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3. Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer: impact on prognosis?

Author

Beijert, Irene J., Hentschel, Anouk E., Bründl, Johannes, Compérat, Eva M., Plass, Karin, Rodríguez, Oscar, Subiela Henríquez, Jose D., Hernández, Virginia, de la Peña, Enrique, Alemany, Isabel, Turturica, Diana, Pisano, Francesca, Soria, Francesco, Čapoun, Otakar, Bauerová, Lenka, Pešl, Michael, Bruins, H. Maxim, Runneboom, Willemien, Herdegen, Sonja, Breyer, Johannes, Brisuda, Antonin, Calatrava, Ana, Rubio-Briones, José, Seles, Maximilian, Mannweiler, Sebastian, Bosschieter, Judith, Kusuma, Venkata R. M., Ashabere, David, Huebner, Nicolai, Cotte, Juliette, Contieri, Roberto, Mertens, Laura S., Claps, Francesco, Masson-Lecomte, Alexandra, Liedberg, Fredrik, Cohen, Daniel, Lunelli, Luca, Cussenot, Olivier, El Sheikh, Soha, Volanis, Dimitrios, Côté, Jean-François, Rouprêt, Morgan, Haitel, Andrea, Shariat, Shahrokh F., Mostafid, A. Hugh, Nieuwenhuijzen, Jakko A., Zigeuner, Richard, Dominguez-Escrig, Jose L., Hacek, Jaromir, Zlotta, Alexandre R., Burger, Maximilian, Evert, Matthias, Hulsbergen-van de Kaa, Christina A., van der Heijden, Antoine G., Kiemeney, Lambertus A. L. M., Soukup, Viktor, Molinaro, Luca, Gontero, Paolo, Llorente, Carlos, Algaba, Ferran, Palou, Joan, N’Dow, James, Ribal, Maria J., van der Kwast, Theo H., Babjuk, Marko, Sylvester, Richard J., and van Rhijn, Bas W. G.

Published
2024
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8. Consistencies in Follow-up After Radical Cystectomy for Bladder Cancer: A Framework Based on Expert Practices Collaboratively Developed by the European Association of Urology Bladder Cancer Guideline Panels

Author

Mertens, Laura S., Bruins, Harman Maxim, Contieri, Roberto, Babjuk, Marek, Rai, Bhavan P., Puig, Albert Carrión, Escrig, Jose Luis Dominguez, Gontero, Paolo, van der Heijden, Antoine G., Liedberg, Fredrik, Martini, Alberto, Masson-Lecomte, Alexandra, Meijer, Richard P., Mostafid, Hugh, Neuzillet, Yann, Pradere, Benjamin, Redlef, John, van Rhijn, Bas W.G., Rouanne, Matthieu, Rouprêt, Morgan, Sæbjørnsen, Sæbjørn, Seisen, Thomas, Shariat, Shahrokh F., Soria, Francesco, Soukup, Viktor, Thalmann, George, Xylinas, Evanguelos, Mariappan, Paramananthan, and Alfred Witjes, J.

Published
2024
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12. International Opinions on Grading of Urothelial Carcinoma: A Survey Among European Association of Urology and International Society of Urological Pathology Members

Author

Irene J. Beijert, Liang Cheng, Fredrik Liedberg, Karin Plass, Sean R. Williamson, Paolo Gontero, Maria J. Ribal, Marko Babjuk, Peter C. Black, Ashish M. Kamat, Ferran Algaba, David M. Berman, Arndt Hartmann, Alexandra Masson-Lecomte, Morgan Rouprêt, Antonio Lopez-Beltran, Hemamali Samaratunga, Shahrokh F. Shariat, A. Hugh Mostafid, Murali Varma, Steven Shen, Maximilian Burger, Toyonori Tsuzuki, Joan Palou, Eva M. Compérat, Richard J. Sylvester, Theo H. van der Kwast, Bas W.G. van Rhijn, and Michelle R. Downes

Subjects
Bladder, Cancer, Grading, Survey, European Association of Urology, International Society of Urological Pathology, Diseases of the genitourinary system. Urology, RC870-923, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Background: Grade of non–muscle-invasive bladder cancer (NMIBC) is an important prognostic factor for progression. Currently, two World Health Organization (WHO) classification systems (WHO1973, categories: grade 1–3, and WHO2004 categories: papillary urothelial neoplasm of low malignant potential [PUNLMP], low-grade [LG], high-grade [HG] carcinoma) are used. Objective: To ask the European Association of Urology (EAU) and International Society of Urological Pathology (ISUP) members regarding their current practice and preferences of grading systems. Design, setting, and participants: A web-based, anonymous questionnaire with ten questions on grading of NMIBC was created. The members of EAU and ISUP were invited to complete an online survey by the end of 2021. Thirteen experts had previously answered the same questions. Outcome measurements and statistical analysis: The submitted answers from 214 ISUP members, 191 EAU members, and 13 experts were analyzed. Results and limitations: Currently, 53% use only the WHO2004 system and 40% use both systems. According to most respondents, PUNLMP is a rare diagnosis with management similar to Ta-LG carcinoma. The majority (72%) would consider reverting back to WHO1973 if grading criteria were more detailed. Separate reporting of WHO1973-G3 within WHO2004-HG would influence clinical decisions for Ta and/or T1 tumors according the majority (55%). Most respondents preferred a two-tier (41%) or a three-tier (41%) grading system. The current WHO2004 grading system is supported by a minority (20%), whereas nearly half (48%) supported a hybrid three- or four-tier grading system composed of both WHO1973 and WHO2004. The survey results of the experts were comparable with ISUP and EAU respondents. Conclusions: Both the WHO1973 and the WHO2004 grading system are still widely used. Even though opinions on the future of bladder cancer grading were strongly divided, there was limited support for WHO1973 and WHO2004 in their current formats, while the hybrid (three-tier) grading system with LG, HG-G2, and HG-G3 as categories could be considered the most promising alternative. Patient summary: Grading of non–muscle-invasive bladder cancer (NMIBC) is a matter of ongoing debate and lacks international consensus. We surveyed urologists and pathologists of European Association of Urology and International Society of Urological Pathology on their preferences regarding NMIBC grading to generate a multidisciplinary dialogue. Both the “old” World Health Organization (WHO) 1973 and the “new” WHO2004 grading schemes are still used widely. However, continuation of both the WHO1973 and the WHO2004 system showed limited support, while a hybrid grading system composed of both the WHO1973 and the WHO2004 classification system may be considered a promising alternative.

