, gene rearrangements and point mutations [26, 7]. Since most tumors of the bladder are carcinomas and are associated with dedifferentiation and high metastatic capability, we investigated whether reduced expression of so-called differentiation factors in combination with increased cell motility might be correlated with tumor progression.
 ...
PMID:Prognostic factors for bladder cancer. 748 38

We have induced tumors by feeding guinea pigs with a diet containing 25 or 30% dried bracken fern for 100 or 150 days. A high incidence of bladder tumors was obtained. All but one animal had preneoplastic or neoplastic lesions after 4 months; after one year, 24 or 25 exposed animals had carcinoma. Bladder tumors obtained were essentially pure transitional cell carcinomas, although 4 cases (7% of the exposed animals and 10% of the 39 transitional cell carcinoma observed) showed areas of focal squamous metaplasia. Immunohistological detection of cytokeratins 10, 13, and 18 confirmed the transitional nature of these tumors. Tumor development can be followed by ultrasonography and cytology. Bladder tumors arose through several steps. Dysplasia and preneoplastic hyperplasia were seen after 4 months and papillary carcinomas appeared after 6 months, whereas muscle-invasive carcinomas required 1 year. Thus this model reproduces the full spectrum of preneoplastic and neoplastic bladder lesions observed in humans. Interestingly, when tumors were induced in older guinea pigs, none of them progressed to a muscle-invasive stage. This phenomenon should provide the opportunity to study the molecular mechanisms associated with these two different growth patterns, a major issue in understanding human bladder tumor progression.
 ...
PMID:Bracken fern-induced bladder tumors in guinea pigs. A model for human neoplasia. 886 88

We reviewed the clinical records of 37 patients who had been treated with neoadjuvant chemotherapy + radical cystectomy and bilateral lymphadenectomy. The patients were followed until they died and the survivors have a follow-up of 43 to 68 months. There were 28 deaths: 20 patients died within 24 months following treatment and 6 died after two years. Five patients were not submitted to surgery due to rapid tumor progression while they were receiving cytostatic therapy. Bladder removal was ruled out in 5 patients with important loco-regional spread demonstrated on laparotomy. The bladder was preserved in 12 patients. Eight patients had cRC: 1 died from causes unrelated to the disease; 1 was lost to follow-up at 16 months, with no evidence of bladder cancer or metastasis; 3 developed distant metastasis, and 3 are alive and tumor-free. One pCR died with evidence of metastasis; 1 cRP required radical cystectomy and died from metastasis. Of the patients classified as sRC, 1 subsequently underwent radical cystectomy and is disease-free and the other died from metastasis. Fifteen patients underwent radical cystectomy: 3 are alive and tumor-free, 2 were lost to follow-up and 10 patients died (3 from causes unrelated to the disease and 7 died from the disease). Lymph node invasion was observed in 54%. Metastasis was observed in 57.3% and local recurrence in 17.3%. The preoperative chemotherapy schedule under study did not prolong the metastasis-free period in this group of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Infiltrating transitional carcinoma of the bladder. Preoperative or neoadjuvant chemotherapy. Our experience with 38 patients with long-term follow-up]. 802 28

Bladder tumors were induced by N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) in five Beagles and four mongrel dogs. The tumors were observed for long periods and the tumor progression was traced using histopathological mapping. The results indicated (1) that low-dose BBN over a long period induced multiple low-grade (G1-2) and low-stage (pTa-1) papillary tumors, resembling superficial bladder cancer in humans; (2) that high-dose BBN over a short period induced high-grade (G2-3) and high-stage (pT3b) nonpapillary tumors and carcinoma in situ (CIS) resembling invasive cancer and CIS in humans; (3) that beagle dogs required longer periods and higher total doses of BBN as compared with mongrel dogs; (4) that the tumors induced by low-dose BBN in beagles were observed without BBN as long as the animals lived, and neither increasing numbers of tumors nor malignant features such as deep infiltration and metastasis was observed; and (5) that low-dose BBN seems to induce mild dysplasia, which is followed by Brunn's nest-like proliferation in the lamina propria and nodular change, eventually leading to the development of papillary noninvasive transitional cell carcinoma (TCC); and that high-dose BBN seems to induce severe dysplasia which leads to CIS and nonpapillary invasive TCC. These results may contribute to clarifying the natural history of human bladder cancer.
 ...
PMID:A histopathological mapping study of the urinary bladder tumors induced by N-butyl-N-(4-hydroxybutyl)nitrosamine in dogs. 937 11