Published
2023
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13. Transcriptomic Profiling of Upper Tract Urothelial Carcinoma: Bladder Cancer Consensus Classification Relevance, Molecular Heterogeneity, and Differential Immune Signatures

Author

Fontugne, Jacqueline, Xylinas, Evanguelos, Krucker, Clémentine, Dixon, Victoria, Groeneveld, Clarice S., Pinar, Ugo, Califano, Gianluigi, Bucau, Margot, Verine, Jérôme, Desgrandchamps, François, Hermieu, Jean-François, Radvanyi, François, Allory, Yves, and Masson-Lecomte, Alexandra

Published
2023
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14. Bladder Recurrence Following Upper Tract Surgery for Urothelial Carcinoma: A Contemporary Review of Risk Factors and Management Strategies

Author

Laura S. Mertens, Vidit Sharma, Surena F. Matin, Stephen A. Boorjian, R. Houston Thompson, Bas W.G. van Rhijn, and Alexandra Masson-Lecomte

Subjects
Urothelial cancer, Upper tract, Bladder recurrence, Nephroureterectomy, Ureterorenoscopy, Intravesical instillation, Diseases of the genitourinary system. Urology, RC870-923, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Context: Bladder recurrences have been reported in 22–47% of patients after surgery for upper urinary tract urothelial carcinoma (UTUC). This collaborative review focuses on risk factors for and treatment strategies to reduce bladder recurrences after upper tract surgery for UTUC. Objective: To review the current evidence on risk factors and treatment strategies for intravesical recurrence (IVR) after upper tract surgery for UTUC. Evidence acquisition: This collaborative review is based on a literature search of PubMed/Medline, Embase, Cochrane Library, and currently available guidelines on UTUC. Relevant papers on bladder recurrence (etiology, risk factors, and management) after upper tract surgery were selected. Special attention has been paid to (1) the genetic background of bladder recurrences, (2) bladder recurrences after ureterorenoscopy (URS) with or without a biopsy, and (3) postoperative or adjuvant intravesical instillations. The literature search was performed in September 2022. Evidence synthesis: Recent evidence supports the hypothesis that bladder recurrences after upper tract surgery for UTUC are often clonally related. Clinicopathologic risk factors (patient, tumor, and treatment related) have been identified for bladder recurrences after UTUC diagnosis. Specifically, the use of diagnostic ureteroscopy before radical nephroureterectomy (RNU) is associated with an increased risk of bladder recurrences. Further, a recent retrospective study suggests that performing a biopsy during ureteroscopy may further worsen IVR (no URS: 15.0%; URS without biopsy: 18.4%; URS with biopsy: 21.9%). Meanwhile, a single postoperative instillation of intravesical chemotherapy has been shown to be associated with a reduced bladder recurrence risk after RNU compared with no instillation (hazard ratio 0.51, 95% confidence interval 0.32–0.82). Currently, there are no data on the value of a single postoperative intravesical instillation after ureteroscopy. Conclusions: Although based on limited retrospective data, performing URS seems to be associated with a higher risk of bladder recurrences. Future studies are warranted to assess the influence of other surgical factors as well as the role of URS biopsy or immediate postoperative intravesical chemotherapy after URS for UTUC. Patient summary: In this paper, we review recent findings on bladder recurrences after upper tract surgery for upper urinary tract urothelial carcinoma.

Published
2023
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15. European Association of Urology Guidelines on Upper Urinary Tract Urothelial Carcinoma: 2023 Update

Author

Rouprêt, Morgan, Seisen, Thomas, Birtle, Alison J., Capoun, Otakar, Compérat, Eva M., Dominguez-Escrig, José L., Gürses Andersson, Irene, Liedberg, Fredrik, Mariappan, Paramananthan, Hugh Mostafid, A., Pradere, Benjamin, van Rhijn, Bas W.G., Shariat, Shahrokh F., Rai, Bhavan P., Soria, Francesco, Soukup, Viktor, Wood, Robbert G., Xylinas, Evanguelos N., Masson-Lecomte, Alexandra, and Gontero, Paolo

Published
2023
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16. International Opinions on Grading of Urothelial Carcinoma: A Survey Among European Association of Urology and International Society of Urological Pathology Members

Author

Beijert, Irene J., Cheng, Liang, Liedberg, Fredrik, Plass, Karin, Williamson, Sean R., Gontero, Paolo, Ribal, Maria J., Babjuk, Marko, Black, Peter C., Kamat, Ashish M., Algaba, Ferran, Berman, David M., Hartmann, Arndt, Masson-Lecomte, Alexandra, Rouprêt, Morgan, Lopez-Beltran, Antonio, Samaratunga, Hemamali, Shariat, Shahrokh F., Mostafid, A. Hugh, Varma, Murali, Shen, Steven, Burger, Maximilian, Tsuzuki, Toyonori, Palou, Joan, Compérat, Eva M., Sylvester, Richard J., van der Kwast, Theo H., van Rhijn, Bas W.G., and Downes, Michelle R.

Published
2023
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17. Prognosis of Primary Papillary Ta Grade 3 Bladder Cancer in the Non–muscle-invasive Spectrum

Author

Beijert, Irene J., Hentschel, Anouk E., Bründl, Johannes, Compérat, Eva M., Plass, Karin, Rodríguez, Oscar, Subiela Henríquez, Jose D., Hernández, Virginia, de la Peña, Enrique, Alemany, Isabel, Turturica, Diana, Pisano, Francesca, Soria, Francesco, Čapoun, Otakar, Bauerová, Lenka, Pešl, Michael, Bruins, H. Maxim, Runneboom, Willemien, Herdegen, Sonja, Breyer, Johannes, Brisuda, Antonin, Calatrava, Ana, Rubio-Briones, José, Seles, Maximilian, Mannweiler, Sebastian, Bosschieter, Judith, Kusuma, Venkata R.M., Ashabere, David, Huebner, Nicolai, Cotte, Juliette, Mertens, Laura S., Claps, Francesco, Masson-Lecomte, Alexandra, Liedberg, Fredrik, Cohen, Daniel, Lunelli, Luca, Cussenot, Olivier, El Sheikh, Soha, Volanis, Dimitrios, Côté, Jean-François, Rouprêt, Morgan, Haitel, Andrea, Shariat, Shahrokh F., Mostafid, A. Hugh, Nieuwenhuijzen, Jakko A., Zigeuner, Richard, Dominguez-Escrig, Jose L., Hacek, Jaromir, Zlotta, Alexandre R., Burger, Maximilian, Evert, Matthias, Hulsbergen-van de Kaa, Christina A., van der Heijden, Antoine G., Kiemeney, Lambertus A.L.M., Soukup, Viktor, Molinaro, Luca, Gontero, Paolo, Llorente, Carlos, Algaba, Ferran, Palou, Joan, N'Dow, James, Ribal, Maria J., van der Kwast, Theo H., Babjuk, Marko, Sylvester, Richard J., and van Rhijn, Bas.W.G.

Published
2023
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19. Immediate radical cystectomy versus BCG immunotherapy for T1 high-grade non-muscle-invasive squamous bladder cancer: an international multi-centre collaboration

Author

Lonati , Chiara, Afferi, Luca, Mari, Andrea, Minervini, Andrea, Krajewski, Wojciech, Borghesi, Marco, Schulz, Gerald B., Rink, Michael, Montorsi, Francesco, Briganti, Alberto, Colombo, Renzo, Martini, Alberto, Necchi, Andrea, Contieri, Roberto, Hurle, Rodolfo, Umari, Paolo, Zamboni, Stefania, Simeone, Claudio, Soria, Francesco, Marra, Giancarlo, Gontero, Paolo, Teoh, Jeremy Yuen-Chun, Klatte, Tobias, Bajeot, Anne-Sophie, Roumiguié, Mathieu, Rouprêt, Morgan, Masson-Lecomte, Alexandra, Laukhtina, Ekaterina, Valiquette, Anne Sophie, Mir, M. Carmen, Antonelli, Alessandro, Einerhand, Sarah M. H., Hendricksen, Kees, Carando, Roberto, Fankhauser, Christian D., Baumeister, Philipp, Mattei, Agostino, Shariat, Shahrokh F., and Moschini, Marco

Published
2022
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20. T1G1 Bladder Cancer: Prognosis for this Rare Pathological Diagnosis Within the Non–muscle-invasive Bladder Cancer Spectrum

Author

Beijert, Irene J., Hentschel, Anouk E., Bründl, Johannes, Compérat, Eva M., Plass, Karin, Rodríguez, Oscar, Subiela Henríquez, Jose D., Hernández, Virginia, de la Peña, Enrique, Alemany, Isabel, Turturica, Diana, Pisano, Francesca, Soria, Francesco, Čapoun, Otakar, Bauerová, Lenka, Pešl, Michael, Maxim Bruins, H., Runneboom, Willemien, Herdegen, Sonja, Breyer, Johannes, Brisuda, Antonin, Calatrava, Ana, Rubio-Briones, José, Seles, Maximilian, Mannweiler, Sebastian, Bosschieter, Judith, Kusuma, Venkata R.M., Ashabere, David, Huebner, Nicolai, Cotte, Juliette, Mertens, Laura S., Masson-Lecomte, Alexandra, Liedberg, Fredrik, Cohen, Daniel, Lunelli, Luca, Cussenot, Olivier, El Sheikh, Soha, Volanis, Dimitrios, Côté, Jean-François, Rouprêt, Morgan, Haitel, Andrea, Shariat, Shahrokh F., Mostafid, A. Hugh, Nieuwenhuijzen, Jakko A., Zigeuner, Richard, Dominguez-Escrig, Jose L., Hacek, Jaromir, Zlotta, Alexandre R., Burger, Maximilian, Evert, Matthias, Hulsbergen-van de Kaa, Christina A., van der Heijden, Antoine G., A.L.M. Kiemeney, Lambertus, Soukup, Viktor, Molinaro, Luca, Gontero, Paolo, Llorente, Carlos, Algaba, Ferran, Palou, Joan, N'Dow, James, Ribal, Maria J., van der Kwast, Theo H., Babjuk, Marko, Sylvester, Richard J., and van Rhijn, Bas.W.G.

Published
2022
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24. Survival Outcomes After Immediate Radical Cystectomy Versus Conservative Management with Bacillus Calmette-Guérin Among T1 High-grade Micropapillary Bladder Cancer Patients: Results from a Multicentre Collaboration

Author

Lonati, Chiara, Baumeister, Philipp, Afferi, Luca, Mari, Andrea, Minervini, Andrea, Krajewski, Wojciech, Azizi, Sosan, Hendricksen, Kees, Martini, Alberto, Necchi, Andrea, Montorsi, Francesco, Briganti, Alberto, Colombo, Renzo, Tafuri, Alessandro, Antonelli, Alessandro, Cerruto, Maria Angela, Rouprêt, Morgan, Masson-Lecomte, Alexandra, Laukhtina, Ekaterina, D’Andrea, David, Shariat, Shahrokh F., Soria, Francesco, Marra, Giancarlo, Gontero, Paolo, Contieri, Roberto, Hurle, Rodolfo, Valiquette, Anne Sophie, Mir, M. Carmen, Zamboni, Stefania, Simeone, Claudio, Klatte, Tobias, Teoh, Jeremy Yuen-Chun, Yoshida, Soichiro, Fujii, Yasuhisa, Carando, Roberto, Schulz, Gerald B., Mordasini, Livio, Mattei, Agostino, and Moschini, Marco

Published
2022
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27. PD-L1 expression and pattern of immune cells in pre-treatment specimens are associated with disease-free survival for HR-NMIBC undergoing BCG treatment