Carcinoma of the bladder is the most prevalent cancer in Egypt and in most African countries. At the National Cancer Institute (NCI), Cairo, it constitutes 30.3% of all cancers. The median age at diagnosis is 46 years, with a male preponderance of 5:1. Whether in Egypt or other African countries such as Sudan, Kenya, Uganda, Gold Coast, and Senegal, it is mostly of the squamous cell type, and arises in a background of schistosomiasis or bilharziasis. Tumors are usually advanced at the time of presentation. Bladder carcinogenesis is probably related to bacterial and human papilloma virus (HPV) infections, usually associated with bilharzial infestation. Management is mainly surgery, with 5-year survival rates after radical cystectomy increasing from 35% in the 1970s to 48% in the 1990s. The addition of adjuvant and neoadjuvant radiotherapy and chemotherapy to surgery since 1976 significantly improved both disease-free and overall survival rates. Molecular genetic studies concerning potential prognostic markers, tumorigenesis, and tumor progression in bilharzial bladder cancer are limited. However, a comprehensive detailed analysis of these factors is underway. Bilharzial bladder cancer is a preventable malignant disease. Primary prevention could be possible if the parasite is eliminated nationwide. Chemoprevention using retinoids or cyclooxygenase 2 (COX-2) inhibitors is a possible alternative. Semin Oncol 28:174-178.
 ...
PMID:Bladder cancer in Africa: update. 1130 80

Bladder carcinomas frequently show extensive deletions of chromosomes 9p and/or 9q, potentially including the loci of the Fanconi anemia (FA) genes FANCC and FANCG. FA is a rare recessive disease due to defects in anyone of 13 FANC genes manifesting with genetic instability and increased risk of neoplasia. FA cells are hypersensitive towards DNA crosslinking agents such as mitomycin C and cisplatin that are commonly employed in the chemotherapy of bladder cancers. These observations suggest the possibility of disruption of the FA/BRCA DNA repair pathway in bladder tumors. However, mutations in FANCC or FANCG could not be detected in any of 23 bladder carcinoma cell lines and ten surgical tumor specimens by LOH analysis or by FANCD2 immunoblotting assessing proficiency of the pathway. Only a single cell line, BFTC909, proved defective for FANCD2 monoubiquitination and was highly sensitive towards mitomycin C. This increased sensitivity was restored specifically by transfer of the FANCF gene. Sequencing of FANCF in BFTC909 failed to identify mutations, but methylation of cytosine residues in the FANCF promoter region was demonstrated by methylation-specific PCR, HpaII restriction and bisulfite DNA sequencing. Methylation-specific PCR uncovered only a single instance of FANCF promoter hypermethylation in surgical specimens of further 41 bladder carcinomas. These low proportions suggest that in contrast to other types of tumors silencing of FANCF is a rare event in bladder cancer and that an intact FA/BRCA pathway might be advantageous for tumor progression.
 ...
PMID:Disruption of the FA/BRCA pathway in bladder cancer. 1800 Mar 67