Author

Roumiguié, Mathieu, Compérat, Eva, Chaltiel, Léonor, Nouhaud, François Xavier, Verhoest, Gregory, Masson-Lecomte, Alexandra, Colin, Pierre, Audenet, François, Houédé, Nadine, Larré, Stéphane, Xylinas, Evanguelos, Brunelle, Serge, Piana-Thomassin, Jeanne, Cotte, Juliette, Pignot, Géraldine, Neuzillet, Yann, and Rouprêt, Morgan

Published
2021
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31. Methods for Establishing a Renal Cell Carcinoma Tumor Spheroid Model With Immune Infiltration for Immunotherapeutic Studies

Author

Leonard Lugand, Guillaume Mestrallet, Rebecca Laboureur, Clement Dumont, Fatiha Bouhidel, Malika Djouadou, Alexandra Masson-Lecomte, Francois Desgrandchamps, Stephane Culine, Edgardo D. Carosella, Nathalie Rouas-Freiss, and Joel LeMaoult

Subjects
spheroid, renal cell carcinoma, immune checkpoint inhibitors, standardization, PD-1, heterogeneity, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Tumor spheroids play an increasingly important role in cancer research. Their ability to recapitulate crucial features of tumor biology that are lost in the classically used 2D models along with their relative simplicity and handiness have made them the most studied 3D tumor model. Their application as a theranostic tool or as a means to study tumor-host interaction is now well-established in various cancers. However, their use in the field of Renal Cell Carcinoma (RCC) remains very limited. The aim of this work is to present methods to implement a basic RCC spheroid model. These methods cover the steps from RCC tumor dissociation to spheroid infiltration by immune cells. We present a protocol for RCC dissociation using Liberase TM and introduce a culture medium containing Epithelial Growth Factor and Hydrocortisone allowing for faster growth of RCC primary cells. We show that the liquid overlay technique allows for the formation of spheroids from cell lines and from primary cultures. We present a method using morphological criteria to select a homogeneous spheroid population based on a Fiji macro. We then show that spheroids can be infiltrated by PBMCs after activation with OKT3 or IL-15. Finally, we provide an example of application by implementing an immune spheroid killing assay allowing observing increased spheroid destruction after treatment with PD-1 inhibitors. Thus the straightforward methods presented here allow for efficient spheroid formation for a simple RCC 3D model that can be standardized and infused with immune cells to study immunotherapies.

Published
2022
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32. Fosfomycin-trometamol (FT) or fluoroquinolone (FQ) as single-dose prophylaxis for transrectal ultrasound-guided prostate biopsy (TRUS-PB): A prospective cohort study

Author

Tristan Delory, Annabelle Goujon, Alexandra Masson-Lecomte, Pauline Arias, Anthony Laurancon-Fretar, Béatrice Bercot, Pierre Mongiat-Artus, Jean-Michel Molina, and Matthieu Lafaurie

Subjects
Fosfomycin, Fluoroquinolones, Prophylaxis, Prostate Biopsy, Cohort study, Infectious and parasitic diseases, RC109-216
Abstract

Objectives: The increasing incidence of fluoroquinolones (FQ) resistance may lower its efficacy in preventing UTI following transrectal ultrasound-guided prostate biopsy (TRUS-PB). We assessed the efficacy and safety of FQ and fosfomycin-trometamol (FT) in patients undergoing TRUS-PB. Methods: A prospective observational study was conducted between April 2017 and June 2019 and enrolled men undergoing TRUS-PB and receiving a single-dose of FQ (FQ-arm) or FT (FT-arm) for UTI prophylaxis per physician’s choice. The primary efficacy endpoint was self-reported TRUS-PB UTI. We assessed baseline factors associated with UTI with logistic regression. Results: A total of 222 men were enrolled, 141/222 (64%) received FQ, and 81/222 (36%) FT. The median age was 67.6 years [IQR, 61.4–72.1] and the Charlson score was 3 [IQR, 3–5]. The overall incidence of self-reported TRUS-PB UTI was 12% (24/197, (95%CI, 8%–17%)): 15% (17/116, (95% CI, 10%–17%)) in FQ-arm, versus 9% (7/81, 95% CI (5%–13%)) in FT-arm (RR = 0.55 (95% CI, 0.22–1.40), p-value = 0.209). No baseline characteristic was significantly associated with TRUS-PB UTI. Safety was similar between the arms: the rate of the reported adverse event was 31% (36/116, (95% CI, 25%–37%) in the FQ-arm versus 36% (28/81, (95% CI, 28%–41%)) in the FT-arm (RR = 1.17 (95% CI, 0.64–2.15), p = 0.602). Conclusions: TRUS-PB UTI prophylaxis with FT and FQ has similar efficacy and safety. A randomized comparison of these two antibiotics is warranted.

Published
2021
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34. Patients non répondeurs au BCG.

Author

Leon, Priscilla, Pradère, Benjamin, Neuzillet, Yann, Bajeot, Anne Sophie, Marcq, Gautier, Prost, Doriane, Thibault, Constance, Xylinas, Evanguelos, Allory, Yves, Audenet, François, Masson-Lecomte, Alexandra, Seisen, Thomas, Rouprêt, Morgan, and Roumiguié, Mathieu

Abstract

L'objectif de cette mise au point était de rappeler les critères permettant de définir un patient non répondeur au BCG mais aussi de décrire les traitements disponibles et en cours de développement dans cette phase de la maladie. Un schéma d'administration de BCG optimal est respecté lorsque le patient a reçu : au moins 5/6 instillations pendant le traitement d'induction et au moins 2/3 instillations durant le 1er cycle d'entretien (un 2e cycle d'induction étant possible). Un patient est considéré comme non répondeur au BCG si la récidive est de haut grade. Ainsi un patient est qualifié de non répondeur au BCG lorsqu'il présente : une récidive papillaire de haut grade dans les 6 mois suivant la dernière instillation de BCG, ou une récidive sous la forme de CIS dans les 12 mois suivant la dernière instillation de BCG. Le traitement de référence pour la prise en charge des patients non répondeurs au BCG est la cystectomie totale. Néanmoins il existe des alternatives à la cystectomie par l'utilisation de traitements systémiques ou endovésicaux. Les traitements systémiques par inhibiteurs du check-point immunitaire. Les traitements endovésicaux, sous les formes d'immunothérapie, de chimiothérapie, de thérapie génique et virale et de thérapie ciblée. Notre rôle auprès des patients est de proposer l'inclusion dans les essais cliniques évaluant ces alternatives thérapeutiques dans cette indication. The objective of this update was to recall the criteria for defining a patient who is non-responsive to BCG but also to describe the treatments available and under development in this phase of the disease. An optimal BCG administration schedule is respected when the patient has received: at least 5/6 instillations during the induction treatment and at least 2/3 instillations during the 1st maintenance cycle (a 2nd induction cycle being possible). A patient is considered non-responsive to BCG if the recurrence is high grade. Thus a patient is qualified as non-responder to BCG when he presents: a high-grade papillary recurrence within 6 months following the last instillation of BCG, or a recurrence in the form of CIS within 12 months following the last instillation of BCG. The standard treatment for the management of patients who do not respond to BCG is total cystectomy. However, there are alternatives to cystectomy through the use of systemic or endovesical treatments. Systemic treatments with immune checkpoint inhibitors. Endovesical treatments, in the forms of immunotherapy, chemotherapy, gene and viral therapy and targeted therapy. Our role with patients is to propose inclusion in clinical trials evaluating these therapeutic alternatives in this indication. [ABSTRACT FROM AUTHOR]

Published
2024
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35. Perioperative outcomes and complications of intracorporeal vs extracorporeal urinary diversion after robot-assisted radical cystectomy for bladder cancer: a real-life, multi-institutional french study

Author

Lenfant, Louis, Verhoest, Gregory, Campi, Riccardo, Parra, Jérôme, Graffeille, Vivien, Masson-Lecomte, Alexandra, Vordos, Dimitri, de La Taille, Alexandre, Roumiguie, Mathieu, Lesourd, Marine, Taksin, Lionel, Misraï, Vincent, Grande, Pietro, Vaessen, Christophe, Ploussard, Guillaume, Granger, Benjamin, and Rouprêt, Morgan

Published
2018
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37. Bladder Recurrence Following Upper Tract Surgery for Urothelial Carcinoma:A Contemporary Review of Risk Factors and Management Strategies

Author

Laura S. Mertens, Vidit Sharma, Surena F. Matin, Stephen A. Boorjian, R. Houston Thompson, Bas W.G. van Rhijn, and Alexandra Masson-Lecomte

Subjects
Urology
Abstract

Context: Bladder recurrences have been reported in 22–47% of patients after surgery for upper urinary tract urothelial carcinoma (UTUC). This collaborative review focuses on risk factors for and treatment strategies to reduce bladder recurrences after upper tract surgery for UTUC. Objective: To review the current evidence on risk factors and treatment strategies for intravesical recurrence (IVR) after upper tract surgery for UTUC. Evidence acquisition: This collaborative review is based on a literature search of PubMed/Medline, Embase, Cochrane Library, and currently available guidelines on UTUC. Relevant papers on bladder recurrence (etiology, risk factors, and management) after upper tract surgery were selected. Special attention has been paid to (1) the genetic background of bladder recurrences, (2) bladder recurrences after ureterorenoscopy (URS) with or without a biopsy, and (3) postoperative or adjuvant intravesical instillations. The literature search was performed in September 2022. Evidence synthesis: Recent evidence supports the hypothesis that bladder recurrences after upper tract surgery for UTUC are often clonally related. Clinicopathologic risk factors (patient, tumor, and treatment related) have been identified for bladder recurrences after UTUC diagnosis. Specifically, the use of diagnostic ureteroscopy before radical nephroureterectomy (RNU) is associated with an increased risk of bladder recurrences. Further, a recent retrospective study suggests that performing a biopsy during ureteroscopy may further worsen IVR (no URS: 15.0%; URS without biopsy: 18.4%; URS with biopsy: 21.9%). Meanwhile, a single postoperative instillation of intravesical chemotherapy has been shown to be associated with a reduced bladder recurrence risk after RNU compared with no instillation (hazard ratio 0.51, 95% confidence interval 0.32–0.82). Currently, there are no data on the value of a single postoperative intravesical instillation after ureteroscopy. Conclusions: Although based on limited retrospective data, performing URS seems to be associated with a higher risk of bladder recurrences. Future studies are warranted to assess the influence of other surgical factors as well as the role of URS biopsy or immediate postoperative intravesical chemotherapy after URS for UTUC. Patient summary: In this paper, we review recent findings on bladder recurrences after upper tract surgery for upper urinary tract urothelial carcinoma.

Published
2023

38. Is CIS a Contraindication to Hyperthermic Intravesical Chemotherapy (HIVEC) after BCG-Failure?

Author

Vassili Anastay, Michael Baboudjian, Alexandra Masson-Lecomte, Cédric Lebacle, Alexandre Chamouni, Jacques Irani, Xavier Tillou, Thibaut Waeckel, Arnaud Monges, Céline Duperron, Gwenaelle Gravis, Jochen Walz, Eric Lechevallier, and Géraldine Pignot

Subjects
CIS, Cancer Research, recurrence, Oncology, BCG failure, bladder cancer, progression, HIVEC, NMIBC
Abstract

CIS of the bladder is associated with a high risk of progression. In the case of BCG failure, radical cystectomy should be performed. For patients who refuse or are ineligible, bladder-sparing alternatives are evaluated. This study aims to investigate the efficacy of Hyperthermic IntraVesical Chemotherapy (HIVEC) depending on the presence or absence of CIS. This retrospective, multicenter study was conducted between 2016 and 2021. Patients with non-muscle-invasive bladder cancer (NMIBC) with BCG failure received 6–8 adjuvant instillations of HIVEC. The co-primary endpoints were recurrence-free survival (RFS) and progression-free survival (PFS). A total of 116 consecutive patients met our inclusion criteria of whom 36 had concomitant CIS. The 2-year RFS rate was 19.9% and 43.7% in patients with and without CIS, respectively (p = 0.52). Fifteen patients (12.9%) experienced progression to muscle-invasive bladder cancer with no significant difference between patients with and without CIS (2-year PFS rate = 71.8% vs. 88.8%, p = 0.32). In multivariate analysis, CIS was not a significant prognostic factor in terms of recurrence or progression. In conclusion, CIS may not be considered a contraindication to HIVEC, as there is no significant association between CIS and the risk of progression or recurrence after treatment.