The aim of this study was to determine the clinical outcome of a bladder-sparing approach using chemoradiotherapy (CRT) for T1G3 bladder cancer. Between May 2000 and August 2007, 11 patients with T1G3 bladder cancer and who were negative for macroscopic residual tumor were treated by CRT after transurethral resection of bladder tumor (TUR-Bt). Pelvic irradiation was given at a dose of 40 Gy in 4 weeks. Intra-arterial administration of cisplatin and systemic administration of methotrexate were carried out in the first and third weeks of radiotherapy. One month after CRT, response was evaluated by restaging TUR-Bt. For persistent tumor after CRT or tumor recurrence, patients received additional treatment. Median follow-up was 21.2 months. Complete response was achieved in 10 of 11 patients (90.9%). Local recurrence for the entire group of 11 patients was 22.1% at both 2 and 5 years. Tumor progression was 0% at 5 years. Disease-specific survival rates were 100% at 5 years. All of survivors retained functioning bladders. Bladder preservation by CRT is a curative treatment option for T1G3 bladder cancer and a reasonable alternative to intravesical treatment or early cystectomy.
 ...
PMID:Clinical outcome of chemoradiotherapy for T1G3 bladder cancer. 1878 98

Prognosis of urinary bladder urothelial carcinomas may be challenging; many tumors with similar histopathologic features show significantly different clinical outcomes. CSE1L, the chromosome segregation 1-like protein, is both a cytoplasmic and nuclear protein. We investigated the cytoplasmic/nuclear expression pattern of CSE1L to determine its potential prognostic significance. In immunohistochemical analysis, nonneoplastic urothelium showed faint CSE1L staining, whereas all tumors in the bladder cancer specimens had significant staining for CSE1L (100%, or 38/38). CSE1L cytoplasmic/nuclear staining was defined based on relative staining intensity. A total of 20 (52.6%) of 38 cancer specimens had strong nuclear CSE1L staining, and 44.7.3% (17/38) of the samples had strong cytoplasmic CSE1L staining. Bladder urothelial carcinomas with high CSE1L nuclear staining had a significantly lower overall survival rate (log-rank test, P = .011). CSE1L expression was not correlated with tumor stage, likely reflecting the faultiness of current urothelial carcinoma evaluation methods. Our results suggest that nuclear CSE1L may play an oncogenic role in bladder tumor progression and that immunohistochemical staining of nuclear CSE1L may be useful for the prognosis of bladder urothelial carcinomas.
 ...
PMID:The prognostic significance of nuclear CSE1L in urinary bladder urothelial carcinomas. 2247 51

Urinary bladder cancer is a common malignancy in industrialized countries. More than 90% of bladder cancer originates in the transitional cells. Bladder transitional cancer prognosis is, according to the most recent definition related to the level of tumor infiltration, characterized by two main phenotypes, Non Muscle Invasive Bladder Transitional Cancer (NMIBC) and Muscle Invasive Bladder Transitional Cancer (MIBC). The genetic profile and the clinical course of the two subtypes are completely different, however among NMIBC the prognosis is not completely predictable, since 20% of the cases experience a relapse, even in the form of MIBC. It has recently been reported that the chromosomal region 12q13-15, containing crucial cancer genes such as MDM2, CDK4, GLI and an entire cluster of HOX genes, is amplified in bladder cancer. HOX genes codify for transcriptionl factor, involved in embryonal development and cancer progression, with main nuclear expression. Particularly it was also described the strong involvement of HOX B13 in several tumors of urogenital system. In this study we have been investigated, by immunohistochemisty and quantitative Real Time PCR, the HOX B13 expression in bladder cancer evolution and progression, evaluating its ability to discriminate between NMIBC and MBCI phenotypes. Cytoplasmic HOX B13 delocalization significantly relates with muscle invasion (p 0.004). In addition in the series of NMIBC nuclear HOX B13 expression loss is significantly associated to shorter disease free survival (p-value=0.038) defining a potential prognostic role. Overexpression of HOX B13 in more aggressive phenotype is also demonstrate at gene level by quantitative RT-PCR. The de-regulation and delocalization of HOX B13 in urinary bladder cancer supports again the important role of HOX genes in tumor evolution and represents a starting point to establish an integrated analysis, in which HOX genes represent important prognostic and predictive markers for bladder cancer.
 ...
PMID:Deregulation of HOX B13 expression in urinary bladder cancer progression. 2327 38


1 2 Next >>