Published
2023
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39. Prognosis of patients with T1 low-grade urothelial bladder cancer treated with bacillus Calmette-Guérin immunotherapy.

Author

PISZCZEK, Radosław, KRAJEWSKI, Wojciech, SUBIELA, Jose D., DEL GIUDICE, Francesco, NOWAK, Łukasz, CHORBIŃSKA, Joanna, MOSCHINI, Marco, MASSON-LECOMTE, Alexandra, BEBANE, Sonia, CIMADAMORE, Alessia, GROBET-JEANDIN, Elisabeth, ROUPRÊT, Morgan, D'ANDREA, David, MASTROIANNI, Riccardo, GUTIERREZ HIDALGO, Beatriz, GOMEZ RIVAS, Juan, MORI, Keiichiro, SORIA, Francesco, LAUKHTINA, Ekaterina, and MARI, Andrea

Published
2023
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40. Prognostic Model for Predicting Survival in Patients with Disease Recurrence Following Radical Cystectomy

Author

Kluth, Luis A., Xylinas, Evanguelos, Rieken, Malte, Kent, Matthew, Ikeda, Masaomi, Matsumoto, Kazumasa, Hagiwara, Masayuki, Kikuchi, Eiji, Bing, Megan T., Gupta, Amit, Sewell, Joseph M., Konety, Badrinath R., Todenhöfer, Tilman, Schwentner, Christian, Masson-Lecomte, Alexandra, Vordos, Dimitri, Roghmann, Florian, Noldus, Joachim, Razmaria, Aria A., Smith, Norm D., Comploj, Evi, Pycha, Armin, Rink, Michael, Baniel, Jack, Mano, Roy, Novara, Giacomo, Aziz, Atiqullah, Fritsche, Hans-Martin, Brisuda, Antonin, Bivalacqua, Trinity, Gontero, Paolo, Boorjian, Stephen A., Vickers, Andrew J., and Shariat, Shahrokh F.

Published
2015
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41. Partial nephrectomy versus ablative therapy for the treatment of renal tumors in an imperative setting

Author

Long, Jean-Alexandre, Bernhard, Jean-Christophe, Bigot, Pierre, Lanchon, Cecilia, Paparel, Philippe, Rioux-Leclercq, Nathalie, Albiges, Laurence, Bodin, Thomas, Nouhaud, François-Xavier, Boissier, Romain, Gimel, Pierre, Méjean, Arnaud, Masson-Lecomte, Alexandra, Grenier, Nicolas, Cornelis, Francois, Grassano, Yohann, Comat, Vincent, Le Clerc, Quentin Come, Rigaud, Jérome, Salomon, Laurent, Descotes, Jean-Luc, Sengel, Christian, Roupret, Morgan, Verhoest, Gregory, Ouzaid, Idir, Arnoux, Valentin, Bensalah, Karim, and for the French association of Urology Cancerology Comitee (CCAFU)

Published
2017
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42. Oncological Outcomes of Distal Ureterectomy for High-Risk Urothelial Carcinoma: A Multicenter Study by The French Bladder Cancer Committee

Author

Alexandra Masson-Lecomte, Victoire Vaillant, Mathieu Roumiguié, Stéphan Lévy, Benjamin Pradère, Michaël Peyromaure, Igor Duquesne, Alexandre De La Taille, Cédric Lebâcle, Adrien Panis, Olivier Traxer, Priscilla Leon, Maud Hulin, Evanguelos Xylinas, François Audenet, Thomas Seisen, Yohann Loriot, Yves Allory, Morgan Rouprêt, and Yann Neuzillet

Subjects
Cancer Research, Oncology, distal ureterectomy, urothelial carcinoma, cancer, high risk, cancer-specific survival, intravesical recurrence-free survival
Abstract

Upper urinary tract urothelial carcinoma (UTUC) is an uncommon disease and its gold-standard treatment is radical nephroureterectomy (RNU). Distal ureterectomy (DU) might be an alternative for tumors of the distal ureter but its indications remain unclear. Here, we aimed to evaluate the oncological outcomes of DU for UTUC of the pelvic ureter. We performed a multicenter retrospective analysis of patients with UTUC who underwent DU. The primary endpoint was 5-year cancer-specific survival (CSS), followed by overall survival (OS), intravesical recurrence-free (IVR) and homolateral urinary tract recurrence-free (HUR) survivals as secondary endpoints. Univariate and multivariate Cox regressions were performed to assess factors associated with outcomes. 155 patients were included, 91% of which were high-risk. 5-year CSS was 84.4%, OS was 71.9%, IVR-free survival was 43.6% and HUR-free survival was 74.4%. Multifocality, high grade and tumor size were the most significant predictors of survival endpoints. Of note, neither hydronephrosis nor pre-operative diagnostic ureteroscopy/JJ stent were associated with any of the endpoints. Perioperative morbidity was minimal. In conclusion, DU stands as a possible alternative to RNU for UTUC of the pelvic ureter. Close monitoring is mandatory due to the high risk of recurrence in the remaining urinary tract.

Published
2022
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43. T1G1 Bladder Cancer: Prognosis for this Rare Pathological Diagnosis Within the Non-muscle-invasive Bladder Cancer Spectrum

Author

Irene J. Beijert, Anouk E. Hentschel, Johannes Bründl, Eva M. Compérat, Karin Plass, Oscar Rodríguez, Jose D. Subiela Henríquez, Virginia Hernández, Enrique de la Peña, Isabel Alemany, Diana Turturica, Francesca Pisano, Francesco Soria, Otakar Čapoun, Lenka Bauerová, Michael Pešl, H. Maxim Bruins, Willemien Runneboom, Sonja Herdegen, Johannes Breyer, Antonin Brisuda, Ana Calatrava, José Rubio-Briones, Maximilian Seles, Sebastian Mannweiler, Judith Bosschieter, Venkata R.M. Kusuma, David Ashabere, Nicolai Huebner, Juliette Cotte, Laura S. Mertens, Alexandra Masson-Lecomte, Fredrik Liedberg, Daniel Cohen, Luca Lunelli, Olivier Cussenot, Soha El Sheikh, Dimitrios Volanis, Jean-François Côté, Morgan Rouprêt, Andrea Haitel, Shahrokh F. Shariat, A. Hugh Mostafid, Jakko A. Nieuwenhuijzen, Richard Zigeuner, Jose L. Dominguez-Escrig, Jaromir Hacek, Alexandre R. Zlotta, Maximilian Burger, Matthias Evert, Christina A. Hulsbergen-van de Kaa, Antoine G. van der Heijden, Lambertus A.L.M. Kiemeney, Viktor Soukup, Luca Molinaro, Paolo Gontero, Carlos Llorente, Ferran Algaba, Joan Palou, James N'Dow, Maria J. Ribal, Theo H. van der Kwast, Marko Babjuk, Richard J. Sylvester, Bas.W.G. van Rhijn, Urology, CCA - Imaging and biomarkers, and Other Research

Subjects
Europe, Urological cancers Radboud Institute for Health Sciences [Radboudumc 15], Urology, Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15], Humans, Non-Muscle Invasive Bladder Neoplasms
Abstract

Item does not contain fulltext BACKGROUND: The pathological existence and clinical consequence of stage T1 grade 1 (T1G1) bladder cancer are the subject of debate. Even though the diagnosis of T1G1 is controversial, several reports have consistently found a prevalence of 2-6% G1 in their T1 series. However, it remains unclear if T1G1 carcinomas have added value as a separate category to predict prognosis within the non-muscle-invasive bladder cancer (NMIBC) spectrum. OBJECTIVE: To evaluate the prognostic value of T1G1 carcinomas compared to TaG1 and T1G2 carcinomas within the NMIBC spectrum. DESIGN, SETTING, AND PARTICIPANTS: Individual patient data for 5170 primary Ta and T1 bladder tumors from 17 hospitals in Europe and Canada were analyzed. Transurethral resection (TUR) was performed between 1990 and 2018. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Time to recurrence and progression were analyzed using cumulative incidence functions, log-rank tests, and multivariable Cox regression models stratified by institution. RESULTS AND LIMITATIONS: T1G1 represented 1.9% (99/5170) of all carcinomas and 5.3% (99/1859) of T1 carcinomas. According to primary TUR dates, the proportion of T1G1 varied between 0.9% and 3.5% per year, with similar percentages in the early and later calendar years. We found no difference in time to recurrence between T1G1 and TaG1 (p = 0.91) or between T1G1 and T1G2 (p = 0.30). Time to progression significantly differed between TaG1 and T1G1 (p < 0.001) but not between T1G1 and T1G2 (p = 0.30). Multivariable analyses for recurrence and progression showed similar results. CONCLUSIONS: The relative prevalence of T1G1 diagnosis was low and remained constant over the past three decades. Time to recurrence of T1G1 NMIBC was comparable to that for other stage/grade NMIBC combinations. Time to progression of T1G1 NMIBC was comparable to that for T1G2 but not for TaG1, suggesting that treatment and surveillance of T1G1 carcinomas should be more like the approaches for T1G2 NMIBC in accordance with the intermediate and/or high risk categories of the European Association of Urology NMIBC guidelines. PATIENT SUMMARY: Although rare, stage T1 grade 1 (T1G1) bladder cancer is still diagnosed in daily clinical practice. Using individual patient data from 17 centers in Europe and Canada, we found that time to progression of T1G1 cancer was comparable to that for T1G2 but not TaG1 cancer. Therefore, our results suggest that primary T1G1 bladder cancers should be managed with more aggressive treatment and more frequent follow-up than for low-risk bladder cancer.

Published
2022

44. Gender-specific Differences in Clinicopathologic Outcomes Following Radical Cystectomy: An International Multi-institutional Study of More Than 8000 Patients

Author

Kluth, Luis A., Rieken, Malte, Xylinas, Evanguelos, Kent, Matthew, Rink, Michael, Rouprêt, Morgan, Sharifi, Nasim, Jamzadeh, Asha, Kassouf, Wassim, Kaushik, Dharam, Boorjian, Stephen A., Roghmann, Florian, Noldus, Joachim, Masson-Lecomte, Alexandra, Vordos, Dimitri, Ikeda, Masaomi, Matsumoto, Kazumasa, Hagiwara, Masayuki, Kikuchi, Eiji, Fradet, Yves, Izawa, Jonathan, Rendon, Ricardo, Fairey, Adrian, Lotan, Yair, Bachmann, Alexander, Zerbib, Marc, Fisch, Margit, Scherr, Douglas S., Vickers, Andrew, and Shariat, Shahrokh F.

Published
2014
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45. Clinical outcomes of adapted hypofractionated radiotherapy for bladder cancer in elderly patients.

Author

Mignot, Fabien, Fabiano, Emmanuelle, Xylinas, Evanguelos, Alati, Aurélia, Méjean, Arnaud, Masson‐Lecomte, Alexandra, Hermieu, Jean‐François, Desgrandchamps, François, Hennequin, Christophe, Durdux, Catherine, and Quéro, Laurent

Subjects
OLDER patients, TRANSURETHRAL prostatectomy, RADIOTHERAPY, BLADDER cancer, TREATMENT effectiveness, TRANSURETHRAL resection of bladder, CANCER patients, CANCER radiotherapy
Abstract

Objective: To investigate the feasibility, efficacy, and safety of trimodal therapy (TMT) using a bifractionated split‐course hypofractionated radiotherapy (RT) for non‐metastatic muscle‐invasive bladder cancer (MIBC) in elderly patients. Patients and Methods: We retrospectively reviewed the characteristics and outcomes of patients aged >75 years with non‐metastatic MIBC suitable or not for radical cystectomy (RC) and treated with transurethral resection of bladder tumour followed by concomitant radio‐chemotherapy (platinum salt and 5‐fluorouracil) at two institutions (Saint Louis Hospital, Paris, France and European Georges Pompidou Hospital, Paris, France) between 1990 and 2021. RT consisted of an adapted bifractionated split‐course hypofractionated RT. Acute toxicities were reported according to Common Terminology Criteria for Adverse Events version 5.0 and late toxicities were reported according to the Radiation Therapy Oncology Group/European Organisation for Research and Treatment of Cancer late radiation morbidity scoring schema. The primary end‐point was overall survival (OS). Secondary end‐points included other survivals outcomes and safety. Results: A total of 122 patients were identified, with a median (range) follow‐up of 51.1 (0.5–210.8) months. In all, 83.5% of patients completed radio‐chemotherapy. The OS rate was 61.7% at 3 years and 51.2% at 5 years. In multivariate analysis, the completion of RT and concomitant chemotherapy were significantly associated with better OS and cancer‐specific survival. For patients fit for RC, a complete histological response was achieved for 77 patients (91.7%) with radio‐chemotherapy and the bladder conservation rate was 90.5%. Acute and late Grade ≥3 toxicities were <5%. Conclusion: Bifractionated split‐course hypofractionated RT with concomitant chemotherapy regimen appears to be well‐tolerated and effective. Trimodal treatment seems to be a curative option for elderly patients unfit for radical surgery compared with palliative care and may contribute to improved survival in these patients. [ABSTRACT FROM AUTHOR]

Published
2023
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46. A prospective descriptive 1‐year study in France of all BCG therapy dispensations for non‐muscle‐invasive bladder cancer.

Author

Neuzillet, Yann, Leon, Priscilla, Seisen, Thomas, Allory, Yves, Audenet, François, Loriot, Yohann, Masson‐Lecomte, Alexandra, Mejean, Arnaud, Pradère, Benjamin, Roumiguié, Mathieu, Traxer, Olivier, Xylinas, Evanguelos, Fournier, Georges, and Roupret, Morgan

Subjects
BLADDER cancer, CANCER invasiveness, CARCINOMA in situ, CANCER chemotherapy, CHEMORADIOTHERAPY, DATA analysis
Abstract

Objectives: To describe the clinico‐pathological characteristics of non‐muscle‐invasive bladder cancer (NMIBC) treated in metropolitan France over 1 year when bacille Calmette‐Guérin (BCG) was subject to a national quota, and to document, in the context of recurrent shortages of intravesical BCG for NMIBC, the real‐life indications for adjuvant treatment. Materials and Methods: Between February 2021 and February 2022, the French National Agency for the Safety of Medicines (ANSM) asked the French Association of Urology to propose a science‐based quota solution for BCG using a clinical score. The ANSM then asked the distributor of the drug, MEDAC, to collect the scores for all patients for whom BCG was requested by healthcare institutions and to prioritize the requests for patients with the highest scores. Tumour stage, grade, size, number, time to recurrence, carcinoma in situ, age, accessibility of alternative treatments (total cystectomy, radio‐chemotherapy, thermo‐chemotherapy) and BCG treatment progress (initiation or maintenance) were documented for each intravesical BCG prescription. A descriptive analysis of the data collected during the quota year was performed. Results: During the 1‐year quota, 25 878 requests for BCG were made for 19 024 patients, 60.5% of whom were aged ≥70 years. Requests for induction and maintenance treatment accounted for 12 704 (49.1%) and 13 174 prescriptions (50.9%), respectively. NMIBC treated with BCG maintenance therapy was more frequently high‐risk NMIBC (91.7% vs 90.2%; P < 0.0001) than NMIBC for which induction therapy was requested. The number of cases of NMIBC leading to BCG adjuvant treatment was estimated at 12 704 cases/66 062 188 inhabitants over 1 year in metropolitan France. Conclusions: Our data suggest that the incidence of NMIBC at high risk of recurrence and progression is underestimated in reference epidemiological studies. These results should help to better define future care needs. [ABSTRACT FROM AUTHOR]

Published
2023
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47. O3 - Prognosis of primary papillary Ta-G3 bladder cancer in the non-muscle invasive spectrum

Author

Beijert, I.J., Hentschel, A.E., Bründl, J., Compérat, E.M, Plass, K., Rodríguez, O., Subiela Henríquez, J.D., Hernández, V., De La Peña, E., Alemany, I., Turturica, D., Pisano, F., Soria, F., Čapoun, O., Bauerová, L., Pešl, M., Bruins, H.M., Runneboom, W., Herdegen, S., Breyer, J., Brisuda, A., Calatrava, A., Rubio-Briones, J.., Seles, M., Mannweiler, S., Bosschieter, J., Kusuma, V.R.M., Ashabere, D., Huebner, N., Cotte, J., Mertens, L.S, Masson-Lecomte, A., Liedberg, F., Cohen, D., Lunelli, L., Cussenot, O., El Sheikh, S., Volanis, D., Côté, J., Rouprêt, M., Haitel, A., Shariat, S.F., Mostafid, A.H., Nieuwenhuijzen, J.A., Zigeuner, R., Dominguez-Escrig, J.L., Hacek, J., Zlotta, A.R., Burger, M., Evert, M., Hulsbergen - Van De Kaa, C.A., Van Der Heijden, A.G., Kiemeney, L.A.L.M., Soukup, V., Molinaro, L., Gontero, P., Llorente, C., Algaba, F., Palou, J., N’Dow, J., Ribal, M.J., Van Der Kwast, T.H., Babjuk, M., Sylvester, R.J., and Van Rhijn, B.W.G.

Published
2022
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48. The use of hemostatic agents does not prevent hemorrhagic complications of robotic partial nephrectomy

Author

Peyronnet, Benoit, Oger, Emmanuel, Khene, Zineddine, Verhoest, Gregory, Mathieu, Romain, Roumiguié, Mathieu, Beauval, Jean-Baptiste, Pradere, Benjamin, Masson-Lecomte, Alexandra, Vaessen, Christophe, Baumert, Hervé, Bernhard, Jean-Christophe, Doumerc, Nicolas, Droupy, Stéphane, Bruyere, Franck, De La Taille, Alexandre, Roupret, Morgan, and Bensalah, Karim

Published
2015
